SMAS Face and Neck Lift with Fat Transfer - La Jolla, CA

Im 57 years old and I didnt hate my face which...

Im 57 years old and I didnt hate my face which made this decision especially difficult. I should say I didnt hate my face in the mirror! When I hated it was in photos that I didnt take myself, in the angle that I didnt choose. If it was a pic I didnt take I found that person to be someone I didnt know! My lower face was fat!! No matter how much I would diet and although I was not any heavier than I was in my youth I still had what appeared to be a FAT FACE! I saw a few surgeons. One that I visited 2 years ago who said I "was not ready for a lift" 2 years later he said "you're ready now!" I figured that meant it was time , however, I didnt much care for him and went to the doctor who had been doing my dermal fillers for more than 6 years. He always did a great job on my lips, never making them too big or weird and I came to trust his conservative approach. One month ago he did a fraxel laser and though it is still red, the crepey skin around my eyes is gone!
I hounded him with questions and he was always patient and thorough! I felt like he understood my desires. I showed him a pic of just 4 years ago ( before menopause kicked in) and that was all I wanted. Yesterday was the big day! The staff seemed a bit rushed. I felt like that anyway. That was disappointing. A few hours later I was awake and they raved about how quick it went. That didnt exactly ease my mind! The said I looked 25 again...I didnt want to look 25 but I accepted that they were just being nice! Then I asked for a mirror hoping I would see it before the bulk of swelling set in. I was shocked to see ET in the mirror! I looked very pulled! like that windswept look that we always fear! I told them so and I think I hurt their feelings, however, I expected them to say "well you are already swollen and once it goes down you will look great" Instead they said "no you dont you look great!" I didnt and still dont know how to take this! Is this the way Im supposed to look? My eyes look slanted! I am REALLY swollen today and I expect that! I expected to look in the mirror today and hate myself but what about yesterday? What about 4 hours after the surgery? Was that swelling I saw or is that what I will look like in 2 weeks? 3 weeks or 6 months? I keep reassuring myself that none NONE of his pictures of previous clients looked even the least bit unnatural. On the contrary they looked like very little was done which is what I wanted!
Im scared to death that he pulled me too much! Has anyone else felt this way? At this point I wish I didnt do it! All the pain and agony and worry is not worth it! I am seeing them today to have the drains removed. I will ask him if I was truly swollen when I saw myself the first time and report back to you then!

Post op march 27

Drains removed and reassurance that I was not overly pulled. I am much more swollen and I expected that. Still I wondered why the nurse was in the room with us with a very concerned look on her face! Haha! I guess we can be overly sensitive to anything that seems out of the ordinary!

March 28

Stayed home all day and napped a lot which is very unlike me. Well, Im not sleeping well at night so I guess it just makes sense to make up for it during the day. Swollen and painful around the stitches. I looked like an alien still!
Oh gosh, I'm sorry this stage is rough! I hope that once your swelling goes down you will see YOU (but refreshed). Please keep us updated. Here's what some doctors say about the windswept look early in recovery (it looks like it definitely could be swelling).
PHOTOS PLEASE!!!!! It would help us if you can post before and after.
Hi MamaGun -- have a look at other people's pictures at your stage. I don't think I have seen any where people looked good in the first couple of days! Fat transfers may add to the swelling and it does seem that the swelling often peaks around Day 4 so don't let it worry you if it seems to be getting worse before it gets better. Your doc has done a good job with your fillers and you liked the work he had done on other patients so hang in there! Remember your doc and nurses have seen many other patients at this early stage so they may be able to "look past" the early swelling to have a sense of how it will be after the swelling goes down.

Face and neck lift, fat transfer, fraxel laser

4 hours Post F/L surgery

Evening of the surgery. I hate the drains so I took a pill and went to sleep. I just want it over! I feel pulled too tight!

Still feeling pulled and now the swelling is kicking in!

Day 2 post op

My doctor says he put just a "little' bit of fat down the troughs of my eyes and around my chin but that has really swollen up today!

Day 3 post op

Day 4 post op

I really dont have much bruising. A little on the sides of my face and down my neck. I had a lot of kale smoothies weeks before...maybe that helped?

Sick and tired of hanging around the house. Trying on some disguises!

