Facelifts require some factfinding

Q. I’ve been thinking of having a facelift. I’ve gone to several doctors who tell me I should have a facelift along with fat grafting. I’ve also gone to doctors who said I should have a facelift and either inject Restylane or Perlane. What is your recommendation and who’s right and who’s wrong?

They’re both right. The reality is that in plastic surgery, as in many other things in life, there are many ways to reach the same goal. Not all doctors do the same type of surgery but many doctors get the same ultimate result.

The reason that fat grafting may be more advantageous over Perlane and Restylane is that it tends to be permanent. Fat grafting is done by suctioning out some fat from either your stomach, your thighs and/or your hips. The fat is treated in such a way as to remove dead cells and oil so that when it is injected into your face it tends to survive better. Approximately 60 to 80 percent of the fat that is grafted survives. Because not all fat survives, fat grafting is over injected by approximately 20 to 30 percent.

Your doctor may choose to use Perlane , Restylane or any other nonpermanent filler to give you an idea of how you might look.

If the patient likes the look, then face grafting will be done at the time of surgery. Some people are not comfortable with adding facial volume. Many patients don’t realize that the reason they look tired or haggard and don’t look youthful is because the loss of volume.

Volume replenishment is a relatively new aspect of plastic surgery that has revolutionized the way doctors look at their patients. Because of this relatively new view of volumizing the face, facial fat grafting has become a common theme in many face-lifting techniques.

So here is a quick answer to your underlying question: You should pick your surgeon by picking one that is board-certified in facial plastic surgery or plastic surgery, you feel comfortable with in your consultation and that you see pictures of results that you would like, if you were those patients.

Dr. Wolf is a partner in Miami Plastic Surgery. Send questions to