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.

Fat transfer is a great option to restore lost volume in the face. It can improve cheek volume, temple hollowing and improve hollowing around they eye region. It does not significantly lift lax or sagging skin. To treat this laxity a facelift is the best option. Fat transfer can often be used as an adjunct to facelift to enhance the overall results .

Hello, it really depends on what you want , if you really want to address the lower face and laxity, the face and neck lift would be the best approach. You don't always just age in one area so tackling all of this at once will have you appear more youthful. The most comprehensive approach would be the face/neck lift with fat transfer because you can address both at once. Jowls and Laxity will do so much better with facelifts.

You appear youthful with only minimal signs of facial aging. You have a very small jowl forming, and a small amount of redundant skin just lateral to the corner of your mouth. Your overall facial shape and neck contour is excellent. A mini facelift, with SMAS tightening should resolve these early laxity problems with minimal surgery and downtime. Your brow wrinkling would best be treated with Botox or like product. Best wishes.

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello and thank you for your question. You may benefit from a limited incision facelift to address your jowling and cervicomental laxity. To address your temporal and lower 2/3 face volume deficiency an autologous fat transfer could certainly be implemented. A consultation with a specialist who commonly practices these procedures would be useful.

You are an excellent candidate for a face lift and brow lift. The brow lift will lower the hairline, decrease the vertical height of the forehead and pull up the eyebrows. The corrugators can be released at this time. The face lift will pull up the jowls as well as the neck.

Best Wishes,

Gary Horndeski, M.D.

My first observation is that you have had quite a few minimally invasive procedure without a great deal of satisfaction. Unfortunately, I am not surprised.
The most important question for you to consider is what aging changes would you like to see addressed?
Addressing the neck, lower and midface will best be accomplished by a deep plane facelift. A chin implant will improve the result in your neck with the facelift. Fractionated CO2 laser resurfacing will improve the quality of your skin. An endoscopic browlift will help relax your expressive brow/upper third.
Fat transfer will produce more facial volume but will not accomplish any of the other things mentioned; it is usually an adjunctive procedure and not stand alone. Additional facial volume may be required, but I would progress with plan described first.
I hope that this is helpful.