Disappointment After Facelift and Fat Transfer (photos)

In October 2012 I underwent a Short Access Facial Elevation face-lift and fat transfer (see a presentation by my surgeon @ http://ijcs.org/12/47/758/index.php?pageFrom=874&pageTo=916.) 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. Thank

Editor's Note:  See also: http://www.realself.com/question/disappointment-after-facelift-and-fat-transfer

Doctor Answers 19


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The most important part of a consult is finding out exactly the patient wants. I have a feeling you are more concerned with surface texture. That would be easily addressed with either a deep chemical peel or a laser treatment

Disappointment after facelift and fat transfer

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

  Thank you for providing the photos, it helps all of us answer the questions better.  Obviously, you should be having this discussion with your doctor who did the surgery.  There simply is NO substitute for personal consultations with your doctor before having any procedure so that you can decide on the best procedures for you.  Perhaps, a short incision lift was not right for you, depending on your anatomy and/or your expectations.  Perhaps, some facial resurfacing might have been better for you depending on your expectations, than fat grafting.  The bad news is that you may incur additional procedures and additional cost to achieve the results you seek.  The good news is that it is almost certainly achievable.  Good luck.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

Facelift and fat transfer

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Sorry to hear that you arent happy with your surgery. Many times these procedures are a very short term solution to the problem. They are attractive for several reason. Usually they are less expensive and they promise a short term recovery but usually end up not lasting or holding very long. It is important to speak with your physician about your expectiations and be on the same page. You should be proud and showing off your new looks. Good luck 

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

Disappointment After Facelift and Fat Transfer

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It would appear that you need more volume added.  It's hard to tell from the pictures because you are smiling.  Photos ideally should be done at rest.  You may also need additional tightening - this can be done by redoing the facelift or what we call a LazerLift.  You should discuss your result with your surgeon.

Rigo Mendoza, MD
Tampa Plastic Surgeon
4.4 out of 5 stars 40 reviews

Facial rejuvenation options

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello aussie,

Thank you for the question and the photos.  Obviously an indepth discussion about what has changed and what has not, as well as what your goals are would be needed for a definitive facial rejuvenation plan.  Based on the photo, however, I suspect that more volume in the way of fat grafting and skin resurfacing would be beneficial.  You may also benefit from a revision face lift to tighten any tissue laxity that is present.  Since you are smiling in the photo this is hard to evaluate but certainly a possibility.

All the best,

Dr. Remus Repta

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

Short scar, minimal access with unhappy result.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Aussie,

Thank you for your question.  I find that short scar or minimal access procedures can have a nice effect if there is good strong skin involved, and just some contour issues that need to be addressed.  In your case, I think a full SMAS face lift with a fair amount of skin excision should be performed, but I also think you need to address the thinness of the skin with various modalities such as laser and dermabrasion.

Best Wishes, 

Pablo Prichard, MD

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

Limitations of Mini-Lifts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for the great question. There are numerous facelift techniques, and not all techniques are suitable for each patient. In some cases, when there is significant laxity of the skin, connective tissues, and muscles, a more involved lift is required.  Just lifting the skin unfortunately results in early recurrence, as the skin stretches easily when it has been separated from the connective tissues and muscles below. Many surgeons seek to cover this up with fat injections, but over a year or so post-op, recurrence is common.

Short scar lift may not have fully corrected problem

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Short scar facelifts can be very useful in some patients but may not be sufficient to correct greater amounts of skin laxity.  Volume enhancement likewise is an important part of facial rejuvenation but does not correct laxity.  Your evaluation at this point should include an assessment of whether skin laxity (corrected by further surgery) or skin quality (corrected by resurfacing techniques) is the primary problem.  One or both approaches may be needed to yield the best results.

Mark Beaty, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

In a facelift the length of the incision will be commensurate with the amount of skin to be removed.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Short incisions in any operation permit only modest removal of surplus skin. In my opinion you retain a sizable amount of redundancy which is predictable with limited incision facelifts. Unfortunately the solution to your problem will be a facelift with more formal incisions. You should expect an excellent result.

Fat lift and fat transfer results

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for asking about your face lift result.

  1. Your skin seems typically thinned and damaged by the Australian sun,
  2. Discuss pre and post op photos with a Board Certified Plastic Surgeon to plan skin protection, therapeutic tretinoin-based skin care  and mid-depth peels or laser and a possible secondary face lift.
  3. I find short scar face lifts unpredictable and avoid them. Sorry you have had this problem. Hope this helps.

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.