Excess facial skin after weight loss - would I benefit from a fat transfer or facelift after hitting my goal weight? (photos)

Question

I have lost around 60 lbs in 2 months and noticed alot of excess skin, especially on my cheeks and jaw. Im a 35 year old male, 6 ft 2, around 235 lbs. I know I still need to lose around 20 lbs or so to hit my goal weight. Would I need a facelift and fat transfer once I hit my goal? I feel like Ive aged 10 years in 2 months.

Randal Haworth, MD, FACS · Answer

Based on your photos, you could benefit from a YSMAS lift (which is a deep plane facelift but more sculptural and lasts longer ) or an elastic lift as well as facial fat transfer.

Make sure to consult with a board certified plastic surgeon well versed in those procedures.

I hope this helps,
Best of luck !

Lexie Wang, MD · Answer

Exactly as you said- losing weight has resulted in some aging of the face because of fat loss around the face and also from skin that used to drape around more volume now being saggy/in excess. YOu should definitely wait until you are at your target weight because ongoing fluctuations will impede any kind of results and risks associated with healing. But I think fat transfer is a great way to start, esp while you still have some fat in you- I'd focus on temples, midface for sure. You could also consider a brow lift to open up your eyes- some of this has fallen due to loss of fat around your temples and likely some bone volume.

Timothy M. Rankin, MD, FACS · Answer

First of all, congrats! That is an impressive accomplishment. You are not alone as this is a common concern after weight loss. 
In general, it depends on how you feel about your jawline and neck. Given that you are able to grow an awesome beard, I would think the neck and jawline would be low on the priority list and a simple fat transfer will help to restore some of the fullness in your cheeks (not feminize) and help to fill the tear trough that can make people look tired.

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

Congratulations on achieving such a profound change and best of luck in pursuing your goal.

In a lot of instances, it is worth waiting a little bit before doing surgery as the skin will be able to adapt to some degree and you will make a better decision.

Fat transfer on its own may create a disproportion with the rest of your features and it is more likely that the facelift would generate an alignment between your facial features and your overall change in body proportions.

Michelle Lee, MD · Answer

Hi there! 
Congratulations on almost reaching your goal weight! While I hesitate to use the word *need* when it comes to cosmetic surgery, I do agree that if the excess skin is bothering you, a facelift with fat grafting is a great option for you. This is a common experience post-weight loss. The facelift will reposition the descending tissues and fat grafting goes hand-in-hand with this by restoring the volume lost as well. 
Hope this helps!

Mats Hagstrom, MD (license on probation) · Answer

If you have pictures from before the wait love, it would be good to have it as a comparison.
Midface volume augmentation is probably what you need to. This can be accomplished using implants, fillers, fat, grafting, or using a mid facelift. I don’t think we need a traditional facelift.
And mid facelift is a very different procedure than a regular facelift, and treat very different ideologies.
I don’t think you look all that bad at all and I suggest continue on your weight loss journey. Overall most people feel and look better with weight loss.
Best,
Mats Hagstrom, MD

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