I got tickets to the baseball game tomorrow! I called the nurse and she said go for it so I trying some looks. Can I get away with it???
I think you look really lovely. I bet things relax as time goes on. You are a beautiful woman!
Thank you for the kind words Angie, Im feeling a little more positive today. I just saw my surgeon. He said at this point if I wasnt complaining about tightness then there would be no change from before. So ok. I will stop complaining :D
I think you you look are going to look amazing in just a few days!. You remind me of Gina Davies.

6 days post op

Out with SOME stitches. I thought I would have them all out but he said only the ones that could possibly leave permanent spots. So most are still in. Thats ok...they dont really bother me and what he took out hurt! He said the staples are what bother people the most and I agree, that is what causes the most discomfort, right in the back of the head! Still cant chew...Im looking quite slender, an unexpected perk since I was worried I'd gain weight from sitting around and not exercising! There is now considerable bruising on my neck and there go my bragging rights!
I know what you mean, Sal9, it is coming! I look forward to being on the other side so I can obsess about healing instead of obsessing about getting the procedure done! :)
I now what you mean - I am looking forward to being on the other side so I can obsess about healing instead of obsessing about getting the procedure done! :)

6 days post op

Off to the baseball game. I got the ok but now that its over I wish I didnt! It seemed a bit too much for me!

profile swelling and bruising but nice cheeks again!

You might feel uncomfortable....but you look great!'s only 6 days!...I'm impressed!...Time to relax a little & enjoy the game.
You look amazing - wow!
Oooo yes, I just want to get on with it.......I look at all the women that are on the 'other side' & am envious...?.I want to be on the 'other side' too...& A to's our turn very soon!

Take me out to the ballgame????

Well other than the pain in my left temple when I chew or even yawn I feel just great! I even went to the baseball game yesterday. It was a mile walk there and a mile back plus all the stairs and walking around the ballpark and even though Im showing no ill signs of pushing myself I still think that was way over the top, a four hour game and my team lost anyway :( Since I can't eat anything more than soup and yogurt I had nothing to eat there, coupled with all the walking I am now down to my lowest weight in a long time! The swelling goes down everyday ever so slightly! I hope I can keep the weight down long enough to enjoy both my new face AND new figure!
I think you are doing SO well....& brave of you to venture out...although you looked fine...pretty tiring! I am 'enjoying' my food at the momment...& put on weight...because it will come off with all the baby puree I am going to be on. This time next week will be my 2nd day at home...makes my tummy go over! Have a good day
By the are you sleeping?...are you sleeping sitting up?, are you sleeping all night?...the how to sleep issue worries me!
I asked the doc yesterday if I could start sleeping flat again and he winced...right then I knew that the longer I can sleep upright the better! Im starting to become like a horse! It hasnt been so bad though. I put 2 pillows behind my favorite pillow and lay back arranging the pillows so my head is back and chin is up. The secret is some kind of pain or sleep aid. I havent been without one in a whole week. I never take that stuff so Im pretty sensitive to it so what I did was take one 500 mg vicodin, divide it into 4 pieces take one quarter at bedtime which would knock me out for about 3 hours, get up and go pee (which is important anyway, you gotta move a little every few hours!!) take another piece of the vicodin, sleep another 3 hours and so on...not saying it has to be vicodin, whatever works for you but remember, get up every few hours! and sleep as long as necessary as it is the best healer of all! I also napped the first few days whenever I felt sleepy.

1 full week post op

I think I am finally less swollen than the moments right after the surgery when they handed me the mirror! My eyes are my own eyes again! I dont look as wide in the temples (like ET :D)) My jawline is still very swollen which Im disappointed about as I would like to see a smooth jaw esp since that heaviness was what bothered me most before surgery. But I know it will subside. Thats probably the area that got beat up the most. A bit of bruising. My temple doesnt hurt as much anymore and more stitches out tomorrow!
Where are you girl? It should be past your op day! Dying to hear how it all went! Let me know where to find your review! Im almost 2 weeks past and gotta keep reminding myself to take it easy still so you will bounce back quicker than you think!

