Fat Injections or Multi-level Fat Grafting Along with a Facelift

Seen 3 doctors. 1: face & necklift, lipoinjections with malar pad elevation. 2: face and neck only. 3: lower face(SMAS) and neck with multilevel fat grafting. What are your feelings on fat grafting? Is it necessary? I'm confused and just wanted jowls and neck corrected.

Doctor Answers (12)

Fat graft and facelift

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In some patients neck liposuction, fat grafting and other procedures to the eyes or forehead are done concurrently.The basis of a facelift is not pulling the skin rather it is repositioning of tissues under the skin and then re-draping the skin over the more youthful understructure. The quality of the skin, loss of volume, or descent of tissues can only be accessed by a physical exam. Also each surgeon has a technique which works in their hands.  I would be less concerned about the plane of dissection and more focused on before/after and comfort with the surgeon.  Consult with a board certified plastic surgeon to get a detailed exam and treatment plan. Most have complimentary or low cost consultations.


Tampa Plastic Surgeon
4.0 out of 5 stars 13 reviews

Fat injections with facelift

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The face and neck lift is done for signs of aging, which includes jowls, neck laxity, muscle cords, and fat deposits in the neck. We do not perform fat grafting in our practice because the results are so inconsistent. We’ve seen multiple cases whereby fat globules can be seen and palpated, which are very difficult to address due to the irregularity of the healing process. With regards to malar pad elevation, we prefer cheek implants for volumetric augmentation of the cheek when patients have flat cheeks.  

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Fat Injections with Facelift

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To answer your first question, let me say that fat grafting is an effective procedure that I have used for 35 years. Each surgeon has his/her own approaches for facial rejuvenation. Look at the results in patients similar to you before deciding which surgeon you will use.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

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Keep it Simple

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You have discovered that correction of aesthetic concerns is very artistic and each plastic surgeon has his or her own interpretation of the methods needed to achieve correction.  Based on your last statement about just wanting neck and jowls corrected you need a facelift with possibly correction of the neck through a smaller incision in a crease beneath your chin.  No one wants to have multiple procedures but it is not unreasonable to have the facelift and allow things to heal over 3-6 months.  If after that time some small enhancements are needed (ie fat grafting ) they can be performed at that time.

Enjoy your journey.

Dr. ES

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 reviews

Fat Grafting is one of the more effective techniques for volume enhancement

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Three dimensional volume loss from fat atrophy and bone resorption begins in 3rd decade of life.  All you have to do is look at relatives from childhood to grandparenting to see we're left with just skin and bones.  Therefore, volume replacement is in almost every discussion with any patient who seeks rejuvenation.  All one has to do is see the success of fillers in todays cosmetic pratice to realize the value of facial augmentation.

I perform my fat transfers at the same time as facelifts.  Yes there is some resorption and increased swelling, but the filler is natural, permanent, and usually abundant.  Before asking your physician about their opinion on fat grafting, ask them how many patients they've grafted....it's more art than science, but the results are unparalleled and long lasting.

That being said, if jowls are your concern, volume augmentation in the midface can improve your result, but your real value is in the facelift, I hope this answers your question. 

Michael J. Rodriguez, MD
Plantation Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

Fat Grafting and Facelift

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There are many ways of achieving aesthetic results with a facelift. Fat grafting can provide excellent results, especially when combined with one of the older methods of facelifting. I prefer a modified MACS Lift (a newer method) that moves the available fat back to where it used to be, thus reducing the need for fat grafting. My best advice is to choose the surgeon you feel most comfortable with and who seems to get results similar to what you desire.
 

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Fat Grafting and Facelift Surgery

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There are several types of facelift surgery and your surgeon needs to customize the technique to address your specific anatomy.  Most patients have loss of volume in their mid face in addition to loose skin.  In most patients, I perform fat grafting to the midface at the same time as the facelift procedure.  However, the procedures are customized to the patient's needs.  Good luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 54 reviews

Facelift with Fat Grafting

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I agree with Drs. Rand and Baxter. When it comes to moderate to severe facial aging the answer frequently is Facelift. As to WHICH Facelift technique is best for you would greatly depend on your examination, your cosmetic goals and your chosen surgeon's experience and preferences.

A lot of Plastic surgeons now routinely supplement the results of a Facelift by adding strategically placed fat grafts (which by their very technical definition MUST be placed in multi-levels IF they have a chance at survival. In other words, Fat Grafting IS = Multilevel Grafting. Another example of Marketing exploiting everyday surgical technique).

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 58 reviews

Fat grafting isn't generally necessary for a great facelift

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Depending on your starting point, an excellent facelift can give you the result you want with a natural, completely rejuvenated look.  Some doctors do fat grafting on everybody and that isn't necessary and does add to bruising and recovery time.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 47 reviews

Fat grafting is common with facelift for a 3-D result

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A few basics: Fat grafting = multilevel fat grafting = lipoinjections etc. They are commonly done as part of a facelift because facial aging is a 3-dimensional process, not just sagging skin. Fat disappears from the face, along with sagging of the fat tissues and the other latyers under the skin. Not everybody needs it, but it can be an important part of a natural-appearing result and help avoid the "pulled" look.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 23 reviews

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.