Thank you for sharing your photographs and seeking advice on the effectiveness of a facelift for someone with minimal subcutaneous fat. Based on your images and description, here is my professional opinion on how to address your concerns: The photographs that you have kindly shared, identify: • Significantly depleted facial volume in the malar region and mid-cheek. • Slight volume excess from the deeper plane in the neck. • Visibility of the platysma bands, particularly on the left side. A deep plane facelift procedure can significantly improve the appearance of the lower face by repositioning and tightening the deeper structures. This technique not only enhances the contours of the lower face but also produces some volume redistribution, which can help with the depleted areas in the malar region and mid-cheek. To address the contours of the neck and the visibility of the platysma bands, a deep plane neck lift procedure can be very effective. This approach targets the deeper structures, including fat and muscles, providing a more defined and youthful neck contour. Regarding volume enhancement for the mid-face, it is important to note that fat transfer relies on the availability of fatty tissue in the body. If your body has very low fatty tissue in general, the stability of fat transfer to the face can be less reliable. In such cases, an alternative treatment like Sculptra can be considered. Sculptra works by stimulating collagen production, building volume in the mid-face without relying on fatty tissue. It is particularly effective for individuals with a very low BMI and can provide a rounder and fresher appearance. I recommend discussing these options with a qualified surgeon who can provide detailed insights into the procedures and help tailor a treatment plan specifically for you.