Depending on your needs, a facelift or facial fat transfer alone may be enough. But many of our patients benefit greatly from combining the two procedures. It’s natural to lose fat volume in your face as you age, but this loss sometimes leads to loose or sagging skin. Addressing the loss of volume and skin laxity together creates a more complete rejuvenation.
Although both a fat transfer to the face and a facelift are effective rejuvenation procedures, each has a specific purpose. A facelift can lift and tighten sagging skin and wrinkles, but it doesn’t address the loss of volume in the face. You’ll have tighter skin, but you may still have noticeable hollows beneath it where you’ve lost fat volume.
Facial fat transfers also have limitations. This procedure can restore lost volume, but it doesn’t lift sagging skin. Patients with jowls and neck bands (platysmal banding), for example, will still have these issues after a fat transfer. Things may improve in certain areas of the face, but the overall results may be less than satisfactory. Combining a facial fat transfer with a facelift addresses both problems to create better results.
Together, these two procedures:
A facelift and facial fat transfer combination is ideal for patients experiencing volume loss along with mild to severe skin sagging. Although there is no age limit for surgery as long as you’re healthy, most of the patients seeking this procedure are somewhere between their 40s and 60s. To be healthy means that you don’t smoke and have any chronic conditions, such as diabetes or high blood pressure, well under control.
Ideal surgical candidates are willing and able to follow their pre- and post-op instructions diligently and have realistic expectations for the procedure. A good plastic surgeon can absolutely make you look younger, but they can’t give you the skin you had as a teenager!
It takes approximately three to five hours to complete a combination facial fat transfer and facelift procedure. You will be under general anesthesia during that time, but you can rest assured that your patient care team will carefully monitor and care for you while you nap. While you’re peacefully sleeping, your procedure will happen in the following sequence:
We’re just going to put it out there: recovering from a combination procedure is more intense than recovering from a standalone surgery. You will likely experience more swelling, bruising, tightness, and numbness after combining a face lift with a facial fat transfer. Any tightness or numbness will still be temporary, and swelling and bruising still manageable, but expect them all to be a bit more profound. You may need a bit longer to recover as well, but your overall recovery time will still be shorter than it would be if you did each procedure separately.
The list of things you should avoid during your recovery is the same for a combination procedure as it is when you have each procedure done separately. The main difference is that since you’ve had more done, there are more surgical results to protect. To get the best possible outcome, it’s vital that you avoid:
After a combination facial fat transfer and facelift procedure, most patients can return to desk jobs in about 10 to 14 days. You will need to wait a little longer if your job is extremely physical, but your surgeon can give you an idea of how long they expect you to be off work during your free virtual consultation.
While you can go back to work in about two weeks, you may want to schedule your surgery at least three to four weeks prior to any social events. This allows time for swelling and bruising to ease. If your event is going to be heavily or professionally photographed, you may want to schedule surgery six weeks ahead of it.
Both facial fat transfers and facelifts are known to produce long-lasting results that patients enjoy for many years, and sometimes for life. Ordinarily, however, about 60 to 80% of the cells injected during a fat transfer to the face survive. These odds can be higher when the procedure is combined with a facelift. Blood flow to the face increases after a facelift to help heal the disturbed tissue, and fat cells that are going to survive in the face need to develop a steady blood supply. It’s a perfect combination.
A fat transfer to the face makes you look younger by replacing lost volume, but it doesn’t stop the aging process. In time, gravity’s pull can shift the transferred fat slightly downward. But a facelift tightens the skin and the facial SMAS layer, and this tightening can serve to help keep the fat cells in place.
The SMAS is more long-windedly referred to as the superficial musculoaponeurotic system. It is a layer of tissue comprised of fat, muscle, and connective tissue located just below the skin’s subcutaneous fat layer and serves as the support structure for the face. The SMAS layer is tightened during a facelift, and it can help support facial fat grafts.
You will continue to age normally after a combination facial fat transfer and facelift procedure. Your plastic surgeon can’t stop the clock—but they can turn it back. After this procedure, the aging process will start anew from a younger place. If you look ten years younger after your procedure, then you’re ten years ahead of the aging game. Touch-ups after this combination are less frequent and more subtle than they may be after either procedure alone.
