Thank you for your query at DoctorSpring.com
Yes, your jowls now appear more prominent after the procedure. Despite fantastic claims, ultherapy does not work in everyone. However, I would still say that you need to wait for at least 2 months more to evaluate the final results. If you feel that you are not getting the desired results then I would say that a mini-facelift at this point of time is going to work wonders, however, your age is a little bit less than ideal.
Regarding your forehead hollowing, I would say that fat grafting would be the best under this situation. A degree of overfilling is recommended as much of the injected fat would absorb over time. I would not recommend fillers to you. No other surgical procedure is recommended for your forehead region at this point of time.
Please let me know if you have further questions. Wish you all the very best!
Dr. Souvik Adhikari, MBBS, MS, MCh (Plastic Surgery)
Patient replied :
I attached even better pictures, so you can get a better idea of my issues. The picture with the hat is right before the ultherapy, that picture with the braids is now. My face looks less plump and deflated. The right side of my face has a sagging appearance. I'm just trying to figure the best procedure to do. Would a mini facelift of fat grafting work better? Can volume lift the face or only a facelift. My skin is in really good condition, but I feel the ultherapy has caused volume loss. Also, my under eye area is very hollow after the procedure. Please advice.
Judging from these pictures, you do not seem to have too much of sagging skin in your face. However, the malar fat pad has drooped quite a bit and therefore the face appears to have an aging look. If you ask for my opinion, I would perform a short scar facelift with fat repositioning so as to provide volume to the midface. Next, I would perform additional fat grafts to restore volume to the face (I would not be too much inclined to use fillers). A combination of these 2 procedures should be able to solve the issue very well.
If you have additional queries please let me know. Please note that a conventional facelift is not recommended in your case.
Patient replied :
I promise this is my last question! After carefully looking at my younger and current pictures my malar fat pad doesn't look to have moved much. My cheeks were always pretty flat. You can compare the picture before with short hair that I sent, to the picture I have attached now. I know something is aging me, I just can't put my finger on it. I also get pretty cheeky when I smile, wouldn't this be bad for a short scar face lift? Wouldn't that make my mid-face appear even wider? The only things I can pinpoint for a fact is my forehead is more hollow and under eyes. I just wanted to post a better picture to see, if you feel a face lift is the best possible option. Please advise again :-)!
If you are quite cheeky when you smile then go ahead with a mini lift. The only reason I recommended a malar fat lift is that it gives excellent long term results, however, if you are satisfied with your malar fat when you smile do not go on with it.
Your face has lost volume and this needs to be corrected with fat. This would need to be placed in areas of forehead hollowness, periorbital area (little bit) and overall to restore volume to the face.
Remember, there has to be a balance between skin tightening and volume. When fat is added, the overlying skin envelope automatically tightens therefore get the fat transfer first and then decide on the mini lift.