2 weeks post op

I have to keep reminding myself I just had surgery a few weeks ago! I feel pretty normal now unless I feel the sides of my numb and hard face. I took a chance to venture to MX for a little R and R and "little" was what I got! Because we had a boat delivered from San Diego I have been on the run since I got here. Walking back and forth the the marina office, searching for banks and services, shopping for needed supplies for the boat. Walking stairs constant movement. Yes Ive been worried Im pushing myself too soon. I have literally been on a chaise lounge 30 minutes in these past 3 days! The good news is my face shows no signs of stress as a result of it all. I still have the pain in my left temple if I chew ANYTHING that has texture at all! That has been rough as the food here is fabulous..oh well, frijoles and rice always work! Im overdue now for my final stitch removal. I hope I am not asking for trouble there! Aside from a few tiny bruises on my neck and jaw it would be tough for a beholder to know I had anything done so I feel confident going anywhere now, even among those who know me. As I said, still numbness, still some swelling but not too visible to an untrained eye. All is pretty good overall and I like what I see. Honestly the redness which continues from the laser more than 6 weeks ago is what bothers me more than anything from the surgery! Anyone having laser??? Prepare for the stubborn redness! It takes a long, long time to subside!
It helps all of us if we have photo's --- some people cover there eyes if they want the privacy aspect. Glad you doing well
Hi have so much energy!. Sounds like you are doing so well. It's still early main goal is 29th April which will be 3 weeks. Like you, so far hardly any bruising...i am on my 3rd day & will have the drains removed this evening....that's going to make a big difference to me...they are pretty disgusting aren't they!. Have a great day!
I hate those things but Im thinking I wish they were left in longer. I have been reading about complications that can arise. One being hematomas which I am concerned I may have developed under my jaw. My drains were removed the very next day. I am seeing nurse today so I will ask if that is what I have. Its just an isolated swollen area that feels tight. But do enjoy getting those things had them in plenty long enough!

3 weeks and 4 days later

I am visiting my 2 daughters ages 22 and 25. I did tell them I was going to do a F/L N/L but did not say when so when they saw me they were still not sure. When I asked what they thought ,,they both said they thought I looked better but weren't sure why.. but as they continued to study my face they both agreed I look great! I showed them a before shot to remind them and they really thought the improvement was amazing! And so here is my wrap up...
I am very happy with my outcome. I do not look done. I have several opinions now to back that up! My neck is not as tight as I would have thought BUT my daughters agree it looks age appropriate and that anything tighter would have looked odd. So props to my PS for that intuition also! I did not do my eyes and I DO NOT regret it. I dont have a problem with my hooded eyes. Its a family trait and I did not want to look like a different person. I DID, however, do the fractional laser around my eyes and that really improved the texture of the eyelid skin which is just what they needed. Perhaps in 6 months I will laser again to tighten them further.
The SMAS method is just amazing! I love having cheeks again! My jowls are tighter and though still swollen, do not make my face look fat when I smile for the camera!
I would lend this advice to anyone reading who is considering cosmetic surgery....think about the eye surgery carefully. Dont just go ahead with it because "oh well, I will be out anyway" Or "its just costs a little more "...etc... As I read many reviews on this site it seems the post eye surgery is what gets most people down. I personally just think its overkill! Do you really hate your eyes? If so then consider it but dont be talked into it just because of convenience sake!
My only complaint is that I still have residual pain in my left temple when I chew. That has me a little concerned as it has been almost a month and I have been only eating soft foods and still cant have a full on yawn without pain.
However....All in all ...Im happy and I would recommend my surgeon 100%.
I will gladly private message anyone with photos if requested. I just dont want anyone I know to run across my photos on the internet. No one would guess what I had done and I would like to keep it that way!
Thanks so much for the review you original fears are exactly mine right now on day 4 - so don't want to look overdone or chinesey. I too had a highly experienced surgeon so will just have to go through the motions & have faith. Totally & absolutely appreciated your review. Much aprc8d.
Dont worry! Yes I felt very pulled but within a week it went down and I was looking pretty normal! Normal enough to go out and not have anyone really notice anything! And now 2 and 1/2 months later there are areas I wish he had pulled a bit more BUT I would rather have too little than too much and its amazing that I am saying this now after the way I felt a few days after surgery! :D
Haha very very reassuring I have to say - think I would have gone into a panic without this site - well actually I probably would not have found the courage at all. The world is filled with such amazing women

