Seeking repair for effects 20 years after full lower bleph (Photo)

Your non-smiling photo demonstrates the after effects of an aggressive lower eyelid blepharoplasty that used to be the standard back a couple decades ago.Our approach has changed significant to minimize volume loss as well as the pulling downward affect of the lower lid and outside corner of the eyes which give the patient a sad appearance.Volume addition [whether fat grafting or hyaluronic acid fillers] certainly can help, but lower lid retraction repair with support of the corner of the eyelids with a canthopexy is indicated to give your eyes the more natural and aesthetically pleasing almond shape to the eyes.

I would recommend to do  fat transference to your cheek bone and a bit to nasolabial fold. Your upper lid could be improved with an upper blepharoplasty without fat pads removal, or something a bit more invasive like an eyebrow lift which would help to lift the brow and the eyelid.Dr. Cardenas. 

Sagging lids and cheeks 20 years post blepharoplasty can be repaired with a cheeklift with or without fat grafting or small combined cheek implants. 

It is unclear from your questions what your goal is.  If your goal is to rejuvenate your lower eyelids, then revision surgery, including surgery on the canthus would be helpful.  A pinch method could be used as part of this procedure.  If your goal is to increase volume in your cheeks, then there are several options.  These procedures can be performed separately or together, again, depending upon your goals.  A consultation with a board certified plastic surgeon would be helpful for you.  If you limit your choices to non-surgical options, then your results will be limited because these options cannot correct all of the issues that may exist, based upon your photos.  An exam is crucial for your to get the best advice.