At 64 and 8 years after a facelift, it’s very common to wonder if you need a “redo” or if you simply need volume. From your photo and history, here’s the simple way to think about it: If your main issue is hollowing (especially under-eyes, temples, cheeks), and your jawline/neck still look reasonably tight, then fat transfer (or another volumizing option) may be enough. If you’re seeing real sagging again (jowls returning, neck laxity, heaviness along the lower face), then a secondary facelift may be the better solution — and volume can be added if needed. About the Under-Eye Fat Transfer That Didn’t Take Under-eye fat can be unpredictable because the skin is thin and the blood supply is delicate. If it didn’t take well before, it doesn’t automatically mean you can’t improve that area — it just means you need a surgeon who is very experienced with lower eyelid anatomy and volume work, and you may discuss alternatives like micro-fat, nano-fat, or filler depending on your tissues. Best Next Step The decision really comes down to what’s driving the change: skin/tissue descent vs volume loss — and that requires an in-person exam. I’d recommend booking a consultation with a qualified, board-certified plastic surgeon who frequently performs revision facelifts and facial fat grafting. Bring your prior operative history if you have it, and be clear that your priority is a natural, refreshed result. Good luck!