Can I expect mini facelift final result to be same as day 1?

Question

I had mini lift 8 days ago, & fat graft to cheekbones. Day after surgery I was Absolutely Thrilled. My face used to be fat, chunky & saggy in lower 1/3rd, & flat front cheeks/ cheekbones. Day 1 post I had a chiseled face, sharp jaw, sharp cheekbones & perfect contours. Day 2, swelling begun, peaked at 72 hrs & will not reduce. My surgeon agreed its ‘above average swelling’,but looks ok. I look hideous. I actually look a lot like my old self. Will my final results be like day 1????

Andrew Campbell, MD · Answer

You are only at 8 days. In my experience, fat grafting can cause a fair amount of swelling. A mini lift doesn't, but the swelling from the fat can start to descend into the lower face over the first week and it typically takes about two weeks for the swelling to resolve enough that you start looking great. I would recommend patience. You will most likely get the result you are looking for.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Dilip D. Madnani, MD, FACS · Answer

You have to give it a few months to see the final results, there is always swelling and bruising initially and then once that settles down, the skin is still tight and takes a few months to further settle as there is a little stretching from the daily use of your face- smiling, talking, swallowing, looking around etc. Be patient and you can eventually compare the before and after results after a few months and go from there.

Robert M. Tornambe, MD · Answer

Monkey109.  I completely understand your frustration, but this too will pass.  I always warn my facelift patients that they will hate me during the first few days after surgery and then love me again after about a month when most swelling has resolved! The reason your swelling did not take affect immediately was most likely because you were given a steroid during surgery to cut down on the immediate swelling. However, you should achieve the look that you had immediately after surgery once all swelling has gone away.  Try to stay patient and positive and before you know it, your wonderful final result will return for good! good luck!

Paul J. Leahy, MD · Answer

Thanks for your question. Many patients experience the exact same thing with this procedure. Do not worry. It takes a few weeks for things to settle down. You will likely be thrilled w/ the results once you've healed. Keep up with your surgeon and his/her recommendations. Best wishes

Jessica Kulak, MD · Answer

Swelling is often worse day 2 and 3 after surgery than the first day when the dressing is removed. Peak swelling is often 48-72 hours after surgery.  The combination of fat transfer with facelift can cause significant swelling. Give yourself a few weeks to months to heal before evaluating your outcome.  Best of luck!

Francis R. Palmer, III, MD (retired) · Answer

Hi, all facelift procedures will have some degree of post-op swelling and downtime.  It's difficult to determine whether the swelling is from the mini facelift (typically not the case) or from the fat transfer (injections).  The reality is, there are many different ways to perform a facelift from incision length, incision placement, level of tissue dissection (skin only, SMAS, Deep Plane, Subperiosteal), different degrees of tissue undermining, how to lift and support (imbrication versus plication of the SMAS layer), how much excess skin to trim, is excess fat going to be reduced and finally will the overall shape of the face be made more feminine or masculine (while avoiding the over pulled, windswept appearance).  Price is determined by the reputation, location and experience of the Facelift Surgeon.
 In my humble opinion however, there are some basic requirements that must be met in order for a facelift to be "effective", yielding "aesthetic pleasing" and "naturally attractive" results.  These include: 
 1. Some type of incision either curved around the front (preferred) or straight in front of the ear.  This is how excess skin is removed which is not possible with an incision behind the ear alone.  If you have so little excess skin on the face that "none" needs to be removed you are not a candidate for a facelift in the first place.
2. The facelift must address correction and softening of the "jowls" using a long lasting and effective technique.  If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
3. Facial shaping must be combined to properly shape the cheeks, chin, jaw line and lips for feminizing or masculinizing the face as the case may be.
 In my experience, this is the "key" factor in making the face soft, feminine and naturally beautiful.  An essential part of any facelift on a woman.  Conversely, men look chiseled and handsome when angularity is created in the cheeks, chin and mandibular angles.  The ability to provide precise, facial shaping separately or in combination with a facelift is in my humble opinion the definition of a "facial shaping expert".  I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.
 If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
proper SMAS Imbrication technique
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.  Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  If the cheeks are flat or concave in the front, Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective. I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or silastic facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.

Can I expect mini facelift final result to be same as day 1?

Answers (7)

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