Step one: Skin. Nothing is going to mean anything if you don't get that sorted. Consult several dermatologists (male/female/otherwise) and spa people to get a proper idea on what to do.

Step two: THOROUGH blood work. Vitamin/Mineral/everything else levels and nutrition plan to go with it. There's the Bryan Johnson blueprint if you want to drop some legwork. It's probably not as magic as claimed but it's a start.

Step three: Intermittent fasting Fasted resistance training.

Step four: Light jaw shaving, buccal fat removal and nose reduction. Note: Keep the general ratios and shapes. Going too far off baseline is going to lead to both personal and social issues. Adjust your face, don't change it.

Assorted: Darken & grow out hair. Experiment with updos and fishtail braids. Utilize small jackets and mother of pearl buttoned blouses for more refined look or on the other hand try bolder colors and looser cuts.

Right now the core issue is that you look like someone who went from a 15 year long coke bender/international espionage career into working at the local DMV. The very used up and spat out look comes from a combination of unkempt hair, uninspired fashion and heavily aged skin and will have to be fought on several fronts in order to be reversed.

PS: Botox should only come dead last. There's better more thorough treatments. Not as fast but you don't want fast when it comes to your face.

All the best. I hope this wasn't too harsh.