Facelift and fat transfer in Switzerland: lifting the tissues, restoring volume

Facial ageing is not just a matter of slackening skin. Over the years, two phenomena overlap: tissues descend under the effect of gravity and ligament laxity, and the face loses volume as fat diminishes, particularly at the temples, cheekbones, under the eyes and around the mouth. A facelift treats the descent: it lifts and tightens the deep tissues and the skin. But on its own, it can give a pulled, flat face that looks smoothed rather than rejuvenated. Fat transfer — reinjecting the person's own fat — treats volume loss. Combining the two, an increasingly common practice, aims for three-dimensional rejuvenation: putting the tissues back in place and restoring their fullness. This page explains what ages in a face, why lifting is not always enough, how the two procedures combine, for whom the combination makes sense, how the operation and recovery unfold, the possible complications of each procedure, how the result develops and how provision is distributed in Switzerland.

Under general anaesthesia or deep sedation, the surgeon harvests fat by fine liposuction, often from the abdomen or thighs, prepares it, then performs the facelift: through an incision that goes around the ear and extends into the scalp, they lift the deep musculo-aponeurotic layer of the face and neck, then redrape the skin without excessive tension. The fat is then reinjected in small amounts into the areas that have lost volume: temples, cheekbones, under-eye hollows, folds, lips or chin. The procedure generally takes three and a half to five hours, with a night in hospital. Swelling and bruising last two to three weeks; the result stabilises between three and six months. It is a cosmetic procedure, at the patient's expense. Budget differences are detailed on the page on facelift with fat transfer prices in Switzerland.

A neck and face lift repositions the tissues of the lower face and neck: it corrects jowls, redefines the oval, tightens the neck and softens the folds running from the corners of the mouth. Fat transfer restores lost volume: it gives back fullness to the cheekbones, fills hollow temples, softens dark circles and folds, and often improves skin quality. The two procedures are complementary: one acts on the position of the tissues, the other on their quantity. Our page on facial fat transfer presents fat transfer on its own.

The first facelifts, in the early twentieth century, simply removed a little skin in front of the ears. For decades, a facelift essentially consisted of tightening the skin, which sometimes gave a pulled look, with a widened mouth and distorted ears. From the 1970s, surgeons began to work on the deep layer of the face, for a more natural and longer-lasting result. More recently, an understanding of the role of volume loss in ageing has led to fat grafting being combined with facelifts more and more often. Today, the aim is no longer to tighten, but to reposition and restore.

Facial ageing affects every layer: the skin thins and loses elasticity; fat diminishes in some areas and descends in others; the muscles and the fibrous layer surrounding them slacken; the ligaments anchoring the tissues to the bone stretch; and the bone itself resorbs slightly, particularly around the eyes and the jaw. The result is a face that is hollower at the top and heavier at the bottom, gradually changing from a triangle pointing downwards to a triangle pointing upwards.

Facial fat is not a uniform layer. It is organised into distinct compartments, separated by thin partitions, superficial under the skin and deep against the muscles and bone. With age, these compartments do not all age in the same way: the deep compartments, which support the cheekbones and the area under the eyes, are the first to diminish, while some superficial compartments, such as those of the jowls, descend or thicken. This uneven change explains why an aged face looks both hollow at the top and heavy at the bottom, and why fat must be reinjected in a targeted way, into the compartments that have lost volume.

Ligaments connect the skin and soft tissues to the bone, like anchor points. With age, they stretch, and the tissues between them descend, creating folds and hollows where the ligaments remain firmer. Jowls, for example, form above a jaw ligament that remains relatively fixed. Deep facelifts release some of these ligaments so that the tissues can be lifted more naturally.

The facial skeleton changes with age: the eye sockets enlarge slightly, the bone around the mouth and jaw resorbs, and the chin recedes a little. These subtle changes reduce support for the soft tissues and contribute to an aged appearance. Fat can partly compensate for this loss of support, particularly around the eyes and on the chin.

The skin loses collagen and elastin, thins, wrinkles and develops pigmentation, especially under the effect of sun and smoking. A facelift does not change skin quality; it repositions the skin. Fat transfer, and in particular very fine fat preparations, can improve it a little. Complementary treatments, such as skin care, laser or peels, act more on its texture.

The young face is often described as a triangle pointing downwards: full, wide cheekbones at the top, a slim, clear jaw at the bottom. With age, this triangle inverts: the cheekbones empty and descend, and jowls weigh down the lower face. The facelift acts on the lower part of this triangle, lifting the jowls and redefining the jaw. Fat transfer acts on the upper part, restoring volume to the cheekbones and temples. Together, they give the face a younger shape.

The oval of the face, that is, the continuous line running from the ear to the chin, is one of the strongest markers of youth. With age, it breaks under the effect of jowls, which create a notch between the cheek and the chin, and neck laxity. The facelift lifts the jowls and restores this continuous line; fat injected into the chin and along the jaw can refine it further. A clear oval transforms the look of the face, from the front and in profile, often more than any other change.

In profile, ageing shows in the angle between the neck and the jaw, the projection of the chin and the position of the cheeks. The neck lift redefines this angle, fat transfer to the chin can project it slightly, and repositioning the cheeks restores contour to the midface. Many patients are surprised by their new profile, as they rarely looked at it before the procedure.

At three-quarters, you see the cheekbone, the cheek and the jawline at the same time. It is often from this angle that the combination of facelift and fat transfer is most visible: a full cheekbone, a smooth cheek, a clear jaw. Three-quarter photographs are therefore particularly useful for judging the result.

A young face reflects light on the cheekbones and temples, thanks to rounded volumes. An aged face has hollows that create shadows. By restoring volume, fat gives the face back this light, which contributes greatly to looking well. It is one of the most subtle, but most noticed, effects of the combination.

The aim is not to fill every hollow or tighten every fold, but to regain the balance of a younger face: well-distributed volumes, a clear oval, open eyes, preserved expressions. Too much fat or tension creates a face that no longer looks like the person. The surgeon seeks this balance, using your old photographs and your face in motion.

The eyes are often the first area where tiredness shows: hollows under the eyes, heavier eyelids, hollow temples. A neck and face lift does not act directly on the eyes. Fat transfer to the tear troughs, cheekbones and temples can soften them. If the eyelids are heavy or have bags, eyelid surgery is more suitable.

How a face ages depends on heredity, but also on lifestyle: sun exposure, smoking, weight changes, sleep, diet. Two people of the same age can have very different faces. The proposed plan takes your actual face into account, not just your age.

A face lives through its expressions. An overly tight facelift can freeze the smile, widen the mouth or change the look of the eyes. Modern techniques aim to preserve the natural movement of the face. Similarly, too much fat can weigh down expressions. The surgeon observes your face in motion during the consultation to take this into account.

One of the major goals of modern techniques is to preserve expression: a natural smile, lively eyes, facial movement maintained. Facelifts that place tension on the deep layer and measured fat grafting make it possible to rejuvenate without freezing. The surgeon observes your face in motion before the procedure, to take this into account.

A face that has lost a lot of volume does not regain a youthful appearance simply by repositioning the tissues. Lifting an empty cheek gives a higher cheek, but it is still empty. Pulling harder to compensate creates a tight, artificial look associated with the facelifts of the past. Adding fat allows the surgeon to lift the tissues with moderate tension and restore fullness, for a more natural result. That is why many surgeons now routinely, or almost routinely, combine fat transfer with a facelift when the face has lost volume.

A facelift with fat transfer can take several years off the face, but it does not transform a face or remove all wrinkles. Fine skin wrinkles, lines around the mouth, pigmentation and skin texture are not changed by the facelift; they call for other treatments. Defining with the surgeon what will and will not be improved avoids disappointment.

Botulinum toxin acts on expression lines of the upper face, such as forehead lines, frown lines and crow's feet, which the facelift and fat transfer do not treat. It can also relax neck bands and the muscle that pulls down the corners of the mouth. It is generally injected a few weeks before or after the procedure, and repeated every few months. It complements the rejuvenation achieved harmoniously.

Skin treatments, such as laser or peels, improve texture, pigmentation and fine lines. Some surgeons combine them with the facelift at the same time, on areas that have not been lifted, such as around the mouth; others prefer to perform them a few months later. They extend the benefit of the procedure by acting on skin quality, which the facelift does not change.

The combination is mainly for people aged fifty to seventy, sometimes a little younger, whose face shows both laxity of the lower face and neck and visible volume loss, particularly at the cheekbones, temples and under the eyes. They are in good health, do not smoke or agree to stop, and want a rested, natural face rather than a transformed one.

Motivations vary: feeling a mismatch between your inner energy and your appearance, no longer recognising yourself, wanting to look less tired at work, marking a new stage of life. A personal, well-considered motivation is often associated with greater satisfaction. A decision made under pressure from others or during a difficult period deserves more time.

Some people feel that their tired face no longer reflects their energy and competence at work. Natural rejuvenation can help them feel more in tune with their professional image. It is important that this remains a personal choice, not a response to outside pressure.

Those around you may express varied opinions, encouraging or reserved. They can help you think things through, but the decision must remain personal. Sharing the information received at the consultation with those close to you often helps you get their support during recovery.

A facial procedure lastingly changes the image you project. It is normal to take several months to decide, to consult two surgeons, to look again at your old photos and to choose the right time. A well-considered decision is often associated with greater satisfaction.

