Smas Facelift with Fat Transfer Age 44

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I planed this sugery long ahead as I am a working...

I planed this sugery long ahead as I am a working mother I have s lots of organizing to do I will even quit my job as I won t get enough time off to heal Right now I am worried about so many things: how things will turn out , how my daughter is going to cope with my new me ( she is only 8) how long the healing will take, if I do the biggest mistake in my life but I am so focussed on the sagging of my face, if I will find another job and many other things.. I will not post the name of my surgeon as I don t want to hear negative comments about him I will be travelling around half of the world to get this surgery I am not rich so I will have to worry if I do not get a job after my recovery period I have been on this site for two years and am very impressed of this community I do hope to get some support and look forward to share my experience with you Almost forgot: I willbr going through this all alone My husband and I will get divorced soon I will be travelling alone and heal alone This sounds awful but I really want to do this.

2.5 months before

Time flies.. Only 2.5 months to go The planing for this surgery started about three years ago I have been carefully searching for an excellent facial plastic surgeon Another plastic surgeon who is well known for his expertise in his field has referred me to him As I knew that healing will take several months I had to plan a sabbatical leave - i actually quit work and have to be looking for a new job after my healing period. I took some pictures of my face - at angles which are not very flattering - to remind me why I am doing this. I have thought about this procedure over and over again and asked myself why my looks are so important to me. I am far from being amused looking at my reflection and I stoped buying clothes two years ago as I didn t like my face anymore and buying clothes didn t seem to be worth it with such a face.
For me it's all about what does really matter in life. If i could choose between a beautiful face and a great job opportunity I would choose the face. It is not rational nor intelligent to think this way it also seems somehow primitive but it is the way i feel. Job success does not feel as good as a younger face - this is odd but exactly how I feel! How come that we are all educated but still somehow focused on our looks? Somehow I think inspite the progress of womens liberation there is no way to overcome biology? I am very curious what you wonderful realself community think about this.

One day before surgery

Right now I am just terrified. I started planing this surgery two years ago and while surgery is now approaching it just feels so unreal. I am staying in an airbnb apartement and will have a private nurse looking after me the first days. But she won' t be here 24 hours just a couple of hours each day.
Besides being terrified I am so ready for it as I cannot look at my face any longer. I am only 44 years but most people think I am older. Even in my early thirties people always thought I am in my forties .
Tomorrow evening I will look like an alien . Even knowing that I am very scared seeing myself like that.
Being all by myself is not optimal but as I come from another country having my surgery in the US there were nit many other possibilities. My husband takes care of my kids while I am here.
So everything is unfamiliar here and that doesn t make it easier. Hope everything goes smooth.

Some other thoughts..

I mostly feel comfortable travelling alone but right now I feel lonely and I miss my daughter and also my cat!! I wished I would have the cat with me.. weird.. It is time to have my surgery otherwise I might become weird lol..

Second day after surgery

Feeling a bit down. Swelling still increases and pain level goes up. Mostly my yearsand my neck hurts. It is not easy to look this scary without questioning if I did the right thing.

Third day

Day 4

Swelling is stil increasing and my neck is super tight. It looks red and feels very hot. I have the aqua cooling machine which helps but my years dont like the mask too much. I am still scarred to loose hair or get an infection or that i might look that way for the next weeks .. I am eating oatmeal, avocado and having smoothies from vega - these are great!!! Yesterday has been a good day and I even went for a walk with my nurse. My son back home - he is 17 years old - warned me not to go outside because he was scared people might make fun of me the way i look - he is so protective when it comes to that. He is back home and writing me sms if everything is ok. I will not send him any pictures it would scare him too much.
So the nurse said I will experience a paek of swelling and pain the third or fourth day. As i am in constantky pain i have no idea if i already reached it.
Tomorrow i will get my drains removed . Hope it will be bearable.

Day 5 -getting my drains out

Ready to get my drains out. Hoping that my swelling will subside after that a little bit. Pain level is going up and down and mostly high in the evening and in the night. Yesterday I took again a walk with my wonderful nurse. From today on I will be alone but can ask her to come anytime. Getting a bit bored being all bymyself. It would be so wonderful to meet others from realself.
One picture is from me around age 30 . I had a hangover and looked a bit swollen around my lips and eyes : i really like that look so my ps took the photo into surgery and i think the outcome might be close to the look back there - hoping so . The other picture is from this morning ready to leave to take my drains out.

