“We also experience a loss of volume in the midface and temples, which can result in a more gaunt appearance.”
‘A facelift restores the facial tissue to its more juvenile position, while fat is injected into the face using microscopic needles from other parts of the body, typically the stomach or flanks, to replace lost volume.
However, the fat transplants will continue to function as abdominal fat, even in the face. Consequently, we caution patients that if they gain weight, it will be evident in their facial features. For this reason, it is also necessary to exercise caution when applying grafts to the face.
The ‘characteristic appearance’ of over-done adipose transfer to the face was acknowledged by Mr. Yapa, a cosmetic surgery expert. I describe it as a swollen, mask-like appearance in which the mid-face remains stationary.
Other cosmetic surgeons have referred to the effect as a “Howdy Doody face,” which is a reference to an American wooden marionette show character who was the protagonist of a 1960s television program.