People with thin faces, often athletic or slight in build, lose volume quickly with age: hollow temples, prominent but empty cheekbones, sunken cheeks. In them, a facelift alone risks accentuating this gaunt appearance. Adding fat is almost always essential for a natural result.

In very slim people, finding enough fat may require harvesting from several small areas, such as the inner knees, flanks and lower abdomen. As the face needs modest amounts, this is generally possible. These people are also those who benefit most from fat transfer, as their face has often lost a lot of volume.

People who practise endurance sport intensively often have a hollow face, with emptied temples and cheeks, sometimes earlier than others. Fat transfer gives them a rested appearance. It should be noted that intense activity and low body fat can, over time, also reduce the volume of injected fat.

People with rounder or heavier faces have often kept their volume, but have jowls and a double chin. For them, the priority is repositioning the tissues and sometimes reducing fat under the chin. Fat transfer is then limited to a few areas, such as the temples or under-eye hollows, or may be unnecessary.

After significant weight loss, particularly after bariatric surgery, the face is often both emptied and lax, with stretched skin. The combination is particularly suitable: the facelift removes excess skin and lifts the tissues, and the fat restores volume. Weight must have been stable for several months, and nutritional status checked.

Certain illnesses or treatments cause the face to lose volume, sometimes rapidly. Once the situation has stabilised and with the agreement of the doctors managing the illness, fat transfer can restore volume. A facelift is considered if significant laxity is also present. These situations call for consultation between the surgeon and the other doctors.

Previous surgery on the nose or eyelids or a previous facelift does not contraindicate the combination, but it must be mentioned. Existing scars, the hairline and the blood supply to the skin are taken into account. Fat transfer is often particularly useful for softening previously operated faces.

• Active smoking, which greatly increases the risk of skin compromise and poor fat survival.
• Poorly controlled high blood pressure, which encourages haematomas.
• Clotting disorders or anticoagulant treatment that cannot be adjusted.
• Ongoing weight loss.
• A poorly controlled general illness.
• Expectations of a radical transformation.

A facelift with fat transfer is a procedure lasting several hours, which requires good general health. The anaesthetist assesses the heart, lungs, blood pressure, any diabetes, clotting disorders and current treatments. Some chronic diseases do not contraindicate the procedure if they are well controlled. A pre-operative assessment, sometimes a consultation with your GP or a specialist, makes sure of this. It is also an opportunity to take stock of your health.

Mention all your treatments, including food supplements and herbal products. Aspirin, anti-inflammatories, anticoagulants, high-dose omega-3s, vitamin E, ginkgo or St John's wort can encourage bleeding and must be stopped or adjusted on medical advice. Hormonal treatments, such as the pill or menopause treatment, increase the risk of thrombosis and must be discussed.

There is no ideal age, but a time when laxity and volume loss become bothersome. Before fifty, lighter procedures, such as fat transfer alone or a mini-facelift, may be enough. Between fifty and seventy, the combination is most common. After seventy, it remains possible if health allows, with a careful medical assessment.

Before fifty, laxity is often just beginning and volume loss is starting. Many people turn first to non-surgical procedures: injections, botulinum toxin, skin care. When these are no longer enough, fat transfer alone or a mini-facelift combined with fat transfer can offer discreet rejuvenation, with a shorter recovery. The more complete procedure can be kept for later.

After seventy, a facelift with fat transfer remains possible if health allows. The medical assessment is more thorough, anaesthesia is adapted, and the goal is often a rested, comfortable face rather than spectacular rejuvenation. The skin, which is thinner, requires a cautious technique. Many patients of this age are very satisfied with a result that gives them back an image in keeping with their vitality.

There is no universally right time. Many people consult when they no longer recognise themselves in the mirror, when they find their face tired or sad even though they feel well, or when jowls and the neck become visible in photos. Some prefer to act early, with lighter procedures; others wait for more marked laxity for a clearer change. The surgeon helps assess what can be achieved at each stage.

Acting early, at around fifty, often allows lighter procedures, faster recovery and a discreet change that those around you hardly notice. Waiting longer leads to more marked laxity, which requires a more extensive procedure, with a more visible change. Both approaches are legitimate; they depend on expectations and how you wish to experience this change.

In people whose laxity is mild but whose volume loss is marked, fat transfer alone can be a first step, with a shorter recovery. It improves volume and skin quality, and can delay the need for a facelift. When laxity progresses, a facelift can be performed later, often with a further fat session.

Many people have used hyaluronic acid injections for years to compensate for volume loss. When laxity becomes significant, these injections are no longer enough and can even weigh down the face if repeated too often. Moving to a facelift with fat transfer then allows both components to be treated more lastingly. The surgeon assesses whether residual product is present and may suggest dissolving it before the procedure.

Men also request this combination, with specific goals: a clear jaw, a defined neck, and less hollow temples and cheeks, without feminising the face. Scars are adapted to the beard and the hairline, which is often shorter. Male skin, with its richer blood supply, carries a slightly higher risk of haematoma. Fat transfer is generally more measured, to preserve an angular face.

Female and male faces do not age in quite the same way, and are not rejuvenated in the same way. In women, full cheekbones and softened temples are signs of youth; in men, a clear jaw and a more angular face are sought. The surgeon adapts the fat volumes and the direction of the lift to the character of each face, so as not to feminise a male face or harden a female face.

Faces of different backgrounds have particular features: skin thickness, fat distribution, bone structure, a tendency to thick or pigmented scars. The facelift and fat transfer must respect these characteristics and the identity of the face. An experienced surgeon adapts their technique, incisions and volumes to each face.

Men account for a growing share of facelift requests. Their faces have particular features: thicker skin with a richer blood supply, a beard, a sometimes receding hairline, a neck that is often heavier. The risk of haematoma is slightly higher, which requires careful monitoring of blood pressure. The incisions are adapted so as not to move beard-bearing skin onto non-bearded areas, such as in front of the ear. The goal is a clear jaw, a defined neck and a rested face, without overly softening masculine features. Fat transfer is generally more limited, focused on the temples, under-eye hollows and sometimes the jaw.

After a facelift, some beard-bearing skin may end up slightly closer to the ear. The surgeon takes this into account when planning the incision. Shaving resumes after a few days, with care on numb areas. Some men choose laser hair removal on small areas if hairs end up in an awkward place.

In men, the neck is often the main concern: double chin, neck bands, a blurred angle. A neck lift, sometimes combined with suction of fat under the chin, often gives a very visible and much appreciated change, restoring a clear jawline.

It begins with what you see in the mirror and what you would like to regain. The surgeon then reviews your health, medicines, smoking, weight history, and any previous injections or surgery. They observe your face from the front, in profile and at three-quarters, still and then in motion, and assess skin quality, laxity of the lower face and neck, the areas that have lost volume and the bone structure. Finally, they identify where to harvest the fat.

A second consultation allows you to review the plan calmly, ask questions that have come up in the meantime, look at the photographs again and confirm the fat areas and the facelift technique. For a procedure of this scale, this extra time is invaluable.

The information document describes the facelift, fat transfer, scars, recovery, risks — including haematoma and facial nerve injury — fat resorption, alternatives and the possibility of a touch-up. Take time to read it, ask your questions and sign after a period of reflection.

A period of several weeks between the consultation and the procedure is recommended. It allows you to review the photographs, compare opinions, stop smoking, control your blood pressure and choose the right time, away from important events.

Photographs of yourself at thirty or forty are a valuable tool. They show where your volumes were, the shape of your cheekbones and how clear your jaw was. The surgeon uses them to plan the distribution of fat and the extent of the lift, with the aim of making you look like a younger you, not creating another face.

For old photos, choose images showing your face from the front and at three-quarters, with a neutral expression or a slight smile, at a time when you liked how you looked. Avoid heavily made-up or retouched photos. These images help the surgeon understand where your volumes were and aim for a result that looks like you.

If you have had hyaluronic acid injections or other fillers, mention them, specifying the product, area and date if possible. Some products can persist and interact with the fat. Permanent products, rarely used today, complicate treatment. Botulinum toxin, on the other hand, is no obstacle; it can even complement the result on upper-face wrinkles.

When old hyaluronic acid injections are still present, particularly under the eyes or in the lips, the surgeon may suggest dissolving them a few weeks before the procedure, using an injected enzyme. This step allows a fresh start on tissues free of residual product, better assessment of the real volumes and avoidance of irregularities when the fat is injected. It is not routine and depends on the type of product, the amount and how long ago the injections were done.

The incision generally begins in the scalp at the temple or along the hairline, runs down in front of the ear following its natural folds, goes around the earlobe, up behind the ear and extends into the scalp at the nape. The surgeon lifts the skin, then works on the deep musculo-aponeurotic layer, called the SMAS, which they lift and fix in a mainly vertical direction. They treat the neck, sometimes through a small incision under the chin to bring the muscles together. The skin is then redraped without excessive tension and the excess removed. The sutures are fine, and the scar is hidden in the folds of the ear and the hair.

The surgeon chooses the type best suited to your face. Fat transfer can accompany any of them.

The mini-facelift uses shorter incisions, often limited to the front of the ear, and more limited undermining. It suits early jowl laxity in younger people. It does not treat the neck, or only slightly. Combined with fat transfer, it can give natural rejuvenation with a slightly shorter recovery.

