Disappointment After Facelift and Fat Transfer?

In October 2012 I underwent a Short Access Facial Elevation face-lift and fat transfer. Unfortunately after several months I noticed skin laxity returning to my lower face region. In May I had 2mls of Voluma injected into my cheeks and pre-jowl areas hoping for some improvement (different doctor). I would appreciate your advice about this problem prior to returning to see my original surgeon. Thanks

Update: Photos added here.

Doctor Answers 15

Disappointment after Facelift

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Thank you for sharing. Without your before and after pictures, it's difficult to give specific recommendations. However, it seems like you are experiencing an all too common issue with mini-facelifts or "quick" lifts and the like. These procedures have a shorter operative time and faster recovery... but the tradeoff is that they tend to have a shorter duration of effect as well. In particular, when the procedure addresses the skin only, early sagging or recurrence of jowls is quite common.  For this reason, I recommend a facelift that lifts the deeper muscle and connective tissue layer of the face -- not just skin.

Improving skin quality and adding volume are also important. Fat transfers add volume, but are absorbed quickly by the body

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As a specialist in facial aging, I wrote a book called “The Fine Art of Looking Younger” where I emphasized the process of facial aging: one is sagging and thinning of the deeper tissues called the SMAS (superficial muscular aponeurotic system), the other process is loss of volume through bone, muscle and fat.

Although a fat transfer is a good strategy to improve facial volume, it has a certain rate of absorption. Sagging and loss of volume will eventually occur so a second procedure to add volume is needed to achieve desired results.

I recommend facelift as the first part of facial rejuvenation where the tissues are placed in the proper position. However, after several months, elasticity and regression may happen at the mandibular notch and cause marionette lines. To help enhance volume, I often use fillers called Radiesse or Restylane and strategically use it to meet the patient’s expectations. I also combine fillers with a material called platelet-rich plasma (PRP) which is drawn from the patient’s own blood. This helps with healing and dramatically improves volume. I hope that was helpful, and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Disappointment After Facelift and Fat Transfer?

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Thank you for your question. Many times, fat transfer fails due to improper harvesting, or poor fat quality due to weight changes over the past few years.  You should talk with a Board Certified Plastic Surgeon, and evaluate all your options, and see if there are other alternatives to explore.  Fat transfers are not an absolute way to improve volume. I hope this helps.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Review your before and after photos as well as your desire with your plastic surgeon

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Thank you for the question.  I would have your plastic surgeon take before and after photos for you if you do not have them already.  Spend some time by yourself reviewing them and then review them with your plastic surgeon and discuss what you would like to accomplish.  This is often a great way to communicate as well as plan the next step in improving your facial appearance.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Many Reasons for Disappointment After Facelift and Fat Transfer

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Recurring Skin Elasticity After Facelift


Without before and after photos, it would be difficult to give you a specific answer as loss of elasticity, age, race, smoking and sun history, all play a role in the type of results you should expect. Other factors are the skill of the surgeon and his experience. I have found for example that for upper neck skin laxity and lower facial rejuvenation, my Lite Lift, modified minimal incision facelifts with fat transfer do just as well as my traditional facelifts. For those patients with Turkey Waddle deformity and neck muscle bands a traditional facelift is recommended.

 More importantly, it sounds like you need a second opinion from a board certified Plastic or Facial Plastic Surgeon who specializes in facelifts.

Dissapointed after facelift

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This is sad to read. We see this all the time with mini lifts and "lifestyle" lifts. They are shorter procedures and have you back in action days later but the trade off sometimes are the results. Many times a full face/neck lift should have been done but without before and after photos there isnt really anyway to be certain. Speak with your surgeon about your expectations. You should be happy and proud of your results. Good luck

George T. Boris, MD, FRCS - Account Suspended
Los Angeles Facial Plastic Surgeon

Disappointment After Facelift and Fat Transfer?

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Dear Aussie,

thank you for your question.  Often times, patients desire a short access type procedure or mini facelift because they desire less down time. However, there are limitations to these procedures, and with a lot of skin laxity, sometimes a full face lift is in order.  Discuss these aspects with your plastic surgeon.

Best Wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Disappointing face lift result

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Thank you for asking about your mini-face lift result.

  1. This kind of face lift is often disappointing. 
  2. A traditional face lift with elevation and repositioning of deep tissues and removal of excess skin gives longer lasting, more predictable results.
  3. If you trust your original surgeon, you can ask if he/she will do it for your for a reduced fee. Otherwise a Board Certified Plastic Surgeon will be best.
  4. Sorry this happened. Best wishes. 

Short scar facelifts do not permit removal of excess skin.

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The amount of skin to be removed during a successful facelift determines the length of the incision. Short incision facelifts are often disappointing because they do not address one of the components of aging-surplus skin.

Disappointing Facelift Results

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     I suspect you have had underdone surgery.  So often these little tinkering procedures simply end up in disappointment and the solution is a real facelift by a well qualified  and fully trained surgeon.  Your second procedure where 2 cc of fat was added falls into the same category of far too little and too late.   You might voice your concerns to your surgeon and see what is offered.  When patients are disappointed, many surgeons will offer procedures without charge to remedy the disappointment.   My Best,  DR C

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.