64, do I need I another face lift with fat transfers or just fat transfers for volume? (Photo)

Thank you for your question and for sharing your photo. At eight years out from your facelift, upper and lower blepharoplasty, and chin implant, it's understandable to begin reassessing your facial rejuvenation options. High-quality face and neck lifts generally maintain results for about 10–12 years, so you're approaching the point where a touch-up or revision procedure could be appropriate depending on your goals.

Based on your photo, you may benefit from a revision upper eyelid blepharoplasty and restoration of volume in the under-eye area. Since your previous fat transfer did not yield the desired outcome and you're understandably hesitant to repeat the procedure, strategically placed dermal filler may be a good alternative. While not permanent, filler in the under-eye region tends to be long-lasting due to minimal movement in that area, and when done correctly, can offer natural-looking improvement.

If you're hoping to achieve more comprehensive and longer-lasting results, a deep plane face and neck lift could be a worthwhile consideration in the coming years. I recommend an in-person consultation with a double board-certified facial plastic surgeon to evaluate your current anatomy and discuss the best path forward based on your specific concerns and goals.

Hi,
I think the issues you have is because the fat transferred looks a little lumpy I would recommend talking to your original surgeon about possibly using some steroid or kybella to dissolve the fat that's there and come back in 3-6 months with microfat that is a much smaller globule fat transfer to add subtle transition from the lid to the midface.