Is there an alternative to fat transfer during a lower face lift?

The laxity in my cheeks, jaw line and neck needs to be repaired but because I am thin, I have no fat to transfer back into my face. Will this negate the results or is there an alternative to fat transfer?

Doctor Answers 6

Fat transfer alternative

Fat transfer for adding fullness to your cheeks can be substituted with Juvederm Voluma or Sculptra. Juvederm Voluma provides immediate results. Sculptra requires multiple (approximately 6) treatments at approximately 8-10 week intervals and leads to a gradual increase in fullness of the cheeks and other parts of the face.  The correction achieved with Juvederm Voluma lasts 18-24 months, with a touch up at 9-11 months. The improvement from Sculptra can last 2 years or longer. I recommend consulting with a board-certified cosmetic dermatologist who has experience with both products. 

Cleveland Dermatologic Surgeon
5.0 out of 5 stars 12 reviews


There are so many terrific alternatives to fat- Voluma is a filler that lasts 2 years- and Volbella is terrific for the lower lids, whereas fat is not reversible, these are both reversible.

I like fat, but not in the lower lids, because they are so thin- fat is less predictable...

Melanie L. Petro, MD
Birmingham Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Is there an alternative to fat transfer during a lower face lift?

The definition of facial rejuvenation varies from surgeon to surgeon and means different things to different patients. In general it is the process to try to reverse the facial appearance caused by aging. It may involve improving the skin texture and complexion, diminishing skin discoloration, minimizing fine lines and wrinkles, contouring hollows, or tightening loose tissue that has lost its elasticity. There are a variety of procedures, both non-surgical and surgical which can be utilized to achieve these various goals. Fillers, Botox or Dysport, micro-fat grafts, chemical peels, a skin care program, lasers, skin tightening, and surgical lifts are some of the methods that are used to achieve a cosmetic improvement. Each has advantages and disadvantages as well as limitations of what they can achieve. The best technique or combination of procedures depends on desired outcome, individual anatomy, underlying medical health, and extent of aging. There is no one approach that is ideal for everyone.

I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with who has all of the modalities of treatment available. You should discuss your concerns with that surgeon in person. Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Is there an alternative to fat transfer during a lower face lift?

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  Non smiling photos of your face from the front and side would help in the evaluation.  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  Despite its recent popularity, fat (transfer, injections) is far less reliable at creating a predictable shape to the cheeks, chin and mandibular angle than an "off the shelf" dermal filler or a facial implant.

 If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions and no incisions extend or are placed within the hair.
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op

I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Volume replacement during face lift

It will depend what areas of your face need to be enlarged. Some volume enlargement may be achieved with plication (tucking) of SMAS (cheeks, zygomatic area). Facial implants may be combined with face lift if more substantial enlargement is needed, as well as fascial flaps and dermal grafts. Facial fillers are good option if you are ready to commit yourself for long term maintenance.

These issues are best to discuss with your surgeon few weeks before planned surgery. Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 14 reviews

Alternatives to fat transfer

Alternatives to fat transfer including placement of temporary fillers performed in the office setting.  When patients have flat cheeks, and desire permanent correction, consider cheek implants.  Cheek implants can be performed simultaneously with a facelift procedure to give adequate restoration of volume in the mid face.  For many before and after examples and more information, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 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.