Modern facelifts do not just pull the skin: they reposition the deep layer, which is stronger and carries the facial tissues. Several techniques exist: plication of this layer, resection of a strip to shorten it, deep undermining that releases the ligaments, sometimes called a deep plane facelift. The deeper the procedure, the more natural and lasting the result can be, but the more experience it requires. The surgeon chooses the technique according to your anatomy and their practice.

A deep plane facelift involves going beneath the musculo-aponeurotic layer to release the ligaments that hold the tissues, then lifting the whole as a single unit, skin and deep tissues together. This technique also corrects the midface, the folds and sometimes the cheekbones, with tension distributed on the deep layer rather than on the skin. The result is often very natural and lasting. It requires great experience, as the dissection takes place close to the branches of the facial nerve.

When the skin alone bears the tension of the lift, it stretches over time, scars widen, the earlobe can be pulled down and the face takes on an artificial look. In modern techniques, the tension is borne by the deep layer, and the skin is simply redraped. This is what achieves a natural result and fine scars.

Facial tissues have mainly descended vertically with age. Modern facelifts lift them in a mainly vertical or oblique direction, rather than pulling them horizontally towards the ears. This orientation avoids the "wind-swept" look of older facelifts and respects the natural shape of the face.

In women, the incision in front of the ear often follows the edge of the cartilage in front of the ear canal, to hide it in the natural folds. Behind the ear, it rises in the crease and then extends into the hair. The hairline is preserved so that the hair can be tied back without revealing a scar or a step.

In men, the incision in front of the ear is often placed in a natural crease, in front of the cartilage, so as not to bring beard-bearing skin onto the cartilage. The surgeon also pays attention to the position of the sideburns and beard line. Hair that is often shorter makes the scar behind the ear more visible, which guides the incision line.

Scars are pink at first, sometimes slightly firm. They fade over six to twelve months. Those in the folds of the ear become very discreet. Behind the ear and in the scalp, they are hidden in the hair. Sun protection and gentle care help them mature. People who form thick scars should mention it.

On olive or dark skin, the risk of thick or pigmented scars is slightly higher. The surgeon adapts the incision line, the closing tension and scar care, and may suggest preventive treatments such as silicone dressings or, if necessary, injections. Pigmentation from bruising may also persist longer; strict sun protection is recommended.

A scar that becomes red, thick and itchy a few weeks after the procedure should be reported. Silicone dressings, massage, corticosteroid injections or certain lasers often improve it. Surgical revision is considered as a last resort, after one year.

An overly tight facelift can pull the earlobe down, giving it an elongated appearance. Modern techniques, which place tension on the deep tissues, reduce this risk. If it happens, a small correction under local anaesthesia is possible.

During a facelift, the surgeon takes care to preserve the position of the hairline at the temples and behind the ears. A poorly adapted incision can raise the sideburns or create a step in the hairline behind the ear, visible when the hair is tied back. The incision line is adapted to each person.

The neck often ages at the same time as the lower face: lax skin, vertical muscle bands, fat accumulating under the chin. A neck and face lift treats the neck by tightening it laterally from the incisions behind the ears and, if needed, through an incision under the chin that allows the muscles to be brought together and fat to be removed. A defined neck is often one of the most appreciated changes.

A clear angle between the neck and the jaw is a sign of youth. With age, this angle softens because of laxity of the skin and neck muscle, fat under the chin and sometimes descending salivary glands. The neck lift redefines this angle by tightening the muscle, removing fat and redraping the skin. It is often one of the most visible changes.

The vertical bands visible on the neck correspond to the edges of the platysma muscle, which slacken and separate. To correct them, the surgeon can bring them together through a small incision under the chin. Botulinum toxin can soften them temporarily in people who do not want surgery.

Some people have a face that is still relatively firm, but a lax neck, with vertical bands, a double chin and a blurred angle. A neck lift alone, possibly combined with suction of fat under the chin, may then be enough. It leaves scars behind the ears and sometimes under the chin. Fat transfer can be added in a targeted way, for example to the temples or chin, to harmonise the whole. The surgeon assesses whether the lower face also needs treatment, as a rejuvenated neck below a lax face can create a mismatch.

Neck skin is thin and heals differently from facial skin. It retracts less well in older people or after significant weight loss. The lift removes excess skin and redrapes it, but small horizontal lines may persist. Skin treatments can soften them.

A double chin can be due to superficial fat, deep fat under the muscle, muscle laxity or a receding chin. Liposuction treats superficial fat; a direct procedure under the chin treats deep fat and the muscle; fat injected into the chin can improve projection. Identifying the cause guides treatment.

In some people, the salivary glands under the jaw descend with age and form a visible bulge below the jawline. The neck lift can soften them by supporting them. Surgically reducing them is a more delicate procedure, reserved for particular situations.

Fat accumulated under the chin, superficially or deeply, erases the angle between the neck and the jaw. Superficial fat can be suctioned; deep fat, beneath the muscle, sometimes requires a direct procedure through the incision under the chin. The surgeon assesses these elements at the examination.

The surgeon harvests fat with fine cannulas and gentle suction, often from the abdomen, flanks, thighs or inner knees. They purify it to remove blood, fluid and oil. They then reinject it with very fine cannulas, depositing tiny amounts in multiple passes, in several planes, so that each fat parcel is in contact with living tissue. The amounts injected are modest, a few millilitres per area, and adapted to each face.

The face has a rich blood supply, which makes it a rather favourable area for fat survival. Injected fat cells, deprived of blood vessels for the first few days, survive thanks to neighbouring tissues, then are reached by new vessels. The more finely the fat is deposited, in small threads in contact with living tissue, the better its chances of survival. The proportion that remains nevertheless varies by area: the temples and cheekbones often retain it well, the very mobile lips a little less.

Some surgeons inject slightly more fat than the desired final volume, to compensate for the share that will be resorbed. Others prefer to inject just what is needed and add more if necessary at a second session. Overcorrection must remain moderate, especially in thin areas such as around the eyes, where excess is difficult to correct.

The fat is harvested by gentle, fine liposuction, often from the lower abdomen, flanks, inner thighs or knees. The amounts needed for the face are modest, a few tens of millilitres in total, so the effect on the donor area is discreet. The small incisions of a few millimetres are hidden in natural creases. The area may be sore and bruised for a few days.

As the amounts needed for the face are modest, harvesting is discreet. The surgeon chooses the area according to your reserves and preferences.

The donor area may be sore, swollen and bruised for a few days. A light compression garment is sometimes advised for one to two weeks. The small incisions heal quickly. In some people, the donor area is even slightly slimmed, which is a small side benefit.

The harvested fat is purified by decanting, gentle centrifugation or filtration, to remove blood, fluid and oil. Depending on the area to be treated, it can then be refined by passing it between two syringes or through filters, to obtain finer fat suited to delicate areas. This preparation, carried out quickly under sterile conditions, determines the quality of the result.

Injection into the face is done with very fine, blunt-tipped cannulas mounted on small one-millilitre syringes. The blunt tip reduces the risk of injuring a blood vessel. The surgeon injects while withdrawing, depositing tiny amounts with each pass, in several planes and directions. This slow, meticulous procedure is the key to a smooth result and good safety.

Some areas of the face, such as the region between the eyebrows, around the nose and around the eyes, contain vessels connected to the eye's circulation. Accidental injection into these vessels can, exceptionally, have serious consequences. That is why the surgeon works there with extreme caution, blunt cannulas, very small amounts and precise knowledge of the anatomy. Some of these areas are sometimes avoided.

The temples hollow with age, and this hollow gives the face a gaunt appearance, sometimes even making the skull more visible at the sides. They often go unnoticed during self-examination, as we rarely look at them in the mirror. Yet filling them with fat softens the contour of the upper face, supports the tail of the eyebrow and opens up the eyes. It is one of the areas where fat transfer gives the most natural and lasting results, and one of the changes that those around you most perceive as a rested look, without being able to pinpoint it.

With age, the fat of the cheekbones diminishes and descends, emptying the upper cheek and accentuating the nasolabial fold. Restoring cheekbone volume gives the face back its downward-pointing triangle shape and visually lifts the midface. The fat is injected deep, against the bone, then more superficially to refine the contour. The surgeon takes care to respect the natural shape of the cheekbones, without creating artificially prominent cheekbones.

The folds running from the sides of the nose to the corners of the mouth deepen as the cheeks descend and the cheekbones lose volume. The facelift, by lifting the cheeks, softens them; fat injected into the cheekbones and, more lightly, into the folds themselves softens them further. Erasing them completely is neither possible nor desirable: a face without any folds looks artificial.

The lines running down from the corners of the mouth towards the chin give a sad or tired expression. The facelift softens the part linked to the jowls; fat can fill the hollow below the corners of the mouth. Botulinum toxin can also relax the muscle that pulls the corners of the mouth down. These combined procedures soften the expression.

With age, some faces take on a sad, stern or tired expression that the person does not feel. The corners of the mouth turn down, the folds deepen, the eyebrows descend and the cheeks empty. This mismatch between expression and state of mind is one of the most common reasons for consultation. The facelift and fat transfer, by lifting the tissues and restoring volume around the mouth, cheeks and temples, soften this expression. Many patients say they are asked less often whether they are tired or upset.

