Elevation of Malar fat pad: What is the "percutaneous technique" spoken about in this article?

Question

My main concern these days is with the descent of the malar fat pad on my face causing deep nasolabial fold. So I searched "elevation of malar fat pad" and found an article. Granted this article is from 2002 but is this the technique widely used for a midface lifts today? Can I find someone who performs this technique? I know fillers like Voluma can address this concern as well but I have concerns about how these substances break down in the body and I also have reservations about fat grafting.

Edgardo Zavala, MD · Answer

Elevation of the mid face is a procedure that is commonly done during a regular facelift if neck, jowls and other facial aging is present or it can be done isolated usually when a lower blepharoplasty is done for other reasons. Any experienced surgeon with facelift skills can do this with excellent results. Just make sure you ask to see pictures of similar cases from your surgeon to see the type of results he or she gets. Good luck

Reps B. Sundin, MD · Answer

Descent of the malar fat pad does lead to the appearance of facial aging, this is typically addressed with fillers or a facelift.   Be wary of any procedure that describes an equivalent result that is not widely performed.  If an easier, less downtime procedure existed, why wouldn't every surgeon offer it.   Percutaneous, suture lifts can elevate skin and fat, but are temporary.  A new generation of thread lifts called NOVA, PDO or silhoette lift are currently being used to give a minimal to moderate temporary lift (6-24 months) of the face and neck.  I also typically caution against midface elevation techniques performed through an eyelid incisions, I find the risk of ectropion unacceptable.

Walton Montegut, MD · Answer

This is a good question.  This is common in the aging face.  The Mid Face ages with flattening out of this area and descent of the Fat Pad.  As this occurs, it ages the person and makes them look TIRED.  There are several ways to correct this problem.When flattening occurs in this area, a Good Face Lift will pick this area up and re-position the Fat Pad.  The deep layer or SMAS layer is the layer to achieve this. If this is not performed at the time of surgery, it will remain flat.  Therefore, this is necessary and Mini Lifts will not accomplish this.The other solution is to add volume in this area.  As you stated, your not in favor of doing this which is fine,.  When performing Face Lifts, I always raise the SMAS and fill this area.  In addition to this part of the procedure, I add Fat Transfer to complete this area.  The addition of Fat Transfer helps create a more youthful look and solve the Flattening of the Malar area.  Therefore, I would look for a surgeon who performs a SMAS type Face Lift and this will solve your problem.  Fat Transfer will always make a big difference as well.  Hope this helps.  Good Luck.

Adam Goodwin, MBBS, FRCS(Plast) · Answer

so elevation of the malar fat pad is a great way to rejuvenate the mid face without a 'facelift' per se. The way I do it is through an eyelid incision and raise the fat and correct lower lid ageing at the same time. It works very well and also softens or removes nasolabial lines at the same time. Ask someone local if they know this procedure and good luck. Adam Goodwin

Elevation of Malar fat pad: What is the "percutaneous technique" spoken about in this article?

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Elevation of Malar fat pad: What is the "percutaneous technique" spoken about in this article?

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Everything you need to know about Eyelid Surgery

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