I had a Facelift 7 months ago. I now have holes in fatty cheek area and in laugh line. What can be done?

It is hard to say for sure, but based on your description it sounds as though you have some areas of depression in the cheek and close to the laugh line. Without knowing what was done during your surgery, it is just purely speculation from all of us.Fat removal in the face can be a source of problems.  For example, liposuction in the face such as around the cheeks and even the jowls can leave depressions and lines if done too aggressively, and unfortunately it is VERY easy to over do it in this area.  Likewise, removal of buccal fat could have contributed to your concerns now.You could also be seeing areas of scar tissue or tethering under the surface.It is not uncommon to see some mild volume loss in the cheeks after a facelift once the early swelling phase resolves.  An added 15 pound weight loss may be making things more noticeable.  However, this does not fully account for the isolated "holes" or areas of depression that you have.It's best to start by meeting with your original surgeon once again.  You can then consider second opinions if you are not fully comfortable with everything, but your surgeon knows you best and can offer the most appropriate advice in your specific case.

Thank you for your question.  I am sorry that you are having this issue after your facelift.  Your weight loss certainly could have had some effect on your facial volume.  Also, you may have had removal of buccal fat during your facelift.  Your surgeon would know exactly what was done during your procedure.  At this point, I would have an in person consultation with your surgeon with your before and after photos to determine why you are having this issue.  You may be a candidate for filler to help correct this area.  Be sure to consult with a board certified, facial plastic or general plastic surgeon who specializes in facelifting.  I hope that this helps!-David Gilpin

The description that you give is helpful, but photos would help to provide a better understanding of your concern.  I would imagine that you likely have some scar tissue and volume loss that together are causing your contour irregularity. With time this should improve, but filling agents could help during the interim.  Best regards

I wish you'd post a photograph demonstrating what you're describing. It sounds as though filler may be a very decent solution to the problem. I'm not sure why you would have these contour issues after a properly executed facelift but with substantial weight loss this could generate some unwanted changes.

Hello,Without photos it's difficult to asses the problem.  Contour irregularities are common after facelift surgery with or without fat transfer (if that is your case). Neither of these operations typically cause holes or dimples unless over aggressive liposuction was performed.  If you have lost 15 lbs after the surgery without any other complications this is the most likely cause.  I recommend waiting the full year to seek a permanent solution to this problem.Regards,J. Phillip Garcia, M.D.

This is hard to evaluate without photos and an exam. You should have healed from your surgery by now. Since you have lost so much weight it may be due to fat loss in the face. This could be treated by fat transfer from another part of your body. It may also be due to something that was done at surgery. Be sure to discuss your concerns with your surgeon and seek a second opinion if you are not satisfied.Hope this helpsDr. J

It sounds like you are disappointed
with the underlying depressions that can occur after a facelift. Usually the
slight irregularities soften within a few weeks, and the fact that you lost
weight may have contributed to them, as you mentioned. Fillers can be used to
soften these areas, and ultimately you might want to consider fat transfer,
which has longer-lasting results. Multiple treatments might be necessary. Best
of luck to you.

It's hard to answer without an examination or at least photos.  But it sounds like you have developed irregular contours in the facelift areas.  I'm assuming the "holes" you mention to be depressions in the cheek areas.  These may have been create during the lifting and contouring of the inner cheek areas (SMAS) just beneath the skin.  Weight loss would certainly make them more visible, when they may not have been that visible before the weight loss.  My best advice is to discuss this with the one person that knows what was done during the surgery....your surgeon.  If you ask the question again on this forum, please include photos from various angles.Thank you.

I am hoping that what you are calling "holes" are not through the the skin but rather contour irregularities. You surgeon will likely have the best insight as to what might be causing these. I the short run, a filler like a hyaluronic acid may help improve the look. In the long run perhaps fat transfer may provide a more definitive treatment. 

Plucking individual pockets of fat during surgery may result in what you are describing, but without photos its hard to evaluate. Consider using a filler such as Volume or Radiesse for re-contour.