Am I candidate for mini/full facelift or would a fat transfer suit better? (Photos)

Hi and thank you for this question! Timing of a facelift is a very personal and complex topic. Ultimately, you are a candidate for surgery from what I can see in your pictures with excess skin laxity, jowls, and midface descent. However, that does not mean that you should do it or that you need it. Many patients in your scenario would wait years and others have already been thinking about it for years. It really depends how much these areas are bothering you and if the timing is right in your life. Fat grafting treats volume deficiencies and is a great adjunct to a facelift procedure by adding volume to the midface/cheeks. Fat grafting can be performed for the temporal region and under eyes as well. Alone, fat grafting would not address your jowls or skin laxity. Ultimately, this decision depends on the areas that are bothering you and particularly if they are bothering you enough to undergo a surgical procedure. Unfortunately, your story with the threads is too common with either zero or a minor amount of improvement that does not last. I would suggest consulting with several surgeons that focus exclusively on facial rejuvenation procedures either in person or virtually. Many surgeons are able to perform a face/necklift and fat grafting together if that is what you decide. You are working hard on your skin already and the next step would be laser resurfacing with a fractional CO2 laser if you were looking to improve the skin pigmentation and fine lines at the same time as surgery. Finding the correct surgeon fit and someone who will stick with you through this journey is critical so take your time when deciding. Good luck!

A deep plane facelift would best improve your upper cheeks, and lower face and jowl area, including tightening of the neck. Fat grafting would not improve areas around your mouth.

You are a suitable candidate for a full facelift; this procedure comprehensively addresses issues such as sagging jowls, increased skin laxity, and volume loss in the temples and around the eyes. Additionally, fat injections can be a great option to restore volume in areas with hollowness, particularly under the eyes and in sunken regions of the face. You have previously tried Botox, fillers, Sculptra in the midface (1.5 years ago), and threads (4 years ago), but these treatments may not have provided the desired lift and definition. While retinols and HGF/exosome serums support skin health, they cannot replicate the comprehensive effects of surgery. Although photographs provide valuable information, a physical examination is crucial to fully understand your facial structure and skin elasticity.