Facelift after fat loss from microneedling RF procedure?

Question

I had a microneedling RF procedure that caused significant apoptosis globally on my face. I now will need a facelift/necklift, lower bleph, and fat transfer as a result of the damage done. How long should I wait after the procedure to have any work done... 6 mos, a year? Will the damage and new scar tissue formed from the microneedling RF procedure make the FL/NL, LB, and FT more difficult to perform? If so, how?

Sirius K. Yoo, MD · Answer

Thank you for your question. Pretty much all the minimally invasive, energy delivery modalities will damage some fat. This can be a good thing for patients who are a little heavy along the neck or jaw line, but is a negative for someone already lean in these areas. The other issue is that these procedures do injure the subdermal plexus vasculature of the skin which may lead to premature aging of the skin (think smoker skin). To answer your question, you really want to wait until any and all fat resorption is completed, 3-6 months is safe. There is usually a little more fibrosis of the subcutaneous tissue in the areas treated, but this isn't a big problem for an experienced facelift surgeon. Best of luck.

Semih Yildiz, MD, FEPOBRAS · Answer

In general, it is best to wait until the tissues have fully settled and the changes are stable before planning a facelift, neck lift, lower blepharoplasty, or fat transfer after RF microneedling. For many patients that means at least 6 months, and often closer to 9 to 12 months if there is ongoing swelling, tightness, tenderness, skin texture change, or progressive volume change.

RF microneedling can cause inflammation and some collagen remodeling in the dermis and superficial fat layer. If there has been significant fat loss or fibrosis, surgery can be somewhat more complex because the tissue planes may feel firmer, the skin may be less mobile, and there may be areas of tethering or uneven thickness. This does not necessarily prevent a facelift or neck lift, but it makes careful surgical judgment more important.

Fat transfer can help restore lost volume, but it should be done conservatively and sometimes in stages because graft survival is less predictable in areas with scar tissue or altered blood supply. A lower blepharoplasty may still be very reasonable, but the plan should be based on eyelid support, skin quality, and volume loss rather than on timing alone.

The best next step is an in-person consultation with a board-certified plastic surgeon or facial plastic surgeon who performs revision and post-energy-device facial surgery. Bring photos from before the RF treatment and from several points afterward. If the face is still changing, waiting closer to a year is usually safer than operating too early.

Ronald J. Edelson, MD · Answer

You could really proceed with a facelift as soon as a few weeks after needling, I’m not so sure that needling led to fat loss. Consider that the plastic surgeon may have told you that to convince you to pay more for fat transfer.,  personally  I think fat transfer is a worthless  procedure

Facelift after fat loss from microneedling RF procedure?

Answers (3)

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