Are fat transfers good for marionette lines and droopy neck area?

Question

How effective are fat transfer for marionette lines and if the procedure doesn't turn out to your expectations what can be done, if anything to change or modify the procedure? Thanks.

Jason Emer, MD · Answer

I suggest going to a facial contouring specialist for fat transfer as the results are long term and if not done properly and well you can get poor results.  Find an expert who uses PRP to get the ultimate results.  Best, Dr. Emer.

Toby Mayer, MD · Answer

Marionette lines are best treated with fillers not fat. Belotero or Juvederm are what I use for this.  Fat grafting in this area usually does nothing or create lumps.

John J. Martin, Jr., MD · Answer

The best thing to do with fat or fillers is to add structure to the face and help rejuvenate its' appearance.  Filling the upper cheek area if this is flat will help to give a triangular appearance to the face and can help to soften the marionettes.  Some fat can also be put directly into the marionettes as well.  You just don't want to overcorrect down there or you will appear boxy.  Any filler, including fat, will often not last too long in this area due to the large amount of movement here.  If done correctly it will not appear lumpy.

Khashayar Mohebali, MD, FACS · Answer

I would suggest first trying fillers for the marionette lines.  Fat is usually not a good option there.  Also, unclear what you're referring to in the droopy neck but that may be related to skin issues and fat not an option. Discuss with your plastic surgeon.

Andrew Kornstein, MD, FACS · Answer

Yes to both. Both areas mentioned are areas where laxiity occurs secondary to lack of adjacent bone support.Fat grafting on the bone will help support these areas---but like anything else only to an extent.  If too much laxity and eventually too much descent of overlying tissues has already occured you may require concomitant soft tissue tightening or perhaps even a lift. Only an in-person, detailed examination can make that determination.Hope this helps.

Robert T. Buchanan, MD (retired) · Answer

Fillers or fat can be used for marionette lines, though it is generally a bad idea to use something permanent like fat in the local area. The main problem with local injection is that the procedure makes the lower face boxy, not youthful. If you are going to use them for this area, I prefer to place them over the malar or lateral zygomatic area to lift the tissues, returning a youthful appearance to the lower face. I then will occasionally use a filler to correct any area not completely effaced from above. No filler or fat can really modify a droopy neck area. This requires a surgical solution.

Are fat transfers good for marionette lines and droopy neck area?

Answers (6)

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