Are fat injections effected if a face lift is performed later?

I have a small degree of skin sagging in the cheek area which causing small skin folders on both sides of my mouth. I have consulted a cosmetic surgeon and he said I am not ready for a face lift and this could be improve through facial fillers or fat injections. While fat injection are more expensive, it seems like a more long term solution. What impact would this have on later having a facelift (5-10 years) if eventually needed or desired? will the fat be "move" when the skin is tightened?

Doctor Answers 21

Fat Transfer & Facelift

Fat transfers are three-dimensional bio-engineering of the face. By borrowing from one area of the body and trans-locating both autologous stem cells, pluripotential cells and fat cells the patient can experience a tremendous improvement in skin folds around the mouth, in the lips and in the cheeks and jowls in general. For a patient who has a very deflated appearance and excess saggy skin often the patient will require having a skin tightening procedure and we just turn to face lift. Most face lifts also involve reordering the architecture of the face by manipulating the tissue plane called the SMAS (submuscular aponeurotic system). The submuscular aponeurotic system is the area of connective tissue and fat that when elevated really eliminates the jowls and gives beautiful volumizing enhancement to the face. These procedures can be done separately or together. If in the discussion in my consultation I feel you can get a substantial improvement with volume enhancing fat transfer alone, then I will apprise you of that once I examine you. If I feel that they should be combined with a SMAS face lift to give a best practice outcome, then I will also apprise you of that at the time of your consultation. Per se the fat will slightly be moved as your tissues are tightened but once it is established in your face it doesn’t really go anywhere. Your results at 6 weeks to 3 months continue to improve for 6 months to a year; but per se your fat doesn’t move anymore once it is placed at the time of surgery.

Fat Transfer & Facelift

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Fat transfers are three-dimensional bio-engineering of the face. By borrowing from one area of the body and trans-locating both autologous stem cells, pluripotential cells and fat cells the patient can experience a tremendous improvement in skin folds around the mouth, in the lips and in the cheeks and jowls in general. For a patient who has a very deflated appearance and excess saggy skin often the patient will require having a skin tightening procedure and we just turn to face lift. Most face lifts also involve reordering the architecture of the face by manipulating the tissue plane called the SMAS (submuscular aponeurotic system). The submuscular aponeurotic system is the area of connective tissue and fat that when elevated really eliminates the jowls and gives beautiful volumizing enhancement to the face. These procedures can be done separately or together. If in the discussion in my consultation I feel you can get a substantial improvement with volume enhancing fat transfer alone, then I will apprise you of that once I examine you. If I feel that they should be combined with a SMAS face lift to give a best practice outcome, then I will also apprise you of that at the time of your consultation. Per se the fat will slightly be moved as your tissues are tightened but once it is established in your face it doesn’t really go anywhere. Your results at 6 weeks to 3 months continue to improve for 6 months to a year; but per se your fat doesn’t move anymore once it is placed at the time of surgery.

Fat Grafting

Great question.


Fat grafting now will not compromise the quality of the facelift in the future and may actually enhance your results. As we age, the skin begins to sag for a number of reasons. Not only does our skin suffer from breakdown of collagen and loss of elasticity, but we also lose fat and our facial skeleton volume. These combined changes result in manifestation of aging. Correction of the aged appearance is therefore directed at the cause of the problem. When fat is placed in the cheek it is carefully layered throughout to achieve a smooth, soft, natural contour. As the fat heals, it is incorporated into the tissue, below the tissue that is manipulated with a traditional face lift. Therefore future face lifting will not change the position of the fat.

Jacob Boeckmann, MD
San Clemente Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Fat Grafting

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Great question.


Fat grafting now will not compromise the quality of the facelift in the future and may actually enhance your results. As we age, the skin begins to sag for a number of reasons. Not only does our skin suffer from breakdown of collagen and loss of elasticity, but we also lose fat and our facial skeleton volume. These combined changes result in manifestation of aging. Correction of the aged appearance is therefore directed at the cause of the problem. When fat is placed in the cheek it is carefully layered throughout to achieve a smooth, soft, natural contour. As the fat heals, it is incorporated into the tissue, below the tissue that is manipulated with a traditional face lift. Therefore future face lifting will not change the position of the fat.

Jacob Boeckmann, MD
San Clemente Facial Plastic Surgeon

Fat Augmentation With Or Without A Facelift

Facial fillers, including fat augmentation, does not impede the result of facial rejuvenation surgery. Modern facial rejuvenation, under my care, requires a “Lift and Fill” Facelift with fat augmentation to the central part of the face to give you a more natural result. This should be done in the hands of a Board Certified Plastic surgeon with expertise in the science of aging and facial rejuvenation.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 67 reviews

Fat Augmentation With Or Without A Facelift

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Facial fillers, including fat augmentation, does not impede the result of facial rejuvenation surgery. Modern facial rejuvenation, under my care, requires a “Lift and Fill” Facelift with fat augmentation to the central part of the face to give you a more natural result. This should be done in the hands of a Board Certified Plastic surgeon with expertise in the science of aging and facial rejuvenation.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

Face lift after fat grafting

Hi.  When you perform a facelift on a patient who has had fat grafting in the face previously, it's often possible to see the grafted fat.  It can have a slightly different color or texture than the surrounding fat.  You can still successfully do the facelift.  If the fat is immediately subcutaneous in its position, some of it will shift with the re-draping of the skin.  It still is helpful, in the long run.

