I understand you’re seeking the best approach to address the flattened areas on your cheeks 13 months after your deep plane facelift and temporal lift. Fat grafting is a common method to restore facial volume, and the choice between macrofat and microfat depends on the specific area and desired outcome. Macrofat vs. Microfat Grafting • Macrofat Grafting: Involves larger fat particles and is typically used for significant volume enhancement in areas like the buttocks or breasts. It’s less commonly used for facial applications due to the larger particle size.  • Microfat Grafting: Utilizes smaller fat particles, making it more suitable for facial areas requiring precision and subtle volume restoration. It’s ideal for regions such as the cheeks, under-eye hollows, temples, and lips. The smaller particle size allows for smoother integration into the delicate facial tissues, resulting in a natural appearance.  Recommendation For addressing flattened areas on your cheeks, microfat grafting is generally preferred due to its ability to provide precise and natural-looking volume restoration in facial tissues. This technique allows for careful sculpting and integration, enhancing facial contours effectively. Next Steps It’s essential to consult with a board-certified plastic surgeon experienced in facial fat grafting. They can assess your specific situation, discuss your aesthetic goals, and determine the most appropriate approach to achieve the desired outcome.