Facelift or fat grafting to lift the mid face? Which type?

Great question!  If you like how your appearance looks after performing the skin pulling maneuver, then your best results will be with a facelift.  You are somewhat correct in that placing more volume could lift the midface and tighten the skin, but the large amount of volume you would need to place to tighten the skin that much will make you look very un-natural.  Fat grafting is great for improving volume and minimal skin laxity.  Facelift and fat grafting combination is a great procedure to not only tighten the loose excess skin, but also improve volume in the areas that have been lost.  However this is only a generalization, without photos it is hard to make an accurate recommendation.Best of luck and hope this information helps!- Dr. Roger Tsai   @DrRogerTsai

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for you.  Always insist on a board certified plastic surgeon.

Hello and thank you for you question. The answer to whether a facelift or facial fat transfer procedure will give you better results depends on how much rejuvenation you need. A facial fat transfer can help rejuvenate your upper cheeks but may not fully address your lower cheek area. Further, since not all fat will survive during a fat transfer, this option may leave you with less rejuvenation than you want.
If you need more rejuvenation, a mini facelift can improve the entire mid-face area and give you long-lasting results. Schedule an in-person consultation with a board-certified facial plastic surgeon in your area, have a full examination and discuss your aesthetic goals with them to determine which course of treatment will give you the best results. Good luck!- Elizabeth Whitaker, MD, FACSThis answer was solicited without seeing the person, and should not be construed as medical advice.

Hi,
It is difficult to answer this question without and pictures however the answer could be both. Midface lift and fat grafting sometimes are required to correct the volume loss and descending of the tissues.
Ali Rıza Öreroğlu, MD, FEBOPRAS
Double Board Certified Plastic Reconstructive and Aesthetic Surgeon
Istanbul - TURKEY

This is difficult to answer without pictures. A significant degree of sagging is best remedied with a full rhytidectomy (facelift). With volume loss in the mid face, this can be improved with fat grafting done during the facelift. I do recommend a neck lift with platysmaplasty to fix any sagging of the chin and neck, plus a chemical peel to improve the wrinkling and stimulate the production of new collagen. Microneedling could help improve the scars. I hope this helps!

Hello and thank you for your question. It is difficult to make a treatment recommendation without a photo. However, if you want to improve mid-face skin laxity, a mini facelift would address this concern. A facial fat transfer or hyaluronic acid filler would restore some volume to your mid-face region as well. Facial fat transfers can be unpredictable, though, since some fat will not survive a mid-facelift and filler are done together. Schedule an in person consultation with a board certified plastic surgeon in your area, have a full examination, and discuss your aesthetic goals with them in detail. You will get the best results when you discuss your desired look openly with your surgeon and select a surgeon who agrees with the final results you want. Best of luck!- Michael Eisemann, MD

It's difficult to answer your question without pictures. However, I always explain my patients that we age in a three dimensional way, a face lift can restore the tissues of your face to the original position they had when you were younger, and fat grafting (if done properly) can restore the volume loss that comes with aging. 
In 90% of my facelift patients I perform fat grafting. Smoothing the skin will not hide a drawn appearance caused by the loss of facial volume, and it is difficult to create natural, attractive contours by lifting and repositioning tissues that have abnormally thinned and deflated with age. In addition, fat injections induce an improvement in facial tissue quality through a stem cell effect, and when performed with a face lift may constitute, for the first time, rejuvenation in the true sense of the word. 

Fat grafting can help plump the cheeks up during  or instead of a facelift. Fat grafting can be unpredictable as it’s hard to estimate how much of the fat will stay. Also the saggy midface that is collecting in the lower face will not be corrected. In order to more naturally address the complete aging changes in the midface an endoscopic facelift should be considered 

Hello!  Fat grafting can often be combined with facelift surgery to improve nasal facial volume loss and help restore a more youthful appearance to the midface, which is often not addressed with traditional facelift surgery.  Fat grafting can be performed alone, but is often performed in conjunction with other surgeries as well.  Best of luck to you!

If you like how your appearance looks after pulling your skin upwards from the temple then your best results will be with a facelift.  Fatgrafting would not give the result you really desire, a large amount of fat grafting / volume would be needed to tighten the skin, this could look very unnatural. It is difficult to give you a excact answer without seeing you, but from what you describe a SMAS facelift with platysmaplasty would be the option I would recommend.