After a Facelift, Can Fat Gradually Disappear from the Path of Lift?

The facelift was two years ago. On one cheek, just below my cheekbone and along the path of the lift, a hollow channel has been inching toward the center of my face. The doctor has assured me that this was not a thread lift. The hollow is about 1.25" in width. The skin above it is taut and looks lifeless. The hollow keeps lengthening and it looks awful. What could be happening? And can anything be done to stop it and/or correct it?

Doctor Answers 23

Fat loss after facelift. Preserving facial volume.

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Old wisdom was:  When in doubt, cut it out.  New wisdom is:  Fuller cheeks are what we seek.  We preserve facial volume, at all costs when lifting faces.  We even bring some fat from outside of he area, from the abdomen for instance, when we lift faces.  Facelift technique should preserve volume because if it doesn't, the cheeks can become hollow for a ghostly look.  This can become apparent even one or two years down the line.  Fat transfer is the most likely option.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Post Facelift skin depressions and hollow cheek may require revisions

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Depressions after a Facelift do not often appear for several weeks or months after the Facelift once the surgical swelling has resolved.

Many factors can cause a visible depression on the cheek or a hollow cheek after Facelift surgery. Some factors are:

  • A tight Cheek SMAS Suture in the deep tissues-this will usually go away with time as tissues relax
  • The surgeon passing Facelift Scissors too close to the skin when undermining the cheek tissue resulting in damage to the fat close to the skin
  • Removal of too much of the fat in the cheek during Facelift
  • Scar Tissue attached to the skin

See your doctor and ask what can be done to correct this. Possible solutions are:

  • Revision Facelift to release scar
  • Fat or Filler Injections to plump the area
  • Release of a suture

Meet with your doctor and discuss your concerns

Face Lift, Mini Face Lift, The Palmer Celebrity Face Lift, Beverly Hills Face Lift

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Not sure, from what you're describing it could be fat loss or a disruption to the underlying SMAS layer during the Face Lift.  Either one could cause what you describe.  You should go back to the plastic and cosmetic surgeon that did your Face Lift or you may want to get a second opinion.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Loss of Fat after a facelift

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It is difficult from your description to assess what is occuring. Photos would be helpful, however, I would discuss the issue with your surgeon and see what options are offered. Some patients may develop fat loss as a result of the aging process or due to the procedure. Some small intervention may be successful in correcting the problem.

Marc Schneider, MD
Fort Myers Plastic Surgeon
4.6 out of 5 stars 28 reviews

Possible Fat Loss From Lift

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Patterns of a facelift vary among patients.  Most commonly, facial fat diminishes with age, with or without a facelift.  Facelifts do not increase the rate of fat loss.


Dr. G

Mitchell F. Grasseschi, MD
Chicago Plastic Surgeon

Volume loss after Facelift?

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I am not exactly sure what you mean by, “path of a lift”. My sense is that if fat is devascularized during surgery, it can melt away over the time; but often changes secondary to surgery in the face are more related to the pull of surgery on the tissues rather than fat melting. Fat grafts done during surgery can disappear (some fat loss after grafting is expected in most areas), but can be usually compensated for by over-grafting or perhaps saving some fat in a special storage facility for later injections.

Robert K. Sigal, MD
Reston Plastic Surgeon

"Fat in face dissapearing"

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I have not seen fat disappear from the path of a facelift, as we get older. Fat generally thins in the face. If you are asking about irregularity and a facelift, I would not think that it is due to fat gradually disappearing, but is more likely to be due to irregularity caused by the procedure.

George W. Weston, MD
Reston Plastic Surgeon

Hollowing after facelift

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It appears that your hollowing may be related to the vector of pull on the underlying muscle or the amount of skin undermined.   Regardless, this can usually be corrected by autologous fat transfer.   This involves taking fat liposuctioned from a problem area to fill the hollowed area.   Approximately half of the fat takes on the first procedure.   

I recommend that you discuss your options with your board certified plastic surgeon and discuss a suitable longterm treatment plan.

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 95 reviews

Facelift, Fat Loss, Aging, and out comes a skeletal appearance.

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This is tough to assess from your photos.  No fat should not diaappear.  Sometimes the lift changes facial structure and reveals areas the ultimately would benefit from fat transfer which is easy to do.   I suggest you discuss this with your surgeon and possibly one other ABPS surgeon and see what they think.  This is the era of fat replacenment in the face and I do it routinely.  Part of aging is fat loss.  Part of  aging is that we progressively look skeletal.  Not a happy thought but true.  I think sometimes the nice structural change we get with facelifts do then reveal an area of fat need.  This is why  fat replacemment is becoming routine.  We all are fat deficient as we age.  Some people gain weight just to get their face back and this works a little.  The facelift does not cause fat loss but can reveal it I think.   Best of everything to you.  Dr Commons

Thin cheek fat after a face lift.

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There are several possible explanations for what you are describing. But your surgeon would be the most qualified to answer this. Though it may be unclear to him as well.

Regardless, from your description, it sounds like you could benefit from AFT (autologous fat transfer). That is when fat is taken from elsewhere in your body, refined and injected into the "hollow" you describe. Our current methods with fat transfer are quite good.

Best of luck

Bernard A. Shuster, MD, FACS
Hollywood Plastic Surgeon

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.