Combining a facelift and facial fat transfer can increase the risk of adverse events. You will have the risks of both procedures to contend with, as well as risks that may come from a longer period under anesthesia. The risks of a combined facial fat transfer and facelift include asymmetry, infection, nerve damage, and fat embolism.
As always, the best way for you to minimize surgical risk is by choosing a skilled, experienced, and knowledgeable plastic surgeon. At Mia Aesthetics, we protect our patients by maintaining a clean and sterile surgical environment, continuously training surgical support staff, and providing our surgeons with the cutting-edge equipment they need to employ current best surgical practices. Blunt cannulas help avoid nerve and vascular damage, as does our microinjection protocol. Microinjections also help prevent asymmetry.
Combining a facelift and a facial fat transfer to the face can result in a powerfully transformative cosmetic surgery, but we don’t recommend it for every patient. We view every patient as the unique individual they are and perform our surgical assessments based on this philosophy. Sometimes prior surgeries, medical conditions, skin quality, or lifestyle factors can negatively impact the expected results or, more importantly, patient safety. We simply won’t compromise the latter.
Not everyone needs to take the combination approach. Young patients, for instance, are sometimes bothered by volume loss but don’t yet have deep facial wrinkles or creases. In this case, a facial fat transfer alone may do the trick. Older patients sometimes retain most of their facial fat but experience sagging skin or jowls. A facelift by itself will often be enough for them. A combination procedure can be beneficial, but it’s not something every patient needs.
A combination procedure may be right for you if you have lost fat volume in your face and have deep wrinkles or sagging skin. You may, for instance, have hollow cheeks and sagging jowls, or have a sunken area beneath your eyes along with loose neck skin. In these cases, a combination procedure is often an excellent choice.
Absolutely. For those with minimal sagging primarily in the lower face, a mini facelift can be combined with the facial fat transfer rather than a full facelift procedure. This combination can result in a bit less downtime while still providing great results. We assess all of our patients individually and never take a one-size-fits-all approach to surgery. If a mini facelift is all you need, we’re happy to accommodate.
Prior to your procedure, your plastic surgeon will perform facial mapping to highlight areas where you may need more volume. Your surgeon further performs your facelift before doing the fat transfer portion of your procedure. The guidance of the facial map combined with the new location of your tissue after the facelift is what guides fat placement. Remember that plastic surgery encompasses a unique mixture of technical skill and artistry, both of which help your surgeon determine the best way to utilize injected fat for a natural result.
Not necessarily. When done properly, the facelift may actually help improve fat retention by improving vascular contact. The healing facelift will prompt your body to send more blood to the area, and transferred fat cells need to establish a good blood supply if they are going to thrive. This sometimes leads to higher fat cell survival rates with a combination procedure.
Yes. Many patients opt for neck tightening at the same time, especially if jowls and platysmal bands are present. The general rule is that you can combine as many plastic surgery procedures as you like, so long as your surgeon deems your chosen combo safe. They may also caution you if combining certain procedures will make recovery significantly more difficult or uncomfortable.
Usually, yes. You will pay more up front for a combination procedure because you’re having more work done. But combining procedures typically costs less overall because you only need to pay certain fees, such as anesthesia fees or surgical facility fees, one time. You may also lose less work time to recovery since it is usually shorter for a combination procedure than it is if you do both procedures separately.
It can, yes. The facelift portion of the surgery would address the jowls while the fat transfer procedure corrected marionette lines. A combination facelift and facial fat transfer is helpful any time loose skin and volume loss are both present.
Most people feel normal looking enough to attend social gatherings and return to work in two to three weeks. You will still be healing internally at this point, but most of the bruising and obvious swelling will have abated.
Approved dermal fillers and fat transfer procedures are both considered safe, and each can be combined with a facelift if desired. Fat, however, is natural rather than manmade, which reduces the risk of an allergic reaction. Fat also integrates permanently into the face, but dermal fillers require ongoing touchups as the body absorbs them.
Maybe. Minor refinements are sometimes needed as you continue to age or if you’re not completely happy with your results. If you want to tweak your surgical outcome, you should wait six to 12 months after your procedure. Touch-ups due to age won’t be necessary for several years, if ever.