Incisions around years

Day 6 Drains out

Trying a little smile. I think my face doesn t show in the pictures how wide and swollen and stretched it actually is. Still in pain during night time. Removing the drains and some stiches didn t hurt. But I took pain meds before - strong ones because i was so scarred of it. Neck still super tight. I think I will still have a perfect jaw line at age 80 ???? My swelling is not going down - or i just don t notice it. And it is very even -this is certainly rare. Bruising is also very low. My tongue is yellow and it looks awful. I have gotten something to wash my mouth as they think it might be some fungus ? Has anyone experienced this before?

Day 9 - just healing

Overall I feel fine on day 9 post. There are some insecurities about my eyes, cheeks but I am still early in the process.
All my stiches came out last Friday. To numb the area some ointment has been applied to the incision areas. This has been fine except that I don t get it out of my hair anymore. After washing it three times it is still greasy. Maybe someone knows a good shampoo for things like that?
Swelling is going down just slowly. My eyes are much better in the morning than in the evening. In the evening i have very puffy eyes especially under my eyes. One eye appears smaller than the other. Face still very wide. The swelling is biggest around my jaw line and upper cheek - - around eyes and temples. Lower part of my cheek looks almost hollow - which is my biggest concern as I wanted it to be filled up there. But yes, i am early in the process and hope that all evens perfectly out.
I seem to be obsessed taking pictures every dayin various lights and angles. In daylight i look nicer than in certain artificial lights.
My scars heal very nicely.
I have another two weeks and one day of healing before seeing my daughter. So I hope that I will look better by then. One other thing: i think the pictures do not show how wide my face looks like. In the mirror it looks worse. How come?

Day 10 -

Feeling good so far. Swelling goes down every day just in tiny little steps. Went out for a few hours and all went well. My glasses don t fit anymore because the swelling went down and the frame of my glasses have widened. So I ll have to find a store to fix that, but don t want them to adjust them directly on my face due to my scars lol.
Started doing some medidation again. Also sending lots of wishes to the universe - hope it helps.

Day 12 - slow healing process

My incisions heal perfectly. I can barely see the incisions behind my ears, first I thought there weren t any. Incisions in front my ears heal very nicely. The incisions above my ears are most noticable - but i think healing will continue and these will most likely also not be detectable. Still a wide face. Upper eyelids are at this stage also still puffy, hopefully this will decrease a bit. My PS did some fat transfer in my upper eyelids as I dont like that hollow look in the upper eyes. I had that when I was younger -genetics- and I always liked my face best in the morning when it showed this perfect amount of puffiness.
My lower lip looks a bit overdone when I try a broad smile. That will go down soon I think. My jowls are gone - i don t miss them at all!! What bothers me most at this stage is the wideness of my face, my broad jawline as there is lots of swelling there. Also lots of swelling in my temples. Puffiness under my eyes increases during the day so it looks best in the morning.
Tightness in my neck remains and one can actually see it from the side- it looks very very tight and unnatural. Everyone must think i have a tine thin rope around my neck.
Yesterday went to the beach walking as it was a cloudy day. First time after surgery I put on suncream and makeup - It looked disastrous as i tried to camouflage the bruising with correction makeup lol . I am not good at this at all! In my normal life I only wear suncream and some light makeup foundation.
What I have not talked about yet and what really bothers me is that I lied to many people about this surgery. As I had to tell people something about my disapearance for almost a month- i had to tell them something. So I told them that I went travelling in the US . So this is actually true!! Everybody has been so happy for me that i had this opportunity. And I felt so bad!!!! about myself!!! I just told a good friend of mine about my fc and my family knows -expect my daughter and my cat. Where i live i bump into so many people everyday i would have had no chance to hide. I am socially a very active person so this will be a challeng to cope when i return home. The good thing about hiding is: i live in a country where it is very cold now so i can wear a warm cap even indoor - there are many people who actually do this. I also can wear big scarf -i am a scarf wearer anyway. I wear scarfs all the time indoors outdoors and light scarfs in summer lol. The scarf wearing thing never had anything to do with my neck. Just liked the warmth around my neck.
At this point I wanted to thank you all for your supportive comments! I wished we could all gather together and meet in person having a super time!! Oh that would be so much fun! As i am by myself for quite some time I don t talk or interact with people at all, so please stay with me on this journey! You are all so wonderful people!!

