To fat graft or not with facelift?

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.

Nanofat grafting with the shaping of the face is very beneficial to the final result. Success of fat grafts is determined by the provider and their technique in placement of the harvested fat grafts.Facelifts shape  the neck, jowls, cheeks and forehead.  Often fat grafts can enhance the jawline, cheeks and smile lines while improving overlying skin appearance as well. I perform nanofat grafts with platelet rich plasma for all my facelift surgeries. It is important to know that each patient's result is determined by the surgeon's judgement and experience with facial lifting and fat grafting. So it is important to consult with a board certified plastic surgeon.

In our experience, the highest customer satisfaction with fat transfer is when it is done with a facelift, such that the issues that fat grafting doesn't resolve are addressed at the same time. When fat grafting is done by itself, it can be effective BUT  when other issues (skin and neck laxity) persist, patients can be more unhappy. In terms of take rates, we have always been supportive of the old Palomar data which showed that fat squeezing provided the best long term results. We now combine PRP with the fat squeezing technologies and we see very good (>80%) retention after 6 months with this technique assuming there isn't alot of weight changes (Loss). For patients who do not wish to have fat transfer with their facelift, we are now offering Bellafill injections which work very well as a permanent filler. This has been a good alternative to the fat transfer.  

Fat grafting is not for everyone. Some patients have lost fat in their face as they age giving a hollow look, for these patients fat grafting is a great addition to their surgery. I have patients that are very happy with their results, the fat grafting lasts a lot longer than dermal fillers. Choose your surgeon carefully and be sure he/she is board certified. Good luck.

Fat grafting is often combined with facelift surgeries with great results. Depending on the needs of the patient, to restore volume and create more prominent, balanced features, fat grafting can be quite beneficial. It would be best to discuss your options with a board certified plastic surgeon who is specialized in facial aesthetics after a physical examination.Hope this helps,Ali Rıza Öreroğlu, MD FEBOPRASEuropean and Turkish Board Certified Aesthetic, Plastic and Reconstructive SurgeonIstanbul, Turkey

Simply put, fat grafting is often not necessary with a facelift procedure.  A well performed deep plane facelift is a self volumizing procedure, leading to repositioning of deeper soft tissues and cheek elevation.  In the event that more volume is required, I favor an off-the-shelf volumizer like Sculptra, which I find to be far more predictable in terms of results.  

Fat grafting during a face lift when done properly should be quite predictable and pleasing.  Every face lift patients requires individual evaluation and individual technique. In my practice, about a third of my face lift patients undergo at least a minor fat grafting, in order to obtain significant, yet natural rejuvenating effect.  Seek out a talented and experienced face lift expert for an in person evaluation. 

In my opinion, volumization is an important component of facial rejuvenation. When done well, fat grafting can be a powerful tool towards achieving a more youthful facial volume, but proper technique and aesthetics are essential. The best evidence shows that about 30% of the grafted fat stays long term (15+ years).  How and where the fat is placed, however, greatly affects it's ability to achieve a blood supply and "take". Surgeon experience is a significant factor. Best of luck!

Hi and thanks for sharing.  Fat grafting will complement a facelift in the right person.  If there is volume deficiency that is not corrected with facelifting then adding a lilttle bit of volume with fat or filler will enhance your result.  Typically it is placed in the cheek areas to help with this deflated area if needed.  Best of luck!