Filler or fat grafting for Face? When getting mini face lift? (photos)

Having a mini face lift with temple lift my doctor does not do fat grafting he's going to do filler in my cheeks , says he doesn't like the fact graphing do too it doesn't last and move want opinions ?

Doctor Answers 4

Filler or fat grafting for Face? When getting mini face lift?

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  From the photos your cheeks are flat anteriorly (in the front), jowls are present and the chin appears to be weak.  These factors combine to create a rectangular shaped face. 

 Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Fat transfer despite its popularity is far less reliable at creating a specific shape than a facial implant (cheek, chin) or using an "off the shelf" filler.  For that reason, I don't use fat to shape the face but instead use a dermal filler or facial implant for a permanent enhancement.

Hope this helps.


Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Fillers in face

You would benefit from volumization of the upper cheeks.  I prefer Voluma but also use Sculptra and rarely fat for the reasons you have mentioned.  I would suggest doing the filer before the lift as you may not need/want the lift if the volumization corrects your problem.

Richard O. Gregory, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 11 reviews

Fillers Work Well With Facelifts

A mini lift plus a hyaluronic-acid based filler such as Juvederm Voluma or Restylane Lyft should provide a natural rejuvenation. You also might use some filler around the eye area and a little Botox to give a slight brow lift. I'm not a big fan of fat grafting. I hope this helps.

Fat grafting with facelift

Thanks for your question. Fat grafting can work very nicely in combo with a mini facelift. It helps to fill in the contours, and would be great for your temples if they feel hollow to you. You could always do the fat grafting at a second step too. Best wishes.

Paul J. Leahy, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.