I am considering autologous fat transfer to face as part of facelift surgery, as recommended by one facial plastic surgeon. However, another plastic surgeon believes once tissue is elevated by facelift procedure alone, I may not need the fat augmentation to my cheeks. My question is not what to do, but if doing fat grafting/injection at a later date is likely to "take" as well. (I've heard fat grafting has better success rates if done during surgery.) Thank you in advance for your comments.
Any Advantage to Fat Transfer During Facelift Vs Injecting at a Later Date?
Doctor Answers (23)
Facelifting and fat grafting/transfer
Fat grafting/transfer is an excellent procedure to have along with a facelift. As we age we lose volume in our faces and a facelift can only do so much to restore that loss through repositioning the fat in the cheeks and jowl area. In the typical facelift patient, many areas remain after lifting that need volume resoration such as the malar areas, nasolabial folds and marionette lines, jawline and others. I perform fat grafting after the facelft is completed but at the same operation. It is an easy convenient way and much easier on the patient than undergoing a separate procedure. I am not aware of any studies that show that there is an advantage to fat grafting at the time of the surgical procedure or later at a separate time. A detailed discussion with your surgeon should lead you to what is best for you.
Fat transfer with facelift
I prefer to perform grafting at the same time as the facelift, in areas NOT undermined by the facelift.
What is to keep the graft there when it is placed between two skin flaps? What is to prevent the fat injection grafts from shifting or moving? The answer is nothing.
Grafting into areas NOT undermined are effective. Grafting into areas of the facelift that ARE undermined is less effective because the grafts can move.
Fat transfer can be done with or without a facelift.
The results will be the same. It is usually done at the same time so that you have only one recovery time and it is cheaper.
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Fat grafting with facelift is all about volume
I don't buy the argument that the take of the fat grafts is better after the facelift as opposed to during the procedure. Fat grafting and the other things that are done under the skin during a facelift are an important part of reshaping the face.
People tend to think of facelifts as just pulling on skin, but it is a 3-dimensional concept. That is one of the keys to having it look natural. If you save it for a later date, then the appearance after the facelift and before the grafts is not what you would want, and then there is another recovery time with some swelling and so forth.
Facial lipoinjections and facelifts
Fat injections to the face is a wonderful adjunct to many Facelift procedures. While Facelift surgery will reposition the soft tissues of the face to counteract the effects of gravity, the procedure alone will not volumize the face to a more youthful appearance. Fat grafting is generally performed at the time of face lifts simply because of surgical convenience. Facial fat grafting is also performed as an independent procedure. Fat graft survival has little to do with whether the procedure is performed with or without Facelift surgery, but, is extremely dependent on fat grafting technique.
Fat grafting to the face is a great idea at the time of the face lift
The reason for the fat grafting at the time of the face lift is to replace natural loss fat from the face. The process involve grafting the fat to the deep layers that not undermine with the face lift. The main advantage of the grafting the fat at time of face lift is that you get a 3 dimentional lift and less lateral pull. Fat grafting results depend on the surgeon' experience.
Fat Transfer During Facelift Vs Injecting at a Later Date?
Fat grafting can be inconsistant under the best of conditions. The keys to successful fat grafting are: acquiring the fat with low suction pressure, properly preparing the fat for grafting, and micro-droplet injections. The reason of the latter is that small grafts are more likely to get a good blood supply before they dissolve than large grafts. So adequate blood supply is paramount for the fat grafts to survive.
This leads us back to the question of fat grafting during or after the facelift. Fat grafting must be done in areas that are not being elevated during the facelift. There is inadequate blood supply in any area where skin has been elevated for fat grafts to survive. Areas that can be grafted would be around the mouth, lips, and even under the eyes and in the pre-jown sulcus (the depresson in front of the jowl). Any other areas, such as the cheeks or jaw, fat grafting should be done during a second procedure.
Fat Graft to the Face and Face Lift Surgery
I prefer to perform fat grafting to the face at the same time as the facelift.
Performing facial fat grafting at the same time as a facelift saves the patient an additional surgery, recovery time, and money.
There is no survival advantage for the fat if it is grafted or injected into the face at the time of surgery or at a later date. However, it is important for the fat that is injected at the time of surgery to be injected in areas that have not been aggressively undermined or dissected. This will ensure maximum vascularity to the grafted fat and maximum fat graft survival.
Jaime Perez, M.D.
Face Lift Specialist in Tampa, Florida
Plastic Surgery Center of Tampa, Florida
Fat Grafting with Facelift
Fat grafting at the time of the facelift will avoid the need for a second procedure. The success rate is the same as long as fat is not placed under skin elevated during the facelift.
Fat Grafting During Facelift
Facial fat grafting requires several important factors to be done well. First, it must be small product injected. Next, it should be placed into multiple planes. Third it needs to stay where it's placed and finally it needs blood supply.
I will only add fat, during a facelift, to areas not undermined. This limits it to areas such as temporal hollowing. I perform SMAS elevation and extensive SMAS facelifts and these procedures often correct facial fullness issues.
I would do these two procedures at different times.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.