Day 15 -ups and downs

I have to admit: i have never taken so many pictures of me of every weird angle there is.. I think I have no idea how I looked before as I have almost never taken pictures of myself. I should stop doing it in such an obsessive way.
This morning I woke up and felt very depressed. My neck feels very tight like it had a cord around the neck. One can also see that invisible cord. I was like: OMG what have I done to myself. Was it worth it? I feel very unconfident about my appearance. I don t know if people can tell that I ve had surgery. I don t know yet how much explaining I have to do back home. I am wearing eyeglasses instead of my contacts that might distract people I hope.i
I think I heal well. Except one incision on my upper eyelid didn t close all the way yet. My scars around the ears are fine. My scars above the ears worry me even though these are healing fine too they are hard to hide. Wearing my hair down is not possible right now as the feeling of hair around my neck drives me crazy. It s like a tickling sensation and at the same time some numbness.
I think there is still lots of swelling in my jawline which makes me look masculine in the evening. I think I look best in the morning as there is more swelling in my cheeks and less in my jawline. There is also swelling in my upper eyelids. Actually I can t see my upper eyelids yet. I do hope this goes down some more. Swelling also increases during the day below my eyes which is not nice too look at.
I still think there is hollowness in my lower cheek. I hope things settle in nicely and swelling in my jawline goes down. Right after surgery may jawline and chin looked perfect to me- it looked more defined and my chin more pointy. Now it s more square.
Another 8 days to heal and look more like myself begore I go home.


Picture of before surgery

Day 18 -

The last days have been tough. I suffered from another depressive episode. Everything seemed not ok. I have not been happy with my face, my life and I felt very lonely. I am now hoping for better days. Today I had a consultation with my PS. Everything seems right and as everyone states:healing takes time.
I look better in the morning than in the afternoon. In the morning my swelling seems to be on the right places on my face. In the afternoon I get malar bags, my chin and jawline feels more swollen and my lower cheek hollow. No idea if things will settle nicely where U would like to have them. Another 5 days till I go home. I miss my family sooooo much.

Day 20 -

I wish all of you a wonderful thanksgiving! Right now I am having my breakfast which is mostly oatmeal with milk and almon butter. I love almond butter - 100% almonds, nothing else added. It s sweet, lots of fat and protein. The perfect combination!!! So when I crave sweet food I eat almond butter. I eat one glass of almon butter within four days!!
as i felt so terrible the last days I texted some very close friends and it made me feel better. I am also greatful about this community where I can share all of my thoughts hopes and worries.
my swelling has gone down in my cheeks and jawline. It feels more softer now which is a relief. The malar bags are getting better and it still shows in the evening but looks better every day. One side is still more swollen than the other but that does not worry me. My neck is still super tight and I think it will be tight till I am a very old lady lol. The fat on my temples still looks a bit weird but keeps decreasing. I am now wearing a compression garment to help keep fluids out of my face. I was not allowed to wear it before because of my fat transfer. I had a total of 43cc fat which may sound like it is a lot but actually average is about 70 to 80cc. I probably wouldn t look good without this fat.
The hollowness in my lower cheek is getting better as my jawline is less swollen. My PS says I would look great by the end of the year. Hope so as i am starting a new job in january. Yesterday I tried to cover my scars around the temple area with makeup and it look much better. I still have to cover them which is not very easy with fine hair. My incisions around my ears are perfectly hidden and the incisions on the back of my ears along the hairline? I have not seen them.. i just can feel them but not see them.. my P S also helped with my wrinkly earlobes and took some skin away there with one or two stiches. Looks perfect. My eyes are getting better but are not yet where I would like them to be.
It would have been nice though to have some more fat in my cheeks but after the healing I can always add some additional filler there. I would go for fat but as I cannot just drop by as I live too far away I will probably go with fillers. But lets see and wait how it will look loke in three or six months.
My depression is still with me. I feel better in the morning than in the evening. In the evening I don t look as good as in the morning that may be one thing that adds to feeling down and I just feel more lonely then.

