You should wait at least another month prior to considering fillers. The fluid that was aspirated was probably a seroma and there is still swelling and healing that will occur. Fillers can be used safely after a face lift, but you should note that if you use a filler now to correct the area of hollowness that this area may improve and the filler may actually make it look fuller instead. Consult with you plastic surgeon.
Most of the fillers used now last quite a while. Swelling after a facelift, on the other hand, changes almost weekly. The risk is that you could use a hyaluronic acid filler and then the swelling might change. The hyaluronic acid filler will then be excessive in the area it was injected.
If there is one particular area that is really objectionable, it may be reasonable to put a shorter acting filler such as Prevelle in to minimize this risk but still deal with asymmetries or "dents".
Your plastic surgeon can guide you through the decision process.
Fillers Following Face Lift Makes Sense for most
Fillers following a face lift makes perfect sense. This is because you age by three factors - sagging (through gravity and time), loss of volume (counteracted by fillers), and skin texture (determined by environmental and genetic factors). Your fillers should enhance your effect of the lifting if placed appropriately by addressing one of the causes of aging..Most often one of these factors are more out of balance than another and therefore your procedures should customize for what is most needed. Often fillers alone can "stall" the inevitable as they only correct one aspect of aging.
Facelift and Skin resurfacing procedures (laser, Ulthera or Thermage ) and fillers are synergistic so as long as you wait until the Sculptra injection site is soft you should do fine. Not a problem and there is no problem with the timing for a facelift. Sculptra, Radiesse, Jeuvederm, Restylane and other fillers address volume issues, resurfacing procedures corrects surface flaws associated with aging and face lifting addresses the sagging loose skin. Resurfacing procedures address skin texture, color variation (e.g. sun spots)- so all three are synergistic and complementary. It is very common in my practice to do all three approaches to rejuvenation at the same time
Your face will continue to change for at least 6 months after your surgery. I suggest that you wait until your face has "settled" and not changed for at least a month and then consider injectable fillers. Best of Luck, Dr. Clevens
It is not unusual to have this indentaton in your face after you have fluid collected under your skin. You can inyect restylene or juviderm if it is extremily uncanforable for you but most likely it will desapear with time.
Fat Requires good Technique
In order for fat grafts to survive, good technique is essential. You also need to inject live tissue. A new study published in the PRS journal shows that Viafill system fat has 20.8 million cells per ml, other systems are reported to be 4.1 million cells per ml or less.
The defect you describe probably is from dead tissue and now you have a depression. The best way to correct this is with live tissue!
Fillers After Facelift Are Fine
I wouldn't give up on the fat just yet. You may be experiencing swelling or you may be experiencing some of the fat dissipating as a certain percentage does not take after any injection. At this point, a shorter term filler is a good option, maybe one lasting only 3-6 months so that you can get a nice result and let the remainder of healing from your face lift occur. At about 6 months, I would consider additional fat injections or other procedures to more permanently fix your concerns.
Correcting depressions after a facelift
It is entirely possible to correct deficiencies in the cheek and mid face with fillers. Some fillers can last a year and others can last several years but require multiple treatments. After several months, it should be safe to proceed.
Fillers after face and neck lift
It is possible that some of the fat injected at the time of your face and neck lift did not "take", and caused some depression in those areas. Hyaluronic acid fillers, such as Restylane, Perlane, and Juvederm may be of benefit to correct the indentations you observe. It is best to make sure that the areas are free of infection and healing well before undergoing additional injections.
Healing after a face and neck lift
The healing process takes months after a face and neck lift. It is not uncommon for one side to be slightly delayed compared to the other. This is especially true when one side had a small fluid collection. Fluid collections typically are either seromas or small blood collections (hematomas). When aspirated, there is commonly a small depression which improves with time. As you are 2 months post-operatively, I would recommend conservative management with message. Most of these irregularities improve with time and I advise patience. You should wait before having any filler injected until there is no day to day fluctuations in swelling and you facial appearance has not changed for a month or so. I generally recommend waiting 5 to 6 months prior to considering any treatment. If a filler is required, I would use a shorter acting hyaluronic acid (HA) product such as Prevelle. If there is still a contour deformity once the Prevelle has gone away, I would consider fat transfer.
I would discussing your concerns with your surgeon.
Best Regards, Andrew Lyos, MD, FACS