Volume loss, facelift and scar tissue. Juvederm voluma or fat transfer? (photo)

4 .5 months post op. i had some volume loss in the temple and cheek area after a surgery that required a deep plane facelift technique to remove permanent filler. i have some internal scarring due to ematoma on both sides and skin doesn't move well. . because massages and steroids made me break out i recently stopped doing it. For volume, should i do fillers such as juvederm voluma or fat grafting? they say fat grafting can soften scars and improve skin..,

Doctor Answers 16

Voluma or fat injections after face lift complications

After a series of surgical complications (hematoma, reactions to steroids, complications from permanent fillers), I suggest you keep things simple for now -
Have standard fillers such as juvederm or voluma.

Fat injections have their pros and cons but they are likely to cause more scarring and risk more bleeding that a filler. Best wishes.

Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Fillers are safer a more predictable than fat injections.

Any of the fillers you mentioned or suitable depending on where they're placed. Fat injections are much less predictable

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Fillers for Cheek Area #voluma

So I will make some general comments since the photos don't really help me too much here. Yes, fat grafting has a high degree of stem cells in them and are good for bringing in better blood supply when grafted. It can soften your scars. Also realize it takes at least a year for scars to soften so if it has been less than that you need to wait. I also do like Voluma and other fillers. Voluma in particular is really good because it lasts a long time and is naturally broken down by the body. In the temple area is a great place for Voluma but it would be off label use and you need to know that. It's current indication is for the mid face. Being that said I have used it in other areas off label and it works great as long as your injector knows what they are doing.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 49 reviews

Treating volume loss with fillers or fat grafting

Dear angelxoxoxo,

  • You have a very pretty and symmetric face
  • If you have scarring, it depends on where it is
  • For surface scars, microneedling works well
  • I just dont think you have a significant amount of volume loss to get a fat transfer (you may look too filled out)
  • This is just an opinion based on your photo, and in person exam would be best
  • Check out the Glasgold Group in New Jersey, they are experts in fat transfer and will not sell you a surgery you do not need

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

Which filler for Volume?

Thank you for your picture but it does not show the extent of your concerns.  I would recommend fat as a solution because it can improve tissue quality and is a permenant solution.

Earl Stephenson, Jr, MD, DDS,FACS

Volume Loss and Scarring Post Facelift. What Can Help?

From what you have told us, it appears that you have already had a poor experience with fillers. If you wish to add a good amount of volume, the filler Voluma can get to be pretty expensive. as it requires multiple syringes to get a significant volume change. Fat transfer not only allows you to add volume, but it appears to have a beneficial effect on the quality of the overlying skin, and it may improve scarring as well. I would wait until you were at least 6 months out from your surgery to give your tissues time to heal as much as possible before embarking on another procedure.

Braden C. Stridde, MD
Kirkland Plastic Surgeon
4.8 out of 5 stars 52 reviews

Volume loss after facelift with hematoma 4 (months).

Volume loss after facelift with hematoma 4 (months). Do nothing for another 8 months and let the skin soften. Fat grafting can cause irregularities especially after a facelift with scarring.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Voluma vs Fat transfer following Facelift

My first advice is to wait a full year prior to considering fillers in light of your complicated history and surgery. All soft tissues should be supple and at their baseline. Second, make sure you are in good hands with a board certified plastic or facial plastic surgeon with large experience in either Voluma or Fat transfer to the face. Both will work - Voluma is predicatable but goes away in a few years, fat transfer has a varied take but has permanent improvement. 

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews


You undoubtedly still have some scar tissue deep which may well improve with time.  I probably wouldn't touch anything until one year after surgery.  There is a good chance much of this will improve on its own by then.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Volume loss after facelift

Ultimately, I think that fat grafting would be a great option for you. Fat is very effective at balancing the face and softening fine lines in the skin. I would consult with an experienced facial plastic surgeon who can give you options. 4.5 months is a bit early in the healing process and I would wait several more months before any intervention.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 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.