A tired look is often due to several elements: hollows under the eyes, hollow temples, drooping eyebrows, heavy eyelids. Fat transfer treats the hollows; eyelid surgery and a brow lift treat the other elements. A precise analysis allows the genuinely useful procedures to be proposed, without multiplying operations.

The forehead can hollow slightly with age, especially in slim people. A small amount of fat can round it and soften wrinkles, but this area requires great caution because of the blood vessels. Forehead expression lines are better treated with botulinum toxin.

The hands also age, with volume loss that makes the veins and tendons stand out. Some patients take the opportunity of the procedure to have fat injected into the backs of their hands, to harmonise their appearance with the rejuvenated face. This is discussed case by case.

The tear trough is the hollow separating the lower eyelid from the cheek. With age, it deepens, giving a tired look and dark circles. The skin there is very thin, and the slightest irregularity of fat shows. The surgeon uses very fine fat, in small amounts, deposited deep, against the bone. The result can be very satisfying, but it is also the area where irregularities are most common. A cautious approach is preferable.

The skin under the eyes is the thinnest on the face. The slightest irregularity of fat shows there, as a small lump or ridge, especially in raking light. That is why the surgeon uses very fine fat, injected in small amounts, deep, against the bone, and often accepts a slightly under-corrected result rather than an excess that is difficult to correct. If an irregularity appears, it can be treated, but prevention remains the best approach.

Dark circles can be due to a hollow, which fat can fill, or to pigmentation or translucency of the skin, which lets the vessels show through. Fat corrects the hollow and can slightly improve the appearance of the skin, but it does not remove pigmentation. The surgeon distinguishes these two components at the examination.

Under-eye bags are due to herniation of the orbital fat, which bulges forward. Filling around them with fat can sometimes mask them, but when they are marked, lower blepharoplasty is more suitable. The surgeon explains the most appropriate approach.

With age, the lips thin and their contour fades. Fat can restore natural volume to them, without the sometimes artificial look of overfilled lips. Resorption is a little greater there than elsewhere, because of the mobility of the area. The surgeon favours a discreet result, in harmony with age and the face.

With fat, the surgeon aims to restore lip volume in keeping with age and the face, rather than creating very plump lips. They can also work on the contour and the area around the mouth, where fine lines develop. The result is more discreet than with some fillers, but also more natural.

A chin that recedes slightly with age and an irregular jawline age the lower face. Fat can strengthen the chin and redefine the jawline, complementing the facelift, which lifts the jowls. In men, it helps achieve a more defined jaw.

Fat can be prepared in different forms: standard fat, to restore volume to the cheekbones or temples; finer, filtered fat for delicate areas such as around the eyes; and a very fine preparation, sometimes called nanofat, which contains hardly any whole fat cells but improves skin quality. The surgeon chooses the preparation according to the area.

Beyond volume, injected fat seems to improve the quality of the overlying skin: a more radiant complexion, suppler skin, softer fine lines. These effects, partly attributed to the regenerative cells present in fat, are reported by many surgeons, even if their mechanism is still being clarified. They contribute to the rested appearance of the result.

Many patients and surgeons report improved skin quality in the months after fat transfer: a more radiant complexion, suppler skin, softer fine lines, sometimes improved acne scars. These effects, still being studied, add to the benefit of the volume and contribute to the rested appearance of the result.

Surgeons proceed differently. Some inject the fat before the facelift, into tissues that are still intact, which makes distribution easier. Others perform the facelift first, then inject the fat into a face that has already been repositioned, to better judge the volumes to restore. In both cases, the fat is injected outside the areas undermined during the facelift, or with caution, to preserve its survival and the blood supply to the skin.

Harvesting and preparing the fat, the deep lift of the face and neck on each side, then the meticulous injection of fat into several areas all take time. A procedure of four to five hours is nothing unusual. This length reflects the precision required, particularly for dissection close to the facial nerve and for fine fat injection. It is taken into account when choosing the anaesthesia and in preventing thrombosis.

The procedure often begins with harvesting the fat, which is prepared while the surgeon starts the facelift. They treat one side of the face, then the other, checking symmetry. They then treat the neck, sometimes through the incision under the chin. The fat is injected before or after the facelift, depending on their method. The incisions are carefully closed, any drains put in place, then the dressing applied.

Before starting the facelift, the surgeon infiltrates the facial tissues with a solution containing a local anaesthetic and a product that constricts the blood vessels. It reduces bleeding, makes dissection easier and prolongs comfort on waking. It also helps limit bruising.

The preceding weeks are used to stop smoking completely, at least a month beforehand and until healing is complete, as it threatens the blood supply to the undermined skin and the survival of the fat. Medicines and supplements that encourage bleeding are suspended on medical advice. Well-controlled blood pressure is essential, as a spike after the procedure encourages haematomas. Also plan two to three weeks away from social life, help in the first few days and a calm environment.

Smoking reduces circulation in the skin. During a facelift, the undermined skin depends on fine vessels that reach it from the edges; in a smoker, part of this skin can suffer, darken and heal poorly, especially behind the ears. Smoking also harms fat survival. Stopping completely, including e-cigarettes and nicotine substitutes, is strongly recommended at least a month before and after the procedure. Some surgeons refuse to operate on active smokers.

Alcohol dilates the blood vessels, encourages bleeding and swelling, and interacts with medicines. It is advisable to avoid it in the days before and the weeks after the procedure.

A balanced diet rich in protein, fruit and vegetables promotes healing. This is not the time for a strict diet, either before or just after the procedure, especially as the injected fat needs a body in good shape to survive.

Well-controlled diabetes does not prevent a facelift, but it increases the risk of infection and delayed healing. Blood sugar control is checked before the procedure and monitored afterwards. Mention your diabetes and treatments at the consultation.

Before the procedure, prepare a quiet bedroom, several pillows or an inclined cushion to keep your head raised, cold compresses, easy-to-chew foods, clothes that open at the front, and things to keep you occupied without effort. In the first few days, it is better not to be alone. Also think about check-up appointments and how you will get there, as you will not be able to drive immediately.

Someone close to you present in the first few days helps with meals, outings, watching for unusual swelling and morale. Explaining to them in advance what to expect avoids worry.

• Pillows or an inclined cushion.
• Cold compresses to wrap in a cloth.
• The prescribed painkillers and treatments.
• Clothes with buttons or zips.
• Soft foods and a straw.
• A hat and sunglasses for going out.
• The team's number and the date of the first check-up.

Haematoma is the most common complication after a facelift, and blood pressure is one of its main factors. The anaesthetist checks that it is well controlled before the procedure and monitors it closely afterwards, avoiding spikes linked to pain, nausea or anxiety. If you have high blood pressure, your treatment must be taken regularly, including on the morning of the procedure as instructed.

The combination is performed under general anaesthesia or deep sedation combined with local anaesthesia, depending on the extent of the procedure and the team's practice. Local anaesthesia, injected into the facial tissues, reduces bleeding and pain on waking.

A facelift with fat transfer can be performed under general anaesthesia or deep sedation, combined with local anaesthesia injected into the facial tissues. Sedation allows faster waking and sometimes less nausea, which is an advantage, as nausea and vomiting increase blood pressure and the risk of haematoma. General anaesthesia ensures complete comfort for a long procedure. The choice depends on the extent of the procedure, your health and the team's practice.

Nausea and vomiting after the procedure are unpleasant, but above all they suddenly increase pressure in the face and encourage a haematoma. The anaesthetist gives preventive treatment, particularly for people who had nausea after a previous anaesthetic. Mention it at the anaesthesia consultation.

• General anaesthesia or deep sedation: what do you propose?
• How will my blood pressure be monitored after the procedure?
• How can nausea, which can encourage a haematoma, be avoided?
• Do my usual treatments need adjusting?
• How long will I stay under observation?

With you sitting or standing, the surgeon draws the facelift incisions and the areas to be undermined, and marks the fat transfer areas on the face, with an estimate of the volumes to be injected. They use the old photographs and the examination of the face in motion. These markings are shown to the patient.

The incisions are closed with fine sutures or staples in the scalp. Fine drains may be placed behind the ears for one or two days. A slightly compressive dressing or a chin strap may be applied. The small fat transfer incisions, a few millimetres long, are closed with a stitch or left open.

The incisions in front of the ears are closed with very fine sutures, removed after five to seven days. In the scalp, staples or sutures are used and removed a little later, at around ten to fourteen days. Some internal absorbable sutures do not need removing. Removal is quick and not very painful.

Fine drains may be placed under the skin behind the ears to drain blood and fluid during the first few hours. They are removed the next day or the day after. Some surgeons use tissue glues or quilting sutures to avoid them.

A slightly compressive dressing, sometimes a chin strap, is applied at the end of the procedure. It limits swelling and supports the tissues. It is removed or lightened the next day. Some surgeons then recommend wearing an elastic chin strap for a few hours a day for one to two weeks.

The face is swollen and held tight by the dressing. A feeling of tightness, rather than real pain, predominates. The fat donor areas are sore. The team monitors blood pressure, the absence of asymmetric swelling and pain. You generally stay one night at the clinic.

The first night is generally spent at the clinic. The team monitors blood pressure, pain, nausea, the drains and the symmetry of the face, to detect a haematoma early. You are positioned with your head raised. The next morning, the surgeon examines you, often removes the drains and the dressing, and gives you discharge instructions.

