Facelift and neck lift surgery is a popular method to enhance one’s appearance, especially for those with excess skin or tissue laxity. Facelift with neck lift surgery is considered by patients and plastic surgeons the best option for those with significant facial aging.
What about excess fat? A question that is often asked to plastic surgeons is the timing of cosmetic facial surgery around weight loss, whether to perform surgery before or after the planned weight loss with diet and exercise.
Most plastic surgeons agree that patients should have a stable weight before proceeding with any elective procedure. Quick or frequent swings in body weight will not only directly affect one’s appearance, the fluctuating size may create more unpredictable outcomes with plastic surgery.
Part of the decision process in facelift surgery depends on the amount of fat currently in the face and neck. For those with limited facial fat, then further weight loss may have limited impact on the facelift result. However, if there is a significant amount of excess neck fat, then it’s reasonable for some patients to loose the body weight first before having the facelift.
Volume loss of the Face and Neck
One issue with weight change is volume. The face ages in a multidimensional manner, and fat transfer enhances one’s appearance in addition to lifting sagging neck tissue with a facelift. Fat transfer to the face, cheeks, lips, etc. is often performed at the same time as facelift surgery to address the various changes from facial aging. Read more about fat transfer in previous blog post.
If one is significantly overweight, then it’s more difficult to determine how much, if any, fat volume would be transferred during the facelift. The plastic surgeon may limit the cosmetic procedure given the existing fat volume of the face and neck.
Sagging skin and tissue after Weight Loss
Another potential issue with weight change is sagging tissue that develops after weight loss. For example, after large volume liposuction, the skin can sag and hang in some patients as it doesn’t appropriately shrink to the smaller body frame. Often the skin and muscle needs to be tightened after significant fat loss. As a result, it makes sense to wait until the planned weight loss has stabilized, otherwise the plastic surgeon may underestimate how much tissue to tighten with facelift surgery. The initial firm neck from the facelift may become loose again as weight loss occurs after plastic surgery.
Advantages of Weight Loss Before Facelift Surgery
The primary advantage of waiting until after weight loss before facelift surgery is that it may improve the facelift result from the volume and tissue laxity. The other advantage is with anesthesia and recovery. Anesthesiologists recommend slimmer patients because the administration of anesthesia is generally smoother. For healthy weight patients, healing and recovery is considered better after plastic surgery too.
Weight loss before Plastic Surgery
Weight loss should be at a gradual and healthy pace. Many plastic surgeons recommend about one pound per week of weight loss for safe and lasting results. You should check in periodically with your plastic surgeon to assess your appearance. Some lose weight from their face first while others can lose significant body weight before seeing changes in their face. Your plastic surgeon may perform fat transfer or injectable fillers to replace any lost volume that occurs during planned weight loss until you’re ready for facelift surgery.
The ideal time for your facelift is once you have stabilized your weight and have a healthy diet and exercise regimen in place. As motivation, some patients think of the facelift as a gift to themselves for achieving certain weight and health goals.
Ideally one would lose the excess weight, especially those with massive weight loss from gastric bypass procedures. But losing a small amount (i.e. 10 pounds) before or after a facelift generally won’t make a difference in the neck lift results. Plastic surgeons have done facelifts on individuals who have later lost some weight who didn’t have sagging tissue again.
Keep in mind that if a significant amount of weight loss occurs after plastic surgery, then you may have some facial sagging that will need to be treated with possibly nonsurgical treatments or another lift or “tuck up” procedure.
Ideal Facelift candidate
The ideal facelift candidate is an individual with good overall physical health, who is close to their ideal weight. They also have a healthy lifestyle to maintain their current weight and do not smoke. In addition, facelift candidates have realistic expectations.
Each patient is unique. The best plastic surgeons offer a variety of facelift and neck lift treatments, both surgical and nonsurgical. Customized treatment is based on several factors including the patient’s individual anatomy and personal preference. After a comprehensive evaluation, a plastic surgeon can help you choose the best option appropriate for you.