Is it possible for any face lifting technique to specifically target superficial fat pads?

Greetings from Washington DC,
Excellent question! As you probably already have researched, during a facelift the SMAS layer is manipulated in some way (my preference is to do the deep plane technique so you can freely move that layer anywhere). You want to think about the fat pads of the face in relation to that SMAS layer and think of it like a carpet. The fat pads that are superficial and medial (closer to the midline) to the SMAS entry point, are the ones that will be repositioned since they sit on top of the carpet. This tends to be the jowl fat pad and the midfacial/malar fat pads. Most of the deeper fat pads do not really get moved during the surgery since they are deep to the carpet/SMAS (unless the buccal fat pad was trimmed through the deep plane), but may be tightened inwards. I hope that helps!
Wishing you all the best,Dr. SitaparaChevy Chase Facial Plastic Surgery

Great reading up on the anatomy! Yes, there are superficial and deep fat pads, and the aging process affects them differently but in a predictable pattern that only varies a bit between individuals. "Sagging" of the superficial fat pads comes mostly from two things--loss of volume in the deep fat pads and laxity in the skin and SMAS layers. Modern facelifts address both the deep and superficial fat pads based on the patterns of the aging process, so the deep pads are revolumized with fat grafting and the superficial fat pads are repositioned with the skin and SMAS layers. Some of the superficial fat pads can be augmented with fat grafting too, usually the superficial high malar and superficial middle malar fat pads to highlight the cheekbones and give the cheeks a more full, youthful appearance.

Different facelifting techniques can target various deep and superficial fat pads, depending on their exact location. Superficial fat can be left attached to the skin flap and raised with it. Fat can also be reduced via surgical dissection or liposuction at the time of skin flap dissection. For example, if fat is left on the platysma muscle when elevating the neck flap, that fat can be trimmed over the muscle surface to thin down the neck.

In addition to addressing skin laxity during face- and neck-lift surgery, fat pads in certain areas can be directly targeted as well. Besides the repositioning of facial fat, two areas are amenable to direct fat-pad extraction: 1)superficially, the jowls can be removed with a very fine 2.4mm cannula on a very low power-assist setting accessed via a 2mm dot behind the earlobe; 2)secondly, people who are concerned with "round/puffy" facial structures, who lack desired definition, can under removal of buccal fat pads (also knows as Bichat's pads) from the intra-oral approach, thereby giving more definition to the cheekbones and jaw by thinning the midface.

There are many different locations of fat within the face. Some a re deeper than others. There a many different facelift techniques. Some address different fat pads better than others. It is important to choose a facelift surgeon who is experienced in many techniques to get the best result. One size does not fit all - so to speak. Good luck.

It’s good that you are studying anatomy. If you define deep fat pads as beneath the SMAS, then your suspicion is inaccurate. Facelifts target lifting SMAS and platysma which in general lift superficial compartments. When you describe the deep fat pads high and healthy located, I assume you are talking about the high mid face around the zygomatic area or just below it, which SMAS lifts would not touch unless it was a deep plane lift. If you are referring to the superficial fat pads on yourself, it’s best to send pictures asking about those areas. It would really depend on examination of the areas.

As you might already have realized, facial anatomy is quite complex, and that is certainly true for understanding the superficial and deeper fat compartments of the face. Rather than answer your question specifically, which cannot be responsibly done without examining you in person or at the very least seeing photos, it would be best to consult with an experienced board certified plastic surgeon or facial plastic surgeon of your choosing to get his or her opinion in person regarding all of your treatment options. Today there are both surgical and more than ever non-surgical treatment options that may achieve beneficial results for you. Best of luck to you.

Your question would require an examination or at least a photo. But most fat can be removed using liposuction at the same time as the facelift

Dear Tasteful 9198,
The entire face and body tissues are compartmentalized by various fibrous coverings and a network of collagen-like mesh. Understanding how these compartments are joined allows the Plastic Surgeon to lift, tether, suspend, reef-up, pull, and imbricate the fibrous compartments to perform rejuvenation and reconstruction of these tissues.
The skin is layered with a superficial epidermal-dermal barrier, then a thin superficial fatty layer, a muscle-aponeurosis (SMAS) and then a deeper fat layer. Until relatively recently, it would require a incision to lift the skin layers to redistribute them. If no excess skin requires excision, a minimally invasive (non-incision) “thread lift” can compress and / or lift the sub-dermal superficial and/or deep sliding fat compartments by hooking onto the fibrous meshwork and stimulating collagen formation to hold it in place.
I hope this has been helpful.

In our practice for over 30 years, we do not remove any fat in the face, only in the neck. During the neck lift component of a face and neck lift, liposuction removes the superficial fat deposits above the platysma muscle, and surgery is required to remove the fat deposits deep in the neck underneath the platysma muscle. Then a platysma plasty is required. Choose your surgeon wisely based on extensive experience. Study your prospective surgeon's facelift photo Gallery to make sure that it is extensive with results that you like and the patients look very natural