To fat graft or not with facelift?

Most fully trained experienced artistic plastic surgeons use fat grafts in the appropriate patient. The facial areas that are deficient in
volume can be nicely improved with artistically placed micro-fat grafts in
addition to the face and necklift in order to produce the most natural
appearing result. The best results are achieved in adding fat in areas
that are depressed and removing excess tissue that is excessive and loose.
The amount of fat that "takes" and is retained long term is variable from patient to patient but is generally around 30-60 percent of the amount injected. The vast majority of patients who have conservative amounts of fat injected into the facial area are pleased with the results.
It is important to realize that following
the advice from a surgeon on this or any other website who proposes to tell you
exactly what to do without examining you, physically feeling the tissue,
assessing your desired outcome, taking a full medical history, and discussing
the pros and cons of each operative procedure would not be in your best
interest. 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. 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
 

I typically perform a Lift and Fill Facelift using fat grafting.  This procedure lifts and excises the sagging skin and fills the areas where facial tissue has atrophied with aging.  I have had good success with this procedure and feel most patients benefit from these procedures. The key is to seek a board certified plastic surgeon or facial plastic surgeon with experience and expertise in this type of facial rejuvenationsurgery.  Ask to see before and after photos of their own patients.  

Fat grafting is frequently done together with facelift surgery. It can help restore fullness and balance in areas that facelift procedures don't address, like the pre-jowl depressions, angle of the jaw, and volume loss in the chin. In general the fat survives well but it is true that is is a bit unpredictable.