Should I Have A Fat Transfer To Fill In Depressions or A Mid-Facelift?

I experience my face as "droopy". I've emailed two PS's: - The first surgeon wrote that I've got depressions under my eyes which results in both undereye hollowness and a lowered midface. He said that a mid-facelift would adress both issues. - Second surgeon wrote that the droopyness was a fat-based issue; there's a lack of fat under my eyes and some excess fat on my lower cheeks. He said that some lipo contouring on my cheeks and fatgrafting under my eyes would fix it. Which surgeon is right?

Doctor Answers 6

Fat or surgey

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Facial aging is three dimensional with changes in surface texture, volume and position. You have gone as far as you can go with virtual analysis and diagnosis and need to get an in person consult to determine if you are best suited by volume enhancement, surgical repositioning or some combination of both.

West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Seriously, you are taking their opinion based on an email?

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There is no substitute for a personal consultation.  The midface surgery is often a high risk proposition by well meaning surgeons.  The fat grafting is safer.  However, I believe that for many individuals who have real schedules and don't want to take time of in this uncertain economy, under eye fillers are proving to be a very reasonable alternative to midface surgery.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Fat grafting vs. midface lift

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Fat grafting and midface lifting do two completely different but overlapping things. Each patient has his own individual anatomical structure. On top of this is the fact that the face is a dynamic, not a static structure. In addition, how a surgeon does fat grafting, where the fat is placed, and how a "mid-face lift' is performed varies widely. Any surgery should address anatomical issues. In general, I think fat grafting is over-used. Midface lifts also may not be done in a way that solves the anatomical issues. I perform a type of midface that obviates the use of most fat grafting. If you perform a half-smile and your face looks fuller and more youthful, you may not need fat grafting. However, it is not uncommon that there are a number of separate manuveurs that are anatomically required since everything inn the face is connected to surrounding structures and do not exist in isolation.

Robin T. W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

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Midface lift vs. fat transfer.

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Midface lift vs. fat transfer is a frequent question and I would need to see you to determine which is right for you. Both  can have complications. Moderate to heavy midface sagging is treated with a midface lift. Volume  loss can be treated with fat or other fillers.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Mid Face lift vs Fat Injections

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The saying "there is more than one way to skin a cat" is applicable here. The depression under the eyes can be addressed with either a mid-face lift or fat-grafting. I always prefer to do the least surgery possible to correct the problem. That being said, you do want the problem fixed and sometimes that means being more aggressive. I am a fan of fat-grafting, but it cant fix everything. Make sure the surgeon you chose has experience and photos from prior patients to show you. Which surgery to choose can't be determined without an examination or at least photographs. Good luck to you.

Benjamin Dunkley, DO
Salt Lake City Facial Plastic Surgeon


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Without seeing you it is impossible to tell. Fat injections can be good or fail. Mid face lifts also can be assiciated with problems. The real question is do you have loose skin or loss of volume? Perhaps both.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.