For this 61-year-old patient, Beverly Hills plastic surgeon Suzanne A. Trott, M.D., F.A.C.S. combined an upper, mid and lower facelift with transconjunctival lower blepharoplasty, microfat grafting, and fractional CO2 laser resurfacing of the skin. Each procedure has a specific responsibility. The facelift addresses tissue position and facial contours. Microfat grafting, a form of facial fat transfer, uses the patient’s own fat to replenish selected areas of volume loss. Together, they address both the descent and the depletion associated with aging. The fractional CO2 laser resurfacing addresses the skin itself, improving its texture and quality — changes no lifting procedure can achieve on its own. The lower eyelid surgery adds another important detail: the incision is inside the eyelid, allowing under-eye fat to be addressed without placing that incision on the external eyelid skin. With these facelift before-and-after photographs side by side, look beyond the outline of the face. Examine the lower eyelids, the cheeks and the relationship between fullness and definition. That is the thinking behind Dr. Trott’s approach to this case. The planning extends beyond how much to lift. It considers where fullness belongs and how the individual corrections will work together. The procedures are separate. The face is not.

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Photos are unretouched