Best to discuss with a board-certified plastic surgeon or facial plastics guy who can advise you in person.

All the best,

Face lift after fat grafting

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Hi.  When you perform a facelift on a patient who has had fat grafting in the face previously, it's often possible to see the grafted fat.  It can have a slightly different color or texture than the surrounding fat.  You can still successfully do the facelift.  If the fat is immediately subcutaneous in its position, some of it will shift with the re-draping of the skin.  It still is helpful, in the long run.

Best to discuss with a board-certified plastic surgeon or facial plastics guy who can advise you in person.

All the best,

Fat injections and subsequent facelift.

Is highly likely fat injections would change the operative strategy of a subsequent facelift. Your surgeon of course would take these into consideration but I don't think you need to worry about the current injection strategy relative to a facelift that might come later.

Fat injections and subsequent facelift.

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Is highly likely fat injections would change the operative strategy of a subsequent facelift. Your surgeon of course would take these into consideration but I don't think you need to worry about the current injection strategy relative to a facelift that might come later.

Fat injections vs face lift

Thank you for asking about your facial fat injections.

  • If your cosmetic surgeon is not a Board Certified Plastic or Facial Plastic Surgeon, I suggest you see one.
  • Fat injections might be a good approach - but it is important to understand that results are variable.
  • From 35% - 85% of the fat will survive. I am surprised yours will be more expensive than a face lift.
  • Be sure this is what you want done - but if it is and the result is pleasing, it will not interfere with your future face lift.
Always see a Board Certified Plastic Surgeon
Hope you found this answer helpful. Best wishes.

Fat injections vs face lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for asking about your facial fat injections.

  • If your cosmetic surgeon is not a Board Certified Plastic or Facial Plastic Surgeon, I suggest you see one.
  • Fat injections might be a good approach - but it is important to understand that results are variable.
  • From 35% - 85% of the fat will survive. I am surprised yours will be more expensive than a face lift.
  • Be sure this is what you want done - but if it is and the result is pleasing, it will not interfere with your future face lift.
Always see a Board Certified Plastic Surgeon
Hope you found this answer helpful. Best wishes.

Fat Transfer Helpful to Restore Face Volume Issues

Facial aging occurs and 3 ways. They include loss of volume primarily in the cheek and temple regions, skin surface aging with loss of wrinkling and age spots and finally:sagging skin because of gravity and loss of elasticity. Each of these 3 mechanisms of aging have to be approached separately. They do not all occur at the same speed therefore it is likely in reasonable to have filllers such as the use of fat transfer if loss of volume is one of the primary concerns you have at this time. If fat transfer is performed by a seasoned plastic surgeon with great experience in this technique and fat is placed in the proper area it should not be a problem when later rejuvenation surgery is needed. This is because  area sites of fat transfer will shift to a more  rejuvenated position with a facelift procedure at a later date. I find this practice extremely helpful for my patients.

Fat Transfer Helpful to Restore Face Volume Issues

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Facial aging occurs and 3 ways. They include loss of volume primarily in the cheek and temple regions, skin surface aging with loss of wrinkling and age spots and finally:sagging skin because of gravity and loss of elasticity. Each of these 3 mechanisms of aging have to be approached separately. They do not all occur at the same speed therefore it is likely in reasonable to have filllers such as the use of fat transfer if loss of volume is one of the primary concerns you have at this time. If fat transfer is performed by a seasoned plastic surgeon with great experience in this technique and fat is placed in the proper area it should not be a problem when later rejuvenation surgery is needed. This is because  area sites of fat transfer will shift to a more  rejuvenated position with a facelift procedure at a later date. I find this practice extremely helpful for my patients.

Fillers in the face

I am not a fan of facial fillers, especially fat.  Most patients I see who have gad it done say it was a waste of money and time.  I'm sure you will get other opinions to the contrary, and you can make the decision for yourself.  Me?  Not a fan!

Fillers in the face

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I am not a fan of facial fillers, especially fat.  Most patients I see who have gad it done say it was a waste of money and time.  I'm sure you will get other opinions to the contrary, and you can make the decision for yourself.  Me?  Not a fan!

Facelift and fat grafting

Most facelifts I perform include fat grafting at the same time. We are not only pulling and repositioning the skin but also adding volume which is important for facial rejuvenation. There are no downsides to performing fat grafting before a facelift.

Facelift and fat grafting

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Most facelifts I perform include fat grafting at the same time. We are not only pulling and repositioning the skin but also adding volume which is important for facial rejuvenation. There are no downsides to performing fat grafting before a facelift.

Fat transfer before facelift

Fat transfer is a great treatment for facial rejuvenation, and though it is more expensive up front that synthetic fillers like Restylane or Juvederm, the results are better and longer lasting.  It will not be a problem in the future if you need a facelift.  For fine facial lines consider adding laser resurfacing to the fat transfer procedure; this works very well in my experience in producing natural-looking youthful results.

Carey Nease, MD
Chattanooga Facial Plastic Surgeon
4.0 out of 5 stars 24 reviews

Fat transfer before facelift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Fat transfer is a great treatment for facial rejuvenation, and though it is more expensive up front that synthetic fillers like Restylane or Juvederm, the results are better and longer lasting.  It will not be a problem in the future if you need a facelift.  For fine facial lines consider adding laser resurfacing to the fat transfer procedure; this works very well in my experience in producing natural-looking youthful results.

Carey Nease, MD
Chattanooga Facial Plastic Surgeon
4.0 out of 5 stars 24 reviews

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