64, do I need I another face lift with fat transfers or just fat transfers for volume? (Photo)

Good day,
thank you for your question.
At 64, if your facial skin has remained relatively firm and your main concern is volume loss—particularly in the midface, temples, or under-eye areas—a fat transfer alone may restore a youthful contour without the need for additional surgery. However, if you're noticing significant sagging, jowling, or deepened folds that are not correctable with volume alone, a secondary facelift combined with fat grafting may provide more comprehensive and longer-lasting rejuvenation. A detailed in-person assessment would help determine the best approach based on your current anatomy and goals.

First of all, fat transfer... what for? to make you look like a balloon? round faced? or maybe to replace the lack of skills to carry out a deep plane facelift? Because I see signs your deep plane was not touched, clear ones, so you got just a basic, quick and easy superficial skin lift (subcutaneous) and I bet you have stretched earlobes, lifted tragus and sweep deformity when you smile. You are a good candidate now for a deep-plane revision face and neck lift, covering the jawls and the platisma vertical bands.

No more fat fillers, did you research the risk of irreversible blindness after that procedure?

What I se below your eyes are lumps due to the fat transferred, which made oily cysts; I wonder myself... if the main complaint of patients at lower eyes is about the fatty bag pads needing removal... how come any surgeon does exactly the opposite increasing the fatty deposits there? It is mind blowing for me.

Never again fat in your face.

Find a good surgeon with solid experience in facial procedures.

Thanks for your question! I think you could benefit from another facelift as well as some fat grafting. I would suggest an in-person consultation for an evaluation. Good luck!

Thank you for your question and for sharing your photo. At eight years out from your facelift, upper and lower blepharoplasty, and chin implant, it's understandable to begin reassessing your facial rejuvenation options. High-quality face and neck lifts generally maintain results for about 10–12 years, so you're approaching the point where a touch-up or revision procedure could be appropriate depending on your goals.

Based on your photo, you may benefit from a revision upper eyelid blepharoplasty and restoration of volume in the under-eye area. Since your previous fat transfer did not yield the desired outcome and you're understandably hesitant to repeat the procedure, strategically placed dermal filler may be a good alternative. While not permanent, filler in the under-eye region tends to be long-lasting due to minimal movement in that area, and when done correctly, can offer natural-looking improvement.

If you're hoping to achieve more comprehensive and longer-lasting results, a deep plane face and neck lift could be a worthwhile consideration in the coming years. I recommend an in-person consultation with a double board-certified facial plastic surgeon to evaluate your current anatomy and discuss the best path forward based on your specific concerns and goals.

You might not be able to get the jowls all the way better without a revision facelift but I would start with fat grafting to the under eyes and cheeks. You might also benefit from a lip lift and CO2 laser to the face. You may be surprised with how much improvement you get with those three things before you consider revising the facelift. Hope that helps!