You go home accompanied, the day after the procedure. At home, alternate rest and short walks, keep your head raised, apply cold to the permitted areas, take the prescribed treatments and avoid all exertion. Having someone close to you present in the first few days is invaluable.

Clothes pulled on over the head rub on the scars and face. Prefer tops with buttons or zips for one to two weeks. Avoid tight collars that compress the neck.

Fatigue is common for one to two weeks, linked to the anaesthesia, healing and sleep sometimes disturbed by lying on your back. Resting, staying hydrated and resuming activities gradually help you recover.

Seeing yourself swollen, with bruising, a face that is asymmetrical or overfilled in places, can be trying. Many people go through a phase of doubt towards the end of the first week. This phase is normal and fades as the swelling goes down. Avoiding judging yourself too early and surrounding yourself with reassuring people helps.

Swelling increases during the first two or three days, then decreases. Bruising appears on the neck, cheeks and sometimes around the eyes, especially in fat transfer areas. Keep your head raised, avoid turning your head abruptly, do not bend down or carry loads, and apply cold compresses to the permitted areas. The drains and dressing are removed after one or two days.

Pain is generally moderate: rather than sharp pain, you feel tightness, a sensation of a tight face, and discomfort around the ears and neck. The fat donor areas are sore. Simple painkillers are usually enough. Pain that suddenly increases on one side should suggest a haematoma and prompt a call to the team.

Bruising appears on the neck, cheeks and sometimes around the eyes, especially in injected areas. It sometimes spreads down to the upper chest. It changes colour and disappears within two to three weeks. Arnica and certain ointments are sometimes suggested, without solid evidence of effectiveness. Concealer can hide it after one to two weeks.

In the first few weeks, bruising may spread down the neck and upper chest. A light scarf or high collar can hide it when going out. This is one of the reasons autumn and winter are often preferred for this procedure.

Some surgeons recommend wearing an elastic chin strap, mainly at night, for one to two weeks. It supports the neck tissues and limits swelling. It must not be excessively tight. Follow your surgeon's instructions.

Cold compresses applied to the cheeks and neck, for a few minutes at a time, reduce swelling and bruising during the first forty-eight to seventy-two hours. Do not apply ice directly to the skin, especially on numb areas, which do not feel cold well.

During the first few weeks, avoid turning your head abruptly, bending forward, carrying loads, exertion that raises blood pressure and very hot baths. These precautions reduce the risk of haematoma and protect the sutures. It is better to turn your whole body rather than just your head.

In the first few days, chewing may be a little uncomfortable because of swelling and tightness of the face. Soft, lukewarm, low-salt foods are easier to eat. Salt encourages swelling. A normal diet resumes gradually.

Fat transfer adds its own swelling, especially in the injected areas, such as the cheekbones and around the eyes. In the first few weeks, it can give the impression of an overfilled or slightly puffy face. This is expected: the surgeon sometimes injects slightly more than necessary, in anticipation of some of the fat being resorbed. The face regains natural proportions within a few weeks.

Manual lymphatic drainage, performed by a trained therapist, can speed up the resolution of swelling. It is generally done from the second week, with the surgeon's agreement, avoiding firm massage of the fat areas in the first few weeks. It is not essential, but many patients appreciate it.

The skin undermined during the facelift is numb for several weeks, sometimes a few months, particularly in front of and around the ears. Sensation returns gradually, sometimes with tingling. Be careful with heat, such as from a hairdryer, on these less sensitive areas.

The skin of the cheeks and neck is numb, sometimes with tingling or itching as sensation returns. A feeling of tightness or stiffness in the neck is common. The ears may be sensitive. These sensations fade gradually over a few weeks to a few months.

The ears are often sensitive and numb for a few weeks, as the incisions go around them. Avoid sleeping on your side, wearing tight earphones or heavy earrings during this period. Sensation returns gradually. The scars, placed in the natural folds, become very discreet over time, to the point of being hard to spot even close up. People who wear their hair short or tied back can ask the surgeon to adapt the incision line behind the ear so that the scar remains invisible day to day, and they quickly learn to live without thinking about it. Over time, most patients simply forget they have had surgery, which is probably the best sign of a successful and well-accepted procedure, both for themselves and for those closest to them, family and long-standing friends alike, who often notice nothing more than a rested look.

Incisions in the scalp can cause temporary hair loss along the scar, which generally grows back within a few months. Hair washing is allowed after a few days, according to the instructions. Colouring and perms wait several weeks.

Showering and washing your hair are generally allowed after two to three days, with a mild shampoo, without rubbing the scars. Use a hairdryer on a low setting, as numb skin does not feel heat well. The scars are cleaned according to the instructions.

At around one week, the surgeon removes some of the stitches, checks the scars, the absence of haematoma and how the swelling is developing, and answers your questions. The scalp stitches are sometimes removed a little later.

For one to two weeks, sleep lying on your back, with your upper body and head raised on two pillows or an inclined cushion, without resting your cheeks or the fat areas on the pillow. A U-shaped travel pillow helps keep your head straight.

Heat dilates the blood vessels and increases swelling. Very hot baths, saunas and steam rooms should be avoided for at least a month. Also be careful with hairdryers, as numb skin does not feel heat well.

It is better to avoid long journeys during the first two weeks, until the risk of haematoma has decreased and the stitches have been removed. Travel later is possible, protecting the face from the sun.

For a self-employed person, time off for a cosmetic procedure is generally not compensated. Plan two to three weeks without public contact, sometimes more, and schedule the procedure during a quiet period.

For a wedding, a celebration or an important professional deadline, it is better to schedule the procedure at least three months beforehand, ideally six, so that the swelling has gone and the fat volume has stabilised.

Most people return to social life after two to three weeks, when the bruising has disappeared or can be concealed. Concealer, a hairstyle that covers the ears and a light scarf help hide the last traces.

Make-up is generally allowed after one to two weeks, avoiding the scars until they have fully closed. Colouring and chemical hair treatments wait several weeks, so as not to irritate the scalp scars.

Driving becomes possible again when you can turn your head without discomfort to check blind spots and the medicines no longer cause drowsiness, often after one to two weeks.

Autumn and winter are often preferred: the sun, which encourages swelling and scar pigmentation, is less strong, and scarves and collars allow the neck to be discreetly covered in the first few weeks.

In the first week, the face is swollen, tight, sometimes asymmetrical, with bruising on the neck and cheeks. You sleep with your head raised, avoid exertion and apply cold. Towards the end of the week, the first stitches are removed. In the second week, swelling decreases markedly, bruising turns yellow and the feeling of tightness eases. In the third week, most people return to social life, with a face that is already rejuvenated but still a little swollen, particularly in the fat areas. Between the second and third months, the face takes on a natural appearance, the scars become discreet and the fat stabilises. The result is established at around six months.

At three months, most of the swelling has gone, sensation is gradually returning, the scars are still slightly pink and the fat has begun to stabilise. The face looks natural and rested. This is often when patients begin to fully appreciate their result and those around them notice how well they look.

At six months, the fat volume has stabilised, the result of the facelift is established and the scars are fading. The surgeon can judge the final result of the volumes and discuss a possible additional session if an area is insufficient.

At one year, the scars have faded and blend into the folds of the ear and the hair. The result is stable. The review is an opportunity to take stock, compare with the before photos and discuss skin care or future maintenance.

Regular photographs, taken under the same conditions, from the front, in profile and at three-quarters, help track the resolution of swelling and the stabilisation of volume. Compared with the before photos, they show the progress made objectively, often better than the daily mirror.

At one year, the scars have faded, the fat volume is stable and the result of the facelift is established. The surgeon compares the photographs, checks the scars and discusses a possible touch-up or complementary skin treatment.

After follow-up has ended, it remains useful to be able to see your surgeon again for a question, a scar, a fat session or advice on skin care. A surgeon who remains available after the procedure is a sign of trustworthiness and quality.

Some of the fat injected into the face is resorbed in the following months. The face is a rather favourable area, with a good blood supply, but the proportion that survives varies from person to person and from area to area. Volume stabilises at around three to six months. A small additional session may be offered if an area has lost more than expected.

During the first few weeks, the injected fat is swollen and inflamed, which makes the face look fuller than the final result. Between the first and third months, some of the fat is resorbed and the swelling disappears. What remains after six months has a blood supply and is integrated into the tissues; it behaves like the face's natural fat. Over the years, this fat changes like the rest of the face: it may decrease slightly with age or weight loss, or increase with weight gain.

If an area has lost more volume than expected, a small additional session can be performed after six months, often under local anaesthesia, as day surgery. It is lighter than the initial procedure and allows the result to be refined. Some people also return to it years later, to maintain volume as the face continues to age.

More rarely, an area may look overfilled, particularly under the eyes or in the cheeks, especially if the person gains weight. Excess fat can be reduced by a small suction procedure, specific injections or, under the eyes, surgical correction. That is why surgeons prefer to remain measured, particularly in thin areas.

Fat injected into the face keeps the characteristics of the area it came from. If it comes from the abdomen or thighs, it may grow with weight gain. In a person who gains a lot of weight after the procedure, the face may then become rounder than expected. A stable weight remains the best guarantee of a lasting result.

Blood can accumulate under the undermined skin in the first few hours or days, especially with a blood pressure spike, exertion or blood-thinning medicines. It shows as rapid, painful, asymmetric swelling of one side of the face or neck. A large haematoma must be drained quickly to protect the skin. Monitoring blood pressure and the face on the first night allows it to be detected early.

