Abstract

Objectives: reconstructive face lift is a new frontier that require attention as over usage of fillers and non surgical interventions leads to long term fibrosis , depression , swelling. so to obtain results in face lift surgery in patients with permanent fillers, previous infection , depressions and fibrosis that can be compared to the routine face lift surgery. what to use in reconstruction and an algorithm for each case Introduction: ladies with history of permanent fillers that was injected between 2000 to 2012 in Kuwait and united Arab emirates suffered from recurrent infections, depressions , recurrent swelling and many failed surgical removal procedures. the main problem was that there is no enough tissue volume or tissue strength that can maintain face lift results. so we proposed an algorithm to use facial grafts and /or dermal fat grafts with buccal fat redistribution to fill the defects and to compensate for the lost SMAS Materials / method: 314 ladies that undergone a reconstructive face lift surgery with permanent filler removal between April 2022 and April 2025 with 6 month to 2 years follow up the used facial grafts was mastoid fascia graft, temporal fascia graft, SMAS graft and dermal fat graft from the abdomen all patient consented to share their results in the study and follow up was done for at least 6 month postoperative with preoperative and post operative documentation the intraoperative filler removal and the grafts application were also documented with videos Results: the results of the ladies with reconstructive face lift using tissue grafts was not less than the results of the routine face lift surgery as stated by two independent surgeons with 23 % of the patients that required fine touch after 6 month by fat transfer or hyaluronic acid . patients satisfaction was measured using a specific designed questionnaire and the post operative results showed 87% satisfaction rate with 10 % acceptable results and only 3 % of he patients were unsatisfied by the procedure Conclusion: fascial grafts and dermal fat grafts in reconstruction of the face lift surgery following permanent filler removal is an excellent choice with less morbidity and more predictable results compared by other options for reconstructionslike free flaps