Incorporating Fat Grafting with Facelift Surgery: When, How, and Where

Facial aging is a multifactorial process with many articles over decades supporting various theories of varying causes. It is generally thought that aging occurs as a combination of changes in skin quality, gravitational descent of tissue with interaction of retaining ligaments on the ptotic tissue, and facial volume loss or the appearance of volume loss. The most significant cause of volume loss is skeletal remodeling and bone loss, which manifests as characteristic shadows and hollows on the face in conjunction with soft tissue changes that are yet to be completely elucidated.