Scars day 20

Scars are healing perfectly. If I had more hair it would be invisible. Pictures without any makeup.

Depression and plastic surgery

I just wanted to share my thoughts about my perspective on depression and plastic surgery and at the same time I want to point out that this is just my perspective and my experience.
I always suffered from depression. It increased the last few years but there are still lots of happy moments in my life when i can enjoy life at its fullest.
I didn t like my face for years. It started with jowls which I think is absolutely the worst thing that happens to a face while ageing. I don t mind wrinkles, darker spots or freckles. But that s just my opinion.
I have always had a low self esteem and it even increased with my ageing face. But it is not only about my appearance and looks. My psychological state isn t very steady. I am a highly sensitive person and experience life, smells
, lights and people's moods and feelings very intensively. I know there are many people out there who are highly sensitive too and this makes me feel more comfortable.
what I d like to point out is: i think my PS did a fantastic job. My body also does a fantastic job in healing. It still needs time. My swelling did go down some more and I feel my face is softening some more which is very comfortable as the tight feeling decreased a bit. It feels better now to go outside as my jawline and under my neck still gets warm but not hot as it did the last week when i went outside.
My anxiety about reactions from my social environment is still with me. But my depression has lightend up a bit since yesterday and I hope it continous to go up.
My husband once told me: " you are travelling around half of the world to get your face done by one of the best PS. But you do nothing about your psychological state. Why don t you look for the best psychiatrist there is on this planet and get help?" And yes he is so right! We are still married but since over an year not a couple anymore. We live as a family under one roof and he is my soul mate and my best friend. After struggling with our relationship for about 26 years he finally said that we should stop trying to be a couple with all this complicated issues related with being a couple. I still miss him though. But he is perfectly right. We were an on and off couple for 26 years and it has always been me breaking up and going back to him. He is truly the best man for me on this planet :-).
What I also wanted to share with you is the issue about not yet coming out with the name of my PS. There are about four people here on realself who are very unsatisfied with their outcome with this PS. One particular is writing all sorts of weird comments on other profiles even on those who were happy with the outcome. It is always about perspectives. I as example wouldn t have like big cheeks on my face as I never had big cheeks my whole life. Sure: right now I feel like it would have been nice to have a bit more fat there but I can still add some fat or fill later after six months or so. I thought about those people and their unsatisfied outcomes. Things can always go wrong with plastic surgery, people heal differently and also have different expectations on their outcome. I pointed out that I d prefer slimmer faces others may say they would like to have round puffy cheeks and so on. I think it is absolutely critical to articulate well what we would like to achieve with surgery.
Five years ago I has sculptra injected. It looked nice but a but too full while smiling that s another reason why I wanted to be very conservative with the fat transfer. I experienced some nodules with sculptra but I only could feel them and these were not seen so it didn t bother me.
So I wish you all the best for body and soul while recovering. And a big hug to all of you! You are amazing ladies! Thank you so much for all your encouraging words and thoughtful thoughts!!

