3 months post-op- Surgeon says I will need a mid facelift, is this needed to see more improvement? (Photos)

If your surgeon took out 3 cm of skin, that’s aggressive and more than enough skin excision. Any suture extrusion as you describe could be PDS suture in which the suture tail feels like wire. It is dissolvable but can extrude. This can occur and is not any indication of the quality of care received. From his response, this sounds like a traditional SMAS lower facelift. It is difficult to get great pulls of the nasolabial fold at the level of the upper lip with this technique. You can get a better pull with a deep plane vertical lift as long as the technique extends fairly far to the modiolus or close to the fold. You can only get dissection that far forward with a deep plane and not a SMAS; however many don’t do this because of the extensive dissection and risk involved. For the technique used, it’s possible that the technique has been maxed out. Talk to your doctor and if you’re still not happy, see other opinions.

By looking at the post-operative pictures, although there is some improvement in the jowling area, there's not much improvement of the nasolabial folds, and in the positioning of the volume of the mid face. Also, the brows seems to be too low, although they may not have been treated at the same time.

But to answer your question: yes improvement can be achieved and in my opinion, I would perform this with a Mid Face and Brow Lift.

Hello Dear @Shiv19699 thank you for your question and showing your picture. From the pictures I suggest a facelift of the second and third thirds of the face and the first third of the neck. I would add an eyebrow pexy (lift), this would be a complete surgical plan to obtain better results in your case. In this kind of interventions is important to have a surgical plan that takes into account the relationship the areas to be treated have with the other areas of the face to get an even, harmonious and long lasting result in the over all face. Best wishes! Alan Gonzalez MD, FACS.

Your pictures show significant improvement in the lower lid area.
To get further improvement, as your surgeon has said, would require lifting of the mid face area.
What is addressed at the time of surgery is determined by the things that are of concern and counselled for at consultation. The skin laxity in your lower eyelids has been treated.
If it is the deep suture that is creating a problem for you, this could be removed with a local anaesthetic.
Go back and discuss the issues with your surgeon.