Should I get fillers or a facelift? (photos)

I lost 30 pounds a couple of years ago and my skin is sagging. I workout a lot and building muscle has helped but not with my face.

Doctor Answers 62

Filling, Volumizing, or Facelift

Hello,

First off, congratulations on losing the weight.  

There is a lot of mis-information about fillers and how they "lift".  Fillers are important and useful, but they do not lift, at least not when used in any reasonable quantity.  For the most part, fillers "push", they don't "pull".  When used in the upper face, they often give the illusion of a lift, but the lower face will still hang just the same.  I would suggest that you look at a lower face lift to address the jowl and neck tissues, as well as the laxity you see when leaning forward.  I would not do any lifting of your forehead since this will accentuate the upper eyelid hollows.  I would  suggest some filling in the cheek and temple area.  This is probably best done after you have healed from the lower facelift.  And finally, you might consider laser skin resurfacing.  This will smooth out many of the wrinkles, especially those around the mouth.  While it won't make your skin more elastic, it will build collagen and make it smoother, brighter, and more robust.

Best Regards,

Dr. A


Austin Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

Should I get a facelift or simply have filler injections after 30 pound weight loss?

Meeting with an ABPS board-certified plastic surgeon will allow you to formulate a plan based on your priorities.  Though filler may be of some limited help, my suggestion would be to consider a facelift with browlift and transfer of your own body fat into your cheeks chin and jaw line.  This not only adds volume that you may have lost with aging and weight loss but the contained stem cells often rejuvenate the skin.  Incidentally, congratulations in your weight loss.


Best of luck with your decisions.  Regards,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Fillers Or Facelift?

Often I have this question asked of me by my patients. The answer varies from patient to patient depending on  health, anatomy, the quality of skin, age, expectations, time constraints, etc.  As we age, the face loses volume, and due to your weight loss (which I congratulate you about), your face has become fat depleted.  To address the sagging skin, a facelift and necklift would be most effective to tighten the skin, provide support with SMAS plication, create a sharp jawline, and reduce jowling. Fat transplantation would be useful to create volume (as compared to fillers which are temporary), and a laser could be used to help reverse the sun damage to your skin. Botox could be used in your frown area, and possibly filler as well depending on the response.

Fillers or Facelift

The good news is that your lifestyle is now much healthier but unfortunately you look older and fatiqued. It would be best to have a facelift combined with some augmentation with fat or fillers and skin resurfacing either at the time of surgery or at a later date. Treating this with just fillers would require a lot of material, it would be very expensive, the results would be temporary, and you would have a full face not a defined more rested look that can be achieved with surgery

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Facial Rejuvenation

Congratulations and continued success on your healthy lifestyle. Based on your photos and for your best results, I recommend a two stage approach. I would start with a Total FX laser to your face and neck with fat grafting to the areas that have lost volume with your weight loss and with aging. This will improve the overall texture of the skin, remove the fine lines and wrinkles,as well as tighten, and add volume particularly to the cheek area. Then, approximately 3-6 months later, we would address the structural issues with lifting procedures. Much of the approach is also based on downtime and expense, so consult with a Board Certified Plastic Surgeon and view as many before and afters of their work prior to making a decision.

Clayton L. Moliver, MD
Houston Plastic Surgeon
4.5 out of 5 stars 29 reviews

Face lift

Thank you for your question and pictures. Congratulations on your weight loss.  You would benefit the most from a face and neck lift with some possible fat grating to the face.  Be sure to see a Board Certified PS for a consultation.

Ramiro Morales, Jr., MD
Pembroke Pines Plastic Surgeon
4.6 out of 5 stars 22 reviews

Facelift

Congratulations on your weight loss! What an accomplishment! Based on your photographs, it appears you would benefit from a facelift with fat injections to your cheeks. Fillers would not be enough to correct the sagging skin, however, they are a nice addition to incorporate after a facelift. Hope this helps!

John S. Lee, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Facelift and fat injection

You are probably a good candidate for a facelift and might want to consider some facial fat grafting to augment what looks like your deflated face. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Facelift

I would recommend fat grafting in the order of 30-40 cc throughout your cheeks, lower lids, lips, temples and brow and a mini facelift.  This would give you the best results with regard to your excess skin and the loss of volume.  

Multimodality Treatment

Facial aging is multidimensional and dynamic.  In this situation, it isn't an either or, because fillers should never be considered a replacement for a facelift when a facelift is indicated.  At least, that is if you want to be satisfied with your results.  Most likely, a facelift, laser resurfacing and possibly some filler to address lost volume would be appropriate. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 82 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.