Facelift for thin face? (Photo)

Question

Would a deep plane facelift work for someone like me with minimal subcutaneous fat and bone density? If yes, should a fat transfer be added to the mid or outer face to create a more rounder fresher appearance?

Jeffrey H. Spiegel, MD · Answer

The key to a deep plane facelift is releasing ligaments that connect the skin to the bone and thus prevent the skin from moving back most effectively. This can certainly be done for you. I'd expect a very significant result.

Erman Ak, MD · Answer

A deep plane facelift can still be highly effective in lifting and repositioning the deeper facial tissues, addressing sagging, and enhancing facial contours. Since the procedure works on the deeper layers, it can create a more natural and long-lasting lift even in individuals with minimal fat. , Fat transfer can soften the contours of the face, reduce any hollow areas, and contribute to a fresher, rejuvenated look. The combination of lifting with the facelift and volumizing with fat transfer can enhance the overall harmony and aesthetic result.
Best WishesDr Erman Ak

Jonathan Cabin, MD · Answer

When undergoing any facial plastic surgery, all three components of facial aging must be considered and potentially addressed: 
1) Skin quality2) Gravitation descent of tissues3) Loss of volume
If a patient issues are not addressed in a balanced way, an otherwise well-performed surgery could turn out to look unnatural.
A deep plane facelift is the gold standard facelift for anyone who has had gravitational shift of tissue. But for balance, laser resurfacing (CO2 or Erb:YAG) for skin and fat grafting for volume restoration must be considered. For issues related to volume loss or a thin face, fat grafting should be considered as an adjunct procedure.

Rafael Arenas, MD · Answer

This is a great question!! A deep plane facelift  restores   volume in the upper cheeks that have dropped into the lower face, removes sagging facial skin and elevates the facial volume . In  thin patients like your case, the natural volume you already have,  might not be enough and some fat infiltration must be used on the cheeks and under the eyes to restore a youthful appearance to the face.
sincerely ,

Dr. Rafael Arenas Quintana
Instagram.com/Dr.RafaelArenas/

Arthur Dean Jabs, MD, PhD, FACS · Answer

A deep plane lift is appropriate in any case. Care must be taken in developing the plane for the lift so as not to endanger the motor nerves. You have obviously read about or talked to a surgeon in your area about fat grafting which would be of benefit for you. The problem with very thin people is where to get the fat to transfer. Not much is needed but I have seen thin people who have almost none.

Best of luck

Dr. J

Best of luck

Dr. J

Jacob Tower, MD · Answer

Hello, hope you are well. Thank you for submitting your questions and photos! You would be a great candidate for facial rejuvenation. A deep plane facelift would be the most important part of that process, but I would highly suggest fat grafting and possibly some additional procedures to refresh your appearance. Good luck on your journey!

Best,
Dr. Tower

Best,
Dr. Tower

Donald B. Yoo, MD, FACS · Answer

I think you've done a good job point out an area that will enhance your deep plane facelift results. During a deep-plane facelift, there will be some restoration of the natural volume in your midface and cheeks as the soft tissue and skin is resuspended, but as you noted this volume will still be somewhat deficient. Supplementing your subcutaneous facial fat with additional purified fat for your temples, undereyes, and midface will help to restore a more youthful appearance.

Lucian Ion, FRCS · Answer

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.

Ruslan Zhuravsky, DO · Answer

Hi! You're exactly right. In a case like yours the combination of a facelift and fat grafting works well. It allows us to elevate the tissues AND replinsh volume. Fat can even have secondary improvements on the skin itself. Additionally, a CO2 laser resurfacing can be a great complimentary procedure. Be aware that with fat grafting for someone that is naturally very thin, we cannot be sure how much of it will be retained. In some cases we need to do an additional fat grafting session approx 9 months later. Harvesting fat with smaller cannulas and lower pressure can help improve retention. Adding fat in small aliquots and spreading it throughout the target areas is also helpful.Good luck!

Ronald J. Edelson, MD · Answer

I agree you are a good candidate for a facelift. There are many surgeons who would do fat transfer but I am not a fan of it. Standard well done facelift by a reputable surgeon

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