I'm 58 yr old female with fallen jowls, hooded eyes, sunken cheeks, and wrinkles. What treatment would you recommend?

Nonsurgical treatments such as  fillers can help address your concerns, along with a brow or eyelid lift to address sagging lids. Regardless what you do, however, please try to stop smoking as the habit will only make your appearance worse.

Without photos it is hard to mention specific surgical procedures. However from your description you should ask your plastic surgeon about a face lift, fat transfer or fillers to your cheeks, and eyelid surgery. Peels, Dermabrasion or Laser treatment might be beneficial for your lines about your lips.

In the first place, you need a caring plastic surgeon who can help you sort out what is bothering you most, taking into account your psychological and physical health. There is no formula for facial rejuvenation and no one approach is suitable for all. Surgery may be the best way to restore a youthful, more refreshed look, but there adjuncts, like lipo-filling, laser resurfacing, medical skin care, that can go a long way to making you look and feel better. While re-suspension of the fallen facial tissues with a facelifting procedure is the most powerful way to obtain facial rejuvenation, there are many adjuncts that are used with and without a facelift that can helpful.  It is good to quit smoking since smokers age about ten years faster than their twins, studies have shown, and smoking makes facelift surgery more prone to skin necrosis.   All of these issues would be addressed when you have an in person consultation with a board-certified plastic surgeon

Without a photograph it is impossible to comment specifically. However most patients age synchronously so a full facelift often times combines eyelid surgery would yield an excellent result.

Sorry to hear about all the difficulties you have had in your life. I hope there are some positives mixed in there as well. I think the most important thing to remember before considering any cosmetic procedure, there is no magic. We can achieve great resutls doing many of the things we do but we have to be realistic in our approach. Having major surgery will not change a persons life. I always tell people, surgery should be about you. It should make you feel better and not make other people feel better about you. I just think that is an important point to make as some people look for cosmetic surgery for the wrong reasons.  You also have to be prepared for complications, as things do go wrong even in the best surgeons hands. The difference between a good surgeon and a great surgeon (in my opinion) is the great surgeon is open and honest about complications and learns from them as they happen to everyone. As for treatment, it depends how aggressive you want to go and how healthy you feel these days.  Simple things like skin care, chemical peels, botox and fillers can often really freshen you. Approach surgery with caution however you can have dramatic results. Good luck!