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I am 10 months post facelift and unhappy with hollowness. Is a fat transfer the solution?

Dr. Dean Kane Q & A Q. I am 10 months post facelift and unhappy with hollowness. Is a fat transfer the solution? 10 mos ago had full facelift with upper and lower blephs and fat transfer (that didn’t take I think). Followed by 800 mc Sciton resurfacing 8 months ago. My skin, neck and eyes look great, but cheeks, under-eyes and around my mouth look hollow and aged. I am so disappointed. Is it volume or skin? I don’t know anymore? Considering a full face fat transfer by a specialist. Opinions or advice appreciated, thanks! A. Thanks for sharing your photos. You do have a successful improvement following your facelift, upper and lower blepharoplasty, fat grafting followed by fillers and skin laser tightening.​ ​I am sorry for your disappointment. ​ ​I do find your lower cheeks a bit hollow as well. This may have not been noted preoperatively due to the descent of soft tissues which when suspended, emphasized the sub-malar cheek dimples / hollows. It is possible that the buccal fat pad may have also been removed or re-positioned to the upper cheek fullness. ​The art of face and neck lifting is a mechanical re-distribution of fat, soft-tissues and skin in a more youthful upward direction. The healing process, injection of fillers and skin lasers or peels stimulate a physiological inflammatory response which adds collagen (scar) and other structural molecules to hold the tissues in place but do not reverse the natural and genetic aging of the skin texture or make up. ​ ​It is for this reason that you and others may be less than thrilled with your successful result and on-going aging related changes. Considerations to renew and rejuvenate the skin texture include:
  1. ​retinoids such as tretinoin using a ZO Obagi Skin Health Certified Team,
  2. ​Sculptra sessions to stimulate the remodeling of skin and regeneration of the skin’s structural molecules
  3. ​Quarterly skin stimulus in the form of lasers or peels.
  4. ​Fat grafting as you have suggested.
  5. ​More fillers.
To answer your question then, it is both, lack of volume and aging skin laxity. ​ ​I hope this has helped, I wish you the best.
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