Day 30

It has been 10 days since my last update. I returned home last week and I am happy I did so. Having my family around makes a huge difference psychologically. I feel much better since. My eight year old daughter didn't notice anything about my surgery, my 18 year old son liked my appearance - I still look like mummy! My husband was just happy everything went well. He also liked my appearance in so far as it does not look like plastic, stretched or much different from before. People who know about my surgery said I look different while talking - somehow stiff. Well, my facial muscles have probably still a lot of healing to do.
I am wearing my glasses so my eyes are well hidden - makes a huge difference in appearance. I think other people I bumped into might have noticed some change - some more than others but didn't say anything. One person said I looked tired - well, understandable: my eyes are still swollen, looks like malar bags. The fat below my eyebrow may support the sleepy-look.
Since returning home I have been distracted from looking into the mirror and taking hundres of selfies from all sort of angles, which is very helpful during this healing process.
I still don't like my look too much. I thought of what bothers me, which is not very easily to find out. I like my pictures better than when looking into the mirror. How come? I also think my face looks somehow flat, too wide. I don't like my eyes yet, but they have gotten better. There is still lots of swelling around my jawline, temples. My upper cheek, right on top of my cheekbone is also swollen and hard - exactly where the high smas sutures are placed underneath. I think and hope my face will soften with time: right now it is very tight, also in its appearance, maybe this causes that flat look? Sometimes one eyebrow seems to drop some more than the other and there is asymmetry in my eyes and also in swelling in jawline.
My lower cheek still looks to hollow. But it might also get better when things settle. I still don't know exactly what "to settle" constitutes of: will things soften, drop a bit?
I had 43cc of fat injected all over my face. I have no idea how my face would look like without it. Today I think it could have been more around my cheeks. But I prefered not to have too much fat injected. I also wouldn't have had the downtime which goes with overfilling. I can always go with fillers too fill that up.
Pain and tightness: Most people on realself don't experience pain after a facelift. I think this is very individually. I experience the tightness as pain. Also painlevel increases during daytime. In the afternoon my jawline and ears feel hot, which is very uncomfortable and for me painful. My neck also gets red during daytime and feels tighter in the afternoon/evening. I have been surprised about that. I thought it wouldn't be in pain. I started taking pain pills in the afternoon as it doesn't make sense to me to be in pain for hours.
Since my return home my activity level also increased - had to. And I must admit I am not back to my full energy level yet.
But overall I think I will get a very nice outcome. I knew that it will take at least three months to start liking my new look. The facelift approach of my PS takes longer to heal, so it is all within the scope of the expected healing process. Right now I have to go and get another lymphatic massage. I will post pictures later.

Four Weeks

Almost five weeks - do people notice?

I have been encountering people in various situations. These were friends, colleagues (not seeing them very often) and people I small talk and didn't know before but just met during social daily situations. How do I know if they know??
As example I was talking to another mother on a get together of my daughter's swimmclub. She was sitting right next to me. While talking her eyes constantly wandered to my left cheek. So, I don't know if she thought my cheek looks a bit weird, too pulled, plastic etc. Yes, I am Aware that I am very focussed right now on people's reactions and it might be, that I interpret something into a situation. Anyway: I think I cannot rely on the judgement of my husband only as I think he wouln't even realize if I had one ear less (slightly exaggerated).
Social situations are still very challenging for me as I don't want people to know. And somehow it seems to me so obvious that I had work done as my face just looks too smooth and still swollen.

Yes, they notice

Just a quick update: my 8 year old daughter actually didn t say anything to my changed appearance. Today I asked her if she thinks if I looked different. Here's what she said: she pointed at my lower lip and said these were bigger, also looking at my eyes she noticed a change there. The eyebrows were wider and one eyelid looked droppy like daddy's. My cheeks were fuller. And on top of that she told me that a girl of swimmclub told her that I would look differently since she last seen me. OMG! I didn t even knew the girls name! That girl has not seen me very often and just for seconds. So: Probably most people especially women will notice change. Some are irritated for some time and some are just not interested enough.right now I am tempted to ask a bit around wheater they noticed anything about my appearance. But I don teven know if I really want to know. Maybe that would worry me far more- knowing that people do notice! And right now I am still healing and therefore I am not too selfconcious about my appearance.

Five and a half week - Don't feel like myself yet.