Preventing haematoma begins before the procedure, with stopping blood-thinning medicines and controlling blood pressure. During the procedure, the surgeon carefully cauterises the vessels and may use glues or quilting sutures. After the procedure, the team monitors and treats any blood pressure spike, prevents nausea and pain, and asks the patient to avoid exertion. These combined measures clearly reduce this risk.

The facial nerve controls the muscles of expression. Its branches run beneath the deep layer worked on during the facelift. Damage is rare; it causes weakness of part of the face, such as the corner of the mouth or the forehead, usually temporary, with recovery within a few weeks to a few months. Permanent damage is exceptional. The surgeon's experience and knowledge of the anatomy are essential.

In the first few weeks, some people notice a slight asymmetry of the smile or difficulty raising a corner of the mouth. Most often, this is an effect of swelling or local anaesthesia, which disappears within a few days. True damage to a nerve branch is rare and generally recovers within a few weeks to a few months. The surgeon monitors this at check-ups.

During healing, the undermined skin depends on the vessels that reach it from the edges. In smokers, or if the skin is too tight, an area, often behind the ear, can suffer, darken and heal slowly. Stopping smoking and moderate skin tension reduce this risk.

Infection is rare after a facelift, as the face has a very good blood supply. It shows as redness, warmth, increasing pain or discharge. It is treated with antibiotics and, if necessary, drainage. Good hygiene of the scars and hair helps prevent it.

Any procedure lasting several hours carries a small risk of blood clots in the leg veins. Prevention relies on getting up early, walking, hydration, compression stockings and, depending on risk factors, anticoagulant injections, to be weighed against the risk of facial haematoma. The anaesthetist adapts these measures to each patient.

The fat can form small lumps or irregularities, especially in thin-skinned areas such as under the eyes. They are more common when too much fat is injected or it is injected too superficially. Some soften over time; others can be corrected by massage, an injection of product, a small suction procedure or a touch-up.

The face is rarely symmetrical: one side may be more lax, one cheekbone hollower, one fold deeper. The surgeon takes this into account by adapting the tension and amount of fat on each side. A small asymmetry may persist, often already present before the procedure. Pre-operative photographs allow it to be identified.

In the first few weeks, swelling is often uneven between the two sides of the face, giving an impression of asymmetry. It generally corrects itself as the swelling resolves. You need to wait several weeks before judging the real symmetry.

Small bumps or firm areas can be felt under the skin where fat was injected or where the lift was fixed. They generally soften within a few weeks to a few months. The surgeon may advise gentle massage after a certain time. Irregularities that persist beyond six months can be treated.

Exceptionally, injected fat can enter a blood vessel and travel, with potentially serious consequences, particularly for vision when it is injected near the eyes or between the eyebrows. This risk is very rare, but it justifies using blunt cannulas, slow injection of small amounts while withdrawing, and a thorough knowledge of the anatomy. It is part of the information you should receive.

• Sudden, painful swelling of one side of the face or neck.
• Difficulty breathing or swallowing.
• An area of skin turning dark or blackish.
• Fever, redness or discharge from a scar.
• Visual disturbance, especially after injections near the eyes.
• Sudden weakness of part of the face.

In the event of sudden swelling of one side of the face, increasing pain, fever or visual disturbance, call the team immediately. For routine questions, note them and ask them at check-ups or by phone.

A touch-up can be considered after six months to a year: a small fat session for an under-filled area, correction of an irregularity, revision of a scar, slight re-tightening of the neck. It is often done under local anaesthesia. It is useful to know the surgeon's touch-up policy from the quote stage.

Touch-ups are discussed after six months to a year: a small fat session, correction of an irregularity under the eyes, revision of a scar, slight re-tightening of the neck. Most are done under local anaesthesia. Knowing the surgeon's policy from the outset avoids surprises.

A successful combination gives a rested face, rejuvenated without looking operated on: a clear jaw, a defined neck, refilled cheekbones, softened temples, less hollow eyes. Friends and family talk about how well you look rather than about surgery. This is the whole point of volumetric rejuvenation: restoring rather than tightening.

The most satisfied people are those who wanted a rested, natural face and accepted that the result would emerge gradually. Above all, they appreciate recognising themselves in the mirror, only better. Disappointments come more often from expectations of transformation or from judging too early, during the swelling phase.

The most satisfied patients are those who had clear, realistic expectations: looking rested, regaining a clear oval, softening a hollow face, without trying to look twenty years younger or to change their face. A frank discussion with the surgeon about what is possible, how long recovery will take and how the result will develop is the best guarantee of satisfaction.

Several observations come up repeatedly. In the first few days, facial tightness and sleeping position are the main discomforts, more than pain. Swelling of the fat areas is surprising. Around the third week, the face becomes presentable, and those around you begin to notice how well you look. At three months, most patients say they are satisfied, and satisfaction increases further up to six months.

Those around you often notice a rested look, without identifying a procedure. Some people prefer not to talk about it, others are open about it. This choice remains personal. A result that is not noticed as a procedure is often the sign of successful work.

After a successful facelift with fat transfer, those around you rarely notice the procedure itself. They notice rather a rested look and a healthy glow, sometimes assuming a different hairstyle or better fitness. This gap between the real change and how it is perceived is often appreciated: you feel rejuvenated without others thinking of surgery.

For many people, regaining a face that reflects their energy and state of mind restores confidence, at work and in their personal life. This benefit, difficult to measure, is often the one patients mention first, well before the number of years gained.

What many patients describe after a facelift with fat transfer is less the impression of having become younger than that of finding themselves again. The face in the mirror once again matches the image they have of themselves, their energy and their mood. This sense of coherence, difficult to describe, is often the most lasting benefit of the procedure. It also explains why surgeons place so much emphasis on naturalness: the aim is not to become someone else, but to regain the best version of your own face, the one you recognise in photographs from a few years ago, with added experience. This approach, more respectful of identity, is also the one that ages best over the years.

A facelift does not stop ageing, but it turns it back by several years. The result of a well-performed deep plane facelift often lasts about ten years, during which the face continues to age from a rejuvenated starting point. The fat that has survived after six months is lasting and ages with the face. Over time, further volume loss may justify an additional fat session.

How long the result lasts depends on the facelift technique, deep or more superficial, skin quality, lifestyle, weight stability and sun protection. Once stabilised, the injected fat also contributes to the duration of the rejuvenation. A well-performed deep plane facelift, maintained by a healthy lifestyle, can keep its effect for many years.

A facelift does not freeze the face. After the procedure, the face continues to age, but from a rejuvenated starting point. Ten years later, it generally looks younger than it would have without the procedure. The injected fat ages with the face: it may decrease slightly with weight loss or age, but it does not disappear. This natural development is an advantage: the face remains coherent over the years.

Protecting your skin from the sun, not smoking, keeping a stable weight, sleeping well and caring for your skin prolong the result. Regular skin care, or even treatments such as laser or light peels, can maintain its quality. A small fat session years later can compensate for further volume loss.

After a facelift with fat transfer, many patients maintain their result with regular skin care, sun protection and, if necessary, small procedures such as botulinum toxin for expression lines or a fat session several years later. This light maintenance prolongs the benefit of the procedure.

Significant weight loss after the procedure empties the face again, including the injected fat, and can make the skin lax. Significant weight gain can weigh down the lower face. A stable weight preserves the result.

A facelift repositions the skin but does not change its texture. Suitable care, prescribed by a dermatologist or offered by the surgeon, can improve radiance, pigmentation and fine lines: creams, gentle peels, laser, stimulation techniques. These are generally done well after the procedure, once healing is complete.

After healing, a simple routine helps preserve the result: gentle cleansing, moisturising, daily sun protection and, on a dermatologist's advice, active ingredients that stimulate skin renewal. These simple, regular habits count as much as one-off treatments.

For several months, the sun can darken scars and increase swelling. High-factor sunscreen, a wide-brimmed hat and avoiding prolonged exposure are recommended. In the long term, sun protection is the best way to preserve skin quality.

Years after a first facelift, a second can be considered. It is often simpler, but requires particular attention to existing scars, the hairline and the blood supply to the skin. Fat transfer often plays a major role, as the face has continued to lose volume.

Some people have a face that looks pulled after an old facelift performed with a lot of tension on the skin. Adding volume with fat is often the best way to soften this appearance, giving roundness back to the cheeks and temples. Further excessive tension would make the problem worse.

Hyaluronic acid, injected in the practice, restores volume quickly and reversibly, but temporarily: it is resorbed within a few months to two years depending on the product. Fat requires a procedure, with harvesting, but its effect is lasting and it often improves skin quality. During a facelift, fat is often preferred, as it benefits from the anaesthetic and allows several areas to be treated with a larger volume.

Hyaluronic acid injections offer an effect lasting a few months to two years, to be repeated regularly. A facelift combined with fat transfer offers an effect lasting several years, with fat that stays in place once stabilised. Over ten years, the number of injection sessions needed to maintain a comparable result can be considerable. This is one of the arguments that lead some people, after years of injections, to choose a longer-lasting procedure, knowing that it requires recovery and carries the risks of surgery.

The eyes are part of rejuvenation. When the upper eyelids are heavy or bags mark the lower eyelids, blepharoplasty can be combined with the facelift and fat transfer. It lengthens the procedure but harmonises the result. Our page on blepharoplasty describes this procedure.