Bio-identical hormone replacement therapy

Ok so face is looking great! I look younger and so it was now time to FEEL as good as I look so I decided to seek out a natural minded doctor to help with the menopause symptoms. She prescribed BHRT creams...So I have been on this cream for 2 weeks, a mix of estrogen and progesterone and some testosterone. So in just 2 weeks I have gained 5 pounds and I'm bleeding...this did not seem like a good idea at I don't want to go out at all because I feel fat!!! Only positive is that I no longer have the hot flashes but its not worth it! I'd rather be hot than fat! So thats my update....Its the height of summer fun and swimsuits and Im a chubba and I'm MAD!!!! Anyone have experience with this stuff???
MamaGun, As I wrote above, recovery is a long process but sounds like you are doing very well overall. It took me weeks before I realized I looked like Dr. Spock and had to go back to Costa Rica the next year to get my earlobes back which Dr. Lev gladly did at no extra expense plus a little more lipo and all is well now. SMAS lasts a long time. I'm confused as to whether you actually had the laser on the top of your eyelids and under as well? Was it fraxal or carbon dioxide type? I'm told you actually need a series of four treatments to get the full effect of tightening under the eyes. Could you expand on how much fat he put in your face, did he "spin the fat" and how much has been reabsorbed? I've heard that "if" it takes, expect 40- 50% reabsorbed and for it to last five years. Do you see a notiecable change in volumn? Also, at a consult last week, a doctor told me something I"ve NEVER heard before. He said he moves the fat under your face around and then sees if you even need it to be taken from somewhere else. He also said he's tried both ways and prefers not spinning but I'm skeptical as the machine is expensive and he has only been at that clinic for 8 months. He seemed like one of those "trust me" types and clearly did not appreciate my inquisitive questions which I really encourage other people when searching for the right technique and doctor. Thank you for sharing all of your experience. Really helpful.
Hi Chellamia, I had the pearl fractional laser. Lots of bad reviews and I guess I can understand it because it does take a LONG time for the redness to go away but I love the tightness that it did to my eyes! Yes I did do upper and lower and I will do it again in a few months and hopefully tighten them more on the upper lids. The lower eye area is perfect...they really dont need much more. I have never heard of taking fat from other parts of the face...there isnt any to fact there wasnt even enough to take from my abdomen which was their preferred target spot so how on earth would there be enough in ANYONES face? That sounds suspicious! I did have a lot of the fat reabsorb more on one side of my face than the other which is weird! Thanks for the info you shared!
MamaGun: ReBio-identical hormone replacement therapy...I had hysterectomy at 52 because of frequent periods and heavy bleeding and they claimed there was a cyst that "could" be cancerous so a long story short, I was not familiar with NHR and my mother would tell me how she took a pill (premerin) everyday that kept her young so I kindof got pressured into this and if you are every considering this, I could tell you a lot more privately; however, I went from a person who never sweat and didn't know what a headache was to someone who would break out into a major sweat every hour and feel like a vise on my head ...all that lasted a year....even though I had asked them to not take out my ovaries in writing, they still did so IMO that's why the NHR with the bioidential never worked that well.. that intensity finally subsided and I am just generally "hot" most of the time and being out in humidity can get unbearable. Not everyone has this type of reaction to hysterectomy but just to share what can happen..Fortunately over time, one learns to live with this but I now take 1 gram of .625 conjugated estrogens vaginally a couple times a week which really helps and 1mg of estradiol gel (Divigel) about 3/week and that seems to help manage the symptoms. If I could afford it, I would probably do the Bio-identical if I had someone thorough trained in how to read all that. I honestly couldn't tell you if it has attributed to any weight gain. It's one of those things you just have to see through trial and error what works for you. Would love to see your pictures and will share mine as well. I'm really curious about the fat transfer part of your surgery. Very happy all that went well for you. Recovery is a long process...I think I still have some numbness on my head 17 years later.. but all in all, it was the best investment in myself I ever made with my life as I got to truly age gracefully.......included a little lipo as well to hips and stomach which has lasted even though I put on 20 pounds since then.
San Diego Plastic Surgeon

Perfect! He seemed to be on the same page with me at all times. Was willing to discuss any issue I was worried about! Seemed very conservative and I felt he had a great eye for seeing what was needed and what wasnt!

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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