My face still changes every day. The swelling under my eyes seems to diminish and there is only little swelling in the evening. One eye seems to be pulled down a little since today but only noticable to me. There is some discoloration around my ears and on my left cheek. My Skin around my ears looks very tight and shiny but not stretched.
Actually I have no idea how I looked before surgery. I avoided looking into the mirror before as I couldn't stand my reflection anymore. I also took pictures at the worst possible angles to convince myself that surgery is the right thing to do.
When I show people my before picture they say I didn't look like that before and that I have taken very bad pictures of myself. Yes, there are other very nice before pictures.
I get tired of looking at myself. When I get up in the morning I think I just want to get back to normal. I don't want to be confronted with this pulling and stretching sensations. I am also tired of covering my scars above my ears and restyling of my hair. I also don't want to be confronted with people's reactions anymore. Before I was looking forward to meeting friends and colleagues. Now it's like: how will they react, will they notice, will they search my face for changes. And I am like: following there eyes while talking. It seems they keep on staring at my cheeks and jawline but it might also be I only imagine it.
I asked one friend who didn't know about my surgery before if she noticed something. And yes, she did but didn't know what changed. I admitted having my eyes done and getting fat transfer. Actually it feels better to admit having a certain amount of work done than saying nothing.
I don't feel good to write negatively about my experience. As I don't think people like to hear such a discouraging review. I still think my outcome is already very nice and will even be better once all the healing is done.
It's just that I am having difficulties to cope with the psychological effect of having a different face. Probably one should only undergo facelift in a very stable psychological condition before surgery. If there were self doubt before these may worsen after surgery.
I am also wondering what happened to some realself member who updated their review till day 12 or 30 and suddenly seem to dissapear. I take it as a good sign when somebody stops updating their review after a few months as I assume they are just back in their normal lifes. But I wonder if this happens already at such an early stage.
I think I have gotten or will get a very good result. But still: it's a facelift right? Before my surgery I thought I will be perfectly fine after a while and feeling like before. I thought my facelift would feel completely natural and like me. But I don't feel like that at five or almost six week. Will I ever feel like this again?
Recently I have read a quote from Tom Ford:"You always notice a facelift on a woman. It's a tightness around the ears, and the scar is usually inside the ears. If I suspect it's been done, I usually move around until I can see it. But with a man, it actually pulls your beard and your sideburns back, and that's what's so strange." It made me feel so bad. Why is it important to him to see if somebody had a facelift?! He actually moves around a person till he sees her scars?? Now what? Yes, I had a facelift but still don't know how I should feel about it.

Six week - look like myself again

Another try to upload pictures

4 Months update

Now it is about 4 months and my face is still changing. My jowls are gone, my neck tight. Scars are healing nicely. Fat transfer has settled. As I only received 43 cc fat I have no idea how I would have looked without it. The fat in my lower lip has stayed wich is surprising as many RS-members seem to loose the fat in the lips first. There is not much fat in my cheeks - would have been nice to have more there. Enough fat has stayed in my temples which looks nice. Under my eyes it looks somehow hollow, so not much fat stayed there.
Overall I think my facelift looks good, natural and healed fine so far. What bothers me the most are my marionette lines. My PS indicated that a facelift would only have a minor impact on the marionette lines. My right side looks better than my left. So depending on your face you will achieve a great result with a facelift in terms of jowls, eyes etc. But if you had marionette lines before you will most likely still have them afterwards. There has been fat transfer but I will most likely need more filler to flatten them.
Depending on the lightning I look completely different. My marionette lines look worst outside with cloudy weather. This is all very confusing. So, actually I don't trust before and after pictures as depending on the light the face may look very young even with poor results. there are many before and after pictures with filter - even here on this forum. I clearly don't understand why people put filter on their pictures. No one can see the results achieved like this. I also would never trust a doctor who only shows patients a few weeks or only days after surgery as there is still lots of swelling and most of these patients look not better at all after 6 months of healing (see this doctor of the UK who aggressively advertises here on RS-forum. His results are poor after 6 months. Incisions are also very poor). I might be very critical at this point but I think PS should be honest with their patients what can and/or cannot be achieved through this surgery. My PS has been honest with me and told me that I would not get rid of my marionette lines completely after surgery. I am still somehow disappointed but I shouldn't. Going through this surgery at the age of 44 the expectations are very high and although I look younger than before it didn't take 15 years of: maybe 10? Friends of mine who didn't have plastic surgery look better as they never had and probably never will have marionette lines. I also don't think I look better or look as good as I did 10 years ago as I think the surgery changed my looks not in a better way. I think I looked better without surgery 10 years ago. I realized there is no way I can turn back the clock - somehow I thought this surgery could do this: I was wrong.
I paid 35 000 USD for the surgery. Not counted the time I didn't work, the accommodation, nurse, flight etc. That's probably the reason why my expectations were this high. I paid a high price for looking younger and the results achieved are good - I think my doctor did a great job. But he still is not a wizard, right. There is no such thing like this.
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