Facelift, fat transfer, eyelid surgery, lip treatment: several procedures can be combined in a single operation. This allows harmonious rejuvenation and a single recovery, but it lengthens the procedure and can increase certain risks. The surgeon helps set priorities and may suggest spreading the procedures over two stages.

Drooping eyebrows, especially at their outer part, weigh down the eyes. A temporal or forehead lift can raise them. This procedure is different from a neck and face lift, but can be combined with it. Fat injected into the temples also helps support the tail of the eyebrow.

As amounts depend greatly on the facility and the technique, we express each option relative to a reference set at 100: a neck and face lift with fat grafting to the cheekbones, temples and folds, performed in Geneva.

Details are on the page on facelift with fat transfer prices.

The type of facelift, deep or more superficial, treatment of the neck, the extent of fat transfer, combined eyelid surgery, the type of anaesthesia, the stay, the clinic and the surgeon's experience explain the differences.

Cosmetic facelifts and fat transfer are not covered by compulsory insurance. Only certain situations, such as facial paralysis or the after-effects of an accident, may qualify for coverage, on prior request.

As the combination is cosmetic, all costs are at the patient's expense: fees, anaesthesia, theatre, stay, fat harvesting and grafting, check-ups. It is useful to check exactly what the quote includes, particularly for additional fat sessions and touch-ups.

Some clinics offer staggered payment. Calculate the total cost before committing, and keep a margin for any complementary skin care or a fat session.

It should detail the facelift technique, treatment of the neck, the planned fat areas and volumes, the anaesthesia, the stay, dressings, follow-up visits and what is planned in the event of a touch-up or additional session.

The quote is supplemented by medicines, compresses, sometimes a drainage session and, later, a possible additional fat session or skin care. Adding them up helps you measure the overall commitment.

To compare two quotes, check the proposed facelift technique, the extent of neck treatment, the fat areas and planned quantities, the type of anaesthesia, the stay, dressings, check-ups and the touch-up policy. A cheaper quote may correspond to a less complete procedure.

Facelifts are performed by plastic surgeons and facial surgeons. Combining them with fat transfer is now common in the major cities. The table compares provision and fees in twenty-one cities.

A facelift requires a night in hospital and several check-up visits; here, canton by canton, is the centre patients most often turn to and the clinic provision available.

In the Lake Geneva region, Geneva and Lausanne bring together many surgeons experienced in both deep plane facelifts and fine fat grafting. Sion, Neuchâtel and Fribourg offer local options. In German-speaking Switzerland, Zurich dominates, ahead of Basel and Bern; south of the Alps, Lugano hosts most of the provision. As a facelift requires a night in hospital and several visits, distance matters more than for a day-surgery procedure.

The technical choices, risks and instructions must be fully understood. Practices in French-speaking Switzerland work in French; in Zurich, Basel, Bern or Lugano, many surgeons see patients in French.

The post-operative instructions, the information document and the quote must be written in a language you read fluently. If you consult in another language region, ask for them to be given to you in French or explained in detail.

Choosing a distant surgeon is possible, but you must plan for the night at the clinic, sometimes an extra night nearby, stitch removal at around one week and the subsequent check-ups. A local doctor can take over for the first few days.

After a facelift, the most important check-ups take place during the first two weeks: the next day, then at around one week to remove the stitches. If you live far away, plan to stay nearby for a few days or arrange stitch removal with a local doctor in agreement with the surgeon. The subsequent check-ups, at one, three and six months, can be combined.

A second opinion helps compare the proposed facelift techniques, the extent of fat transfer and whether or not to combine other procedures such as eyelid surgery.

Facelifts are performed by plastic surgeons and, in some cases, by facial surgeons with an ENT or maxillofacial background who are trained in facial cosmetic surgery. What matters is choosing a surgeon who regularly performs facelifts and fat transfer, can show comparable results and with whom communication is easy.

Facelifts and fat transfer require two skills: repositioning the deep tissues and fine fat injection. Ask the surgeon about the facelift technique they use, the number of procedures they perform, how they prepare and inject fat, and their complications. Look at results, from the front and in profile, at more than six months, of people of comparable age. Their specialist title can be checked in the public register of doctors.

The procedure involves the surgeon, the anaesthetist, the theatre team and the ward team. Monitoring on the first night is important to detect a haematoma. Ask who your contact is after discharge and how to reach the team at any time.

Your GP helps prepare for the procedure, in particular by controlling blood pressure and adjusting treatments. They can also handle part of your general follow-up. It is useful to send them the operative report.

They will explain what is due to laxity and what is due to volume loss, which technique they propose and why, where the scars will be, how long the swelling will last, what the risks are, and what a facelift cannot do, such as erasing fine lines or changing skin quality. They will not hesitate to advise against a procedure they consider unnecessary.

The quality of the result depends on several elements: a fine analysis of the face, a suitable choice of technique, deep repositioning without tension on the skin, measured and precise fat grafting, well-placed scars and a well-managed recovery. The surgeon's aesthetic sense and ability to preserve the identity of the face count as much as their technique.

Ask for photographs of patients of similar age and build, at more than six months, from the front, in profile and at three-quarters. Look at the oval, the neck, the cheekbones, how natural the expressions look and how discreet the scars are. Be wary of retouched photos or photos taken in different conditions.

To judge result photos, compare images taken under the same conditions: same light, same angle, same expression, without make-up or retouching. Look at the oval, the neck, the cheekbones, the eyes and the scars. A good result can be recognised by a face that looks rested and natural, without visible tension, and that still looks like the same person.

• Which facelift technique do you propose, and why for my face?
• Will the neck be treated, and how?
• Which areas will receive fat, and how much?
• Where will the scars be placed?
• How long will visible swelling last?
• How do you limit the risk of haematoma?
• What happens if a touch-up is needed?

• Wanting a pulled face rather than a rested one.
• Neglecting volume loss in a thin face.
• Continuing to smoke.
• Resuming exertion or blood-thinning medicines too early.
• Judging the fat volume in the first few weeks.
• Scheduling an important event in the following month.

The thin, lax face

A slim, athletic fifty-eight-year-old woman has jowls, a lax neck, hollow temples and emptied cheekbones. The surgeon proposes a deep plane facelift with neck treatment and fat transfer to the temples, cheekbones and tear troughs. At six months, her face looks rested, without a pulled appearance.

The full face

A sixty-two-year-old man has a full face, jowls and a double chin. The surgeon proposes a facelift with neck treatment and suction of fat under the chin, without fat transfer except to the temples.

The previously operated face

A sixty-five-year-old woman had a facelift twelve years ago. Her face looks pulled and hollow. The surgeon mainly proposes extensive fat transfer, with slight re-tightening of the neck.

After weight loss

A fifty-three-year-old woman has lost a lot of weight. Her face is emptied and lax. The surgeon proposes a facelift with removal of excess skin and significant fat transfer, planning an additional session.

A fifty-nine-year-old woman consults because she finds herself looking "tired" despite being in good shape. The examination shows jowls, a lax neck with a blunted angle, hollow temples, emptied cheekbones and a marked tear trough. The surgeon proposes a deep plane facelift with neck treatment and fat transfer to the temples, cheekbones, tear troughs and chin, using fat harvested from the lower abdomen. The procedure takes four and a half hours, with a night in hospital. She returns to social life after three weeks. At three months, her face looks rested; at six months, the volume is stable. Those close to her say she looks "ten years younger", without knowing exactly why.

Several moments mark the journey: the first consultation, where you discover what is due to laxity and what to volume; the day of the procedure and the night at the clinic; dressing removal the next day, when you see yourself swollen; stitch removal at around one week; the return to social life at around three weeks; then the stabilisation of volume at around six months. Keeping these stages in mind helps you go through them calmly and not judge too early.

• I know what predominates in my face: laxity, volume loss or both.
• I know the proposed facelift technique and where the scars will be.
• I know which areas will receive fat.
• I have stopped smoking and my blood pressure is controlled.
• I have planned two to three weeks away from social life.
• I accept that the fat volume will change over six months.
• I have a detailed quote.

Before committing, ask yourself a few questions: is what bothers me mainly laxity, volume loss or both? Do I want a discreet or a more marked change? Am I prepared to plan two to three weeks of recovery? Have I stopped smoking and is my blood pressure well controlled? The answers, shared with the surgeon, naturally point towards the most suitable plan.

Combining a facelift and fat transfer treats both components of facial ageing: tissue descent and volume loss. The facelift lifts the lower face and neck at depth; the fat restores the cheekbones, temples, eye area and lips. The result aims for a rested, natural face rather than a pulled one.

Recovery requires two to three weeks away from social life; the result stabilises in three to six months. Haematoma is the most common complication, hence the importance of blood pressure and stopping smoking. Fees can be up to fourteen per cent lower than in Geneva depending on the canton; the surgeon's experience in both techniques remains decisive.

Choose a surgeon experienced in deep plane facelifts and fat transfer. Bring photos of yourself when younger. Stop smoking and control your blood pressure. Keep realistic expectations: a rested, natural face, not a different face. Plan two to three weeks of recovery. Follow the instructions, particularly regarding exertion and sleeping position. And give the result time to emerge.

