Fat Transfer Vs Revision Facelift or Both? (Photos)

Facelift 6 week check seems to be a pocket or jowl on Left side by mouth that was quite loose once the swelling went down(I can fold it down). Right side has a lot of scar tissue from previous injury & Bell's palsy so is still swollen. Turkey neck also coming back. Skin very inelastic from weight loss and age (62). Cheek areas are very flat. Would fat transfer alone work or would a temporary product like Restylane be better to see how it would look before fat transfer/surg? PS is board cert.

Doctor Answers 10

Candidate for revision facelift or fat grafting?

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It is a bit early to say what your best options are at this stage. You would really want all the swelling to go down before considering further surgery. In many ways the postoperative swelling improves the results temporarily as it gives the appearance of having improved facial volume. This is certainly something that facial fat grafting can address, especially the cheek flatness. Temporary fillers are good options to "test out" the look if you want as well.

Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

More Plastic Surgery with Fat injections after Facelift

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Hi SO,

Thank you for your question. Generally, most plastic surgeons will wait at least 6 months or longer before considering any further facial surgery. While the skin and facial tissue heals relatively heals pretty quickly after a face or neck lift, swelling can normally last for long time. In addition, scar tissue from prior injury and history of Bell's facial paralysis also contribute to challenges with plastic surgery.

Regarding fat transfer, some plastic surgeons will perform fat transfer at the time of the face lift or brow lift. If no fat injections were performed initially, then one must wait several months to allow the final swelling to resolve in order to obtain better fat graft results.

Some options to consider in the meantime to improve skin health is a skin care program, chemical peels, and/or laser treatments. Only after a comprehensive evaluation can a plastic surgeon help determine appropriate options for you. Best of luck.

Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Revision facelift with fat grafting

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Fat transfer would definitely help you but a revision facelift looks like it is in order because it doesnt appear that you have SMAS support(keep in mind photos can be decieving and without a hands on consultation it is hard to say for certain).  There is not a fullness at the zygoma and the corners of your mouth are downturning.  you would also benefit from a canthopexy to adjust the angles of the corners of your eyes.  Did you have a skin only lift?   Stay far away from recommendations for facial implants.  These are usually offered by practitioners outside the field of plastic and reconstructive surgery who have not seen the dreadful complications.  Your best option would be to revise the blepharoplasty/ canthopexy with revision facelift and fat grafting but even just the bleph/canthopexy with fat would be a significant improvement.  I hope this helps! 

All the best,

Rian A. Maercks M.D.

Revision facelift or fat?

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It is too soon to say. I would need to see it in 6 months. Cheek implants may be a better choice. They are permanent and heal symmetrically.

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

Face lift

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 for the deep naso labial fols perioral rhtides, fat transfer will soften these areas , You have one of the most difficult faces to achieve excellent results. Because od DEEP Wrinkles, Loss  of skin laxity and other problems that interfer with the final result.

You had also a forehead lift.

Your right brow is still lower.

You have Upper lid Prosis, which will interfer with the final results and I would recommend that you have a ptosis procedure, that and the brow lift will open you periorbital area and give you a better result.

As for the deep nasolabial fold and perioral rhytides, fat transfer will soften these areas. Also you can put some fat in the cheecks to give you a round or heart shaped face.

The neck in the pictures look good.

In general you had a good result, that need tweeking due to the nature of your aging and skin laxity


Samir Shureih, MD
Baltimore Plastic Surgeon

Facelift / Fat Transfer / Revision.

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This is a good question.  Looking at your phots, this is a tough call.  It appears a s if the goals of your surgery were not accomplished.  All of my facelifts get fat transfer at the same time.  The neck bands are removed as well and the turkey neck is eliminated.  Your cheeks should not be flat as fat transfer should have made them full at the time of surgery.  My recommendation would be to do a revision face lift with attention to the neck and jowls and remove those.  At the same time fat transfer can be added for the volume replacement that is needed.  All of these goals can be accomplished in one revision surgery.   I hope this helps.  Your face is your diamond and polish it well and you will shine.  Good luck.

Walton Montegut, MD
Newport Beach Physician
4.9 out of 5 stars 47 reviews

Fat transfer or filler after facelift

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Based on the history provided, either option is a good option.  Based on the photos, volume in some form may help left the persistent jowl on the left side.  

Fat is a great option as it's your own tissue but it swells for several weeks and has an unpredictable take, usually 70% in experienced hands.  Filler may not last as long and isn't your own tissue but swelling is only for a couple of days and the result is almost always predictable. 

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 50 reviews

Revision Surgery?

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The first aspect I notice in the pre- and postop photos shown is that you have a ptosis (drooping) of your upper eyelids, which is worse on the left than the right.  When there are such signs of aging in the upper third of the face, it is hard to look rejuvenated, regardless of whether a facelift or fat transfer was performed. Regarding your Facelift:  the recovery is not complete. Please defer judgment on further surgery for at least 9 months.  Regarding facial volume:  I would recommend Sculptra which avoids a harvest sight, the lack of predictability of "fat" take, and the "weight gain" propensities of the harvested fat.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

Facelift Revision with Fat Transfer is an excellent option for cheeks. In Lower Face and Neck Revision Surgery is better option.

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I would wait 6 months to see final result. Generally speaking a Fat Transfer or Fat Grafting procedure can produce fullness in the cheeks that is superior to what I can achieve with a Facelift alone.

However recurrent laxity in the lower face along the jaw line and neck usually reqiures Revision Facelift and Neck Lift Surgery to achieve the best result.

Fillers can be successfully used especially to evaluate how a Fat Transfer or Fat Graft procedure would look. However Fillers require repeat treatments on a frequent basis.

Fat transfer vs revision face lift

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I work as an aesthetic facial plastics surgical tech and I have seen many procedures and many situations. I feel Fat Transfer is the best option to go with because the outcome can offer many results that the traditional incision procedures does not. For instance, as described on our web site volumizing will eliminate the extra skin and fill any unwanted wrinkles and lines. If you go with the traditional face lift all that is accomplished is tightening. When we age we experience muscle and bone loss loosing volume. The youthful appearance is much contributed by the volume.  Fat transfer brings back the volume taking of over ten years or more. The procedure is a lot less invasive and the only cutting and sutures are limited to 2-3 centimeters where the fat was harvested.

Kindest regards



Philip Young, MD
Bellevue 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.