What is your opinion on fat grafting during a facelift?

Can this lead to bumps and lumps, or is less likely during an actual facelift, as opposed to at the derm's office, because you can actually see what you are doing?

Doctor Answers 31

What is your opinion on fat grafting during a facelift?

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 I have performed many facelifts over the years as well as facial shaping using reliable off the shelf fillers and/or facial implants.  Despite the growing popularity of fat transfer, I do not use or recommend fat transfer to add facial volume as it is not reliable.  You just can't predict how much of the fat is going to remain, where.  

If you have "jowls" this is sagging facial tissues and an indication for some form of a 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 facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Perlane) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
Hope this helps.

Hope this helps.

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Fat Grafting During a Facelift

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Fat grafting is a part of almost every facial rejuvenation procedure I perform. Most people, as they age, lose volume and fat grafting, when administered conservatively and with expertise can provide results that subtractive surgical procedures alone simply cannot provide.

It is important never to over-correct, or yes, the results can look lumpy, bumpy, overfilled and unnatural.  I urge prospective patients to take a lot of time searching for the right plastic surgeon for you. It is imperative to check the credentials of a surgeon. The best results will be from plastic surgeons with the best education, expert surgical results, experience and record of safety.  

Look at many, many before and after images. You should see patient photos soon after surgery and up to a year after surgery as evidence of lasting results of fat grafting. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Fat Grafting During a Facelift

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During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.
It is possible to #combine #surgeries. In fact, I commonly recommend other procedures to go accompany a facelift, such as blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result. The best procedure approach will be discussed in greater detail during your one-on-one #consultation. I invite you to visit PacificCenterPlasticSurgery.com to view a complete list of surgeries commonly performed.
It is extremely important to seek a board certified plastic surgeon highly trained with your desired procedures. I also encourage you to look at before and after photos of the surgeons actual patients. Also, reading patient reviews of those who have had combined surgeries will be beneficial. Gathering all of this information will help you make a well-informed decision.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Every surgeon's experience is different.

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Fat grafting is becoming more precise with new technology. Microfat grafting, also called autologous fat transfer, is a procedure in which an individual's own body fat is first removed via liposuction, and is then used to plump up sunken or emaciated areas of the face or to add volume where desired. Proponents of fat grafting say this approach is longer lasting than fillers. However, the results of fat grafting are still challenging to predict with the same certainty as dermal fillers. If you do opt for fat grafting, be sure to choose a board certified plastic surgeon with extensive experience in the procedure.

Lee B. Daniel, MD
Eugene Plastic Surgeon

Fat grafting and facelifts

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Fat grafting has been a boon for my facelift patients. It helps by augmenting those areas that may be deficient with age and helps me achieve a more natural result without having to go to other fillers. In addition it has the added benefit of bringing stem cells to the area to help rejuvenate the existing tissue. 

Fat grafting during a facelift

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Fat grafting is often an integral part of the procedure. It can be very effective in treating a flattened mid-face or cheek area and correcting the groove underneath the lower eyelid. When performed properly, it should be smooth and symmetrical.

Opinion On Essential Role Fat Grafting With Facelift

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Fat grafting is an essential component of a modified facelift if done appropriately by using a “Lift” and “Fill” facelift with central facial fat compartment augmentation to reshape the central face and outer deep layer SMAS elevation. This should be done in the hands of a Board Certified Plastic Surgeon with expertise in facial rejuvenation and who understands the science of aging.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

Fat grafting during facelift

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There is no one perfect way to restore volume to the midface region.  Certainly fat transfer has a role, but also with products like Voluma which has its advantages, there are some cases where fat is not the best choice.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.7 out of 5 stars 145 reviews

Fat Grafting with Face Lift Surgery

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Fat grafting is fantastic to combine with face lift surgery.  We like to call this 3 dimensional rejuvenation because we are not just lifting and tightening the face but actually filling in the hollow areas to correct volume loss.  This is extremely important as much of facial aging is caused by volume loss which can only be corrected by adding volume.  Fat is the best volume replacer because it is your own natural living tissue and is permanent.  Technique is extremely important to achieve good results and one should look for a surgeon with extensive experience with fat grafting with face lift surgery.   

Patrick Flaharty, MD
Bonita Springs Oculoplastic Surgeon

Fat grafting during facelift

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  I think that fat grafting during faelift surgery is a wonderful option for patients who require additional facial volume.  Of course, fat grafting is only one method of achieving such results but in my hands it is a very useful adjunctive procedure which may be combined with blepharoplasty and facelift surgery.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

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.