Is fat grafting necessary with my SMAS facelift and upper eyelid surgery?

Structural fat grafting with PRP, sometimes referred to as micro fat grafting with PRP can provide fullness to hollowed upper or lower eyelids and can fill lines and wrinkles on the face.  In the hands of an experienced facial plastic surgeon you can be expect a smooth and natural results.  It can be performed in conjunction with SMAS facelift.
There are several different types of facelift techniques that are currently performed by facelift surgeons. The most important factor is that the technique that is used by a facial surgeon will create a youthful, natural with long lasting result. An ideal facelift result includes in part not having anyone assume you have had a face lift procedure.  I think a patient that desires improved appearance but wants a natural, non-operated result will have to communicate this to his or her prospective surgeon but also seek out an experienced facelift surgeon that prefers to achieve these types of results.  Experience is the key in facial rejuvenation. Vectors of facial tightening vary from patient to patient. For a 45- 50-year-old patient, I would not apply the same vector and tension that I normally apply to a 70-year-old face. In addition, direction of vectors must be modified during secondary or tertiary facelift to avoid artificial look.  I have performed well over 3,500 face and neck lifts and published a specific technique that describe the rotational angles and amount of tension that must be applied during SMAS plication to avoid over or under tightening.  A well-performed neck lift during facial rejuvenation is the paramount in a youthful-appearing face. I apply gradual tension on my SMAS as follow: starting at temple area there is only 20-30% tension on muscle plication, once at the jawlines the muscle is tightened 100%. This prevent pulled looked at the corner of mouth. In neck area the muscle must be tighten with greater tension than 100%, depending on the neck laxity.  Look at the doctor’s before and after pictures, a talented and experienced facelift surgeon will have a smooth and well-contoured neck that enhances the facelift results.  The face ages through a combination of changes including volume loss, skin changes, and soft tissue drooping.  When facial rejuvenation is desired all of these changes must be addressed.  Therefore, fat grafting, a facelift, and skin resurfacing frequently must be combined to accomplish a natural result.

Thank you for your question.  I believe filler is a really good temporary solution for hollow eyes.  If performed correctly the results can be really beneficial.  Fat Grafting is good if the fat survives however sometimes it can die therefore a few tries maybe needed.  Please have a consultation with a board certified plastic surgeon.  All The Best