Beyond the techniques, what matters is regaining a face that looks like you and reflects your energy. A surgeon who takes the time to listen to you, analyse your face, explain their choices and tell you what is not possible is the best guarantee of a result you will be satisfied with in the long term.

If your face seems tired, lax or hollow to you, a consultation will determine what calls for repositioning, what calls for volume, and which plan will give you back a rested face that looks like you. Medespoir Suisse can put you in touch, free of charge, with an experienced facial surgeon.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Facelift and facial fat transfer: prices in Switzerland.

Related procedures

• Rhinoplasty and buccal fat removal in Switzerland
• Rhinoplasty and genioplasty in Switzerland
• Breast implant exchange and breast lift in Switzerland
• Profileplasty: nose, chin and double chin in Switzerland
• Breast implant removal and breast lift in Switzerland
• Breast fat transfer and liposuction in Switzerland

The procedures that make up this combination

• Facial fat transfer in Switzerland
• Breast fat transfer in Switzerland
• Buttock fat transfer in Switzerland
• Facelift in Switzerland

Our guides

• Combined procedures in Switzerland
• Cosmetic surgery in Switzerland

Volume, laxity, scars, swelling, haematoma and longevity: the most frequent questions before a facelift combined with fat grafting.

Understanding

Why combine fat transfer with a facelift? Because a facelift lifts the tissues but does not restore lost volume; fat does.

What is three-dimensional rejuvenation? An approach that repositions the tissues and restores volume, rather than simply tightening the skin.

Does a facelift pull the skin? Modern techniques mainly lift the deep layer; the skin is redraped without excessive tension.

Where does the fat come from? Usually from the abdomen, flanks, thighs or inner knees.

How much fat is injected? A few millilitres per area, adapted to each face.

What is the SMAS? The deep musculo-aponeurotic layer of the face, which the surgeon lifts during the facelift.

What is a deep plane facelift? A facelift that releases the ligaments and repositions the tissues at depth, for a natural result.

For whom?

At what age? Usually between fifty and seventy, depending on laxity and volume loss.

What if my face is full? Fat transfer may be limited or unnecessary; the facelift is then the priority.

What if my face is thin? Fat is almost essential to avoid a gaunt appearance.

Are men concerned? Yes, with a technique and scars adapted to the beard and hair.

Can smokers have the operation? After stopping completely, as smoking endangers the skin and the fat.

Is high blood pressure a problem? It must be well controlled, as it encourages haematomas.

The fat areas

Which areas can be filled? Temples, cheekbones, tear troughs, folds, lips, chin and jawline.

Can dark circles be treated? Yes, with finely prepared fat and a very careful technique.

Does fat improve the skin? It seems to improve skin tone and suppleness, according to many surgeons.

What is nanofat? A very fine preparation of fat, used for skin quality rather than volume.

Can the lips be treated? Yes, fat can restore natural volume to thinned lips.

The procedure

How long does the procedure take? Generally three and a half to five hours.

Do I need to stay overnight at the clinic? Generally one night.

What type of anaesthesia? General anaesthesia or deep sedation with local anaesthesia.

Where are the scars? In the scalp, in front of and behind the ear, sometimes under the chin.

Is the neck treated? Yes, a neck and face lift treats the lower face and the neck.

Are drains used? Sometimes, for one or two days.

Recovery

How long does swelling last? Two to three weeks for most of it, several weeks for residual swelling.

When can I return to social life? After two to three weeks.

How should I sleep? On your back, upper body raised, for one to two weeks.

When are the stitches removed? Generally between five and ten days.

When can I wash my hair? After a few days, according to the instructions.

Will the skin be numb? Yes, for several weeks, sometimes a few months.

Why does my face look overfilled at first? Because of swelling and slight overcorrection in anticipation of resorption.

Risks

What is the most common risk? Haematoma, especially in the first few hours.

Can the facial nerve be affected? Rarely, and usually temporarily.

Can the fat form lumps? Sometimes, especially under the eyes; they can be corrected.

Are there serious risks with fat? Exceptionally, injection into a blood vessel; an appropriate technique greatly reduces this risk.

Can the scars be visible? They are generally discreet; a revision is possible if they widen.

Can I lose hair? Temporarily along the scalp scars; it generally grows back.

Results

When will I see the result? The lift from one month; the fat volume stabilises between three and six months.

How long does the result last? Often about ten years for the lift; the fat that remains is lasting.

Will I look operated on? Not if the technique is well executed: the aim is a rested face, not a tight one.

Will more fat be needed later? Sometimes, a small additional session is useful after a few months or years.

Price and insurance

Does insurance reimburse it? No, except in particular situations such as facial paralysis.

Does the location change the price? Yes, some cantons are up to fourteen per cent cheaper than Geneva.

What makes the price vary? The facelift technique, the neck, the extent of fat transfer, the eyelids and the clinic.

Choosing

Which specialist should I consult? A plastic surgeon or facial surgeon experienced in facelifts and fat transfer.

Should I see photos? Yes, from the front and in profile, at more than six months, of people of comparable age.

Is a second opinion needed? It is useful for comparing the techniques proposed.

Particular situations

Can fat transfer be done without a facelift? Yes, when laxity is mild and volume loss predominates.

Can a facelift be done without fat transfer? Yes, in full faces that have not lost volume.

Can blepharoplasty be combined? Yes, to treat the eyes at the same time; the procedure becomes longer.

Can a brow lift be combined? It is possible if the eyebrows are drooping; this is discussed case by case.

Can a facelift be repeated? Yes, a secondary facelift is possible years later, often with fat.

What if I have had fillers? Mention them; some can be dissolved before the procedure.

Are permanent fillers a problem? Yes, they complicate the procedure and must be assessed.

Is botulinum toxin compatible? Yes, it can complement the result on upper-face wrinkles.

Can wrinkles around the mouth be treated? Fat and other skin treatments can soften them; a facelift does not erase them.

Are forehead wrinkles treated? No, a neck and face lift treats the lower face and the neck.

Can I wear earrings? After healing, generally a few weeks.

Can the earlobe be distorted? This is rare; a careful technique preserves its natural shape.

Can the sideburns move up? The surgeon adapts the incision to preserve the position of the sideburns and hairline.

Can I wear make-up? After one to two weeks, avoiding the scars.

Can I dye my hair? After a few weeks, once the scalp scars have closed.

Can I do sport? Intense exertion waits four to six weeks to avoid haematomas.

Is lymphatic drainage needed? It can help reduce swelling, according to the surgeon's advice.

Can the fat migrate? No, it stays where it has taken.

Does the fat grow if I gain weight? Yes, it behaves like fat from its area of origin.

Can the face look overfilled? This is a risk if too much fat is injected; a cautious surgeon avoids it.

Can excess fat be corrected? Yes, with a small suction procedure or other techniques.

Does the voice change? No.

Can I chew normally? Yes, after a few days of soft food.

Can I wear glasses? Yes, generally without difficulty.

Should I avoid the sun? Yes, for several weeks, to protect the scars and limit swelling.

Is the result visible in photos? Yes, especially in profile and at three-quarters, where the oval and the neck change.

Can the procedure be done at seventy-five? Yes, if health allows, after a medical assessment.

Is diabetes an obstacle? It must be well controlled, as it affects healing.

Are anticoagulants a problem? They must be adjusted with the doctor, as they increase the risk of haematoma.

How long before an important event? At least two to three months, ideally more.

Are the scars visible with short hair? Those behind the ear may show; the surgeon adapts the incision line.

Do I need help at home? Yes, for the first few days.

Can I travel after the procedure? It is better to wait until the stitches are out and the surgeon agrees.

What should I prepare for the consultation? Your expectations, old photos, your treatments, your medical history and your questions.

What is Medespoir Suisse for? To direct you, free of charge, to a specialist in facelifts and fat transfer.

What if I am disappointed with the result? Wait six months, then talk to the surgeon: a touch-up or a fat session can improve it.

Does fat replace hyaluronic acid injections? It can replace them with a longer-lasting effect, after a procedure.

Do the folds disappear completely? They soften; erasing them completely would look artificial.

Is the double chin treated? Yes, with the neck lift and, if needed, suction under the chin.

Is a particular time of year preferable? Autumn and winter, to avoid sun on the scars.

Do I need to explain the procedure at work? No, a sick note without detailed reasons is enough.

Should I stop the pill? This is discussed with the anaesthetist according to your risk factors.

Is the procedure painful? You mainly feel tightness and discomfort, well relieved by painkillers.

When does sensation return? Gradually, over a few weeks to a few months.

Can I drive again? After one to two weeks, when you can turn your head without discomfort.

Does a facelift change your expression? A well-performed facelift preserves expression; excessive tension can freeze it.

Can the fat become infected? Rarely; redness or increasing pain must be reported.

Can fat transfer be repeated later? Yes, to maintain the result over the years.

Are hollow temples corrected well? Yes, fat often gives very good results there.

Does the result depend on the surgeon? A great deal: technique and aesthetic sense are decisive.

What should I do if one side suddenly swells? Call the team immediately: it may be a haematoma.

Is long-term follow-up needed? A check-up at one year, then as needed.

Can a facelift be combined with skin treatment? Yes, treatments such as laser or peels can complement it, often at a later date.

Tell us what bothers you about your face, your age and the region where you would like to consult. An adviser will suggest, free of charge, a facial surgeon experienced in facelifts and fat transfer.