---
title: "Facelifts After 65: How Dr. Robert Paresi Restores Volume in Older Patients"
description: Dr. Robert Paresi of Contour Plastic Surgery in Downers Grove adds Renuva, made from younger donor fat, to facial fat grafting for facelift patients over 65.
author: Dr Marina Nani (Editor-in-Chief)
date: 2026-10-11T11:02:43.116Z
updated: 2026-10-11T11:02:43.135Z
canonical: https://richhealthmagazine.com/article/robert-paresi-facial-fat-grafting-facelift-over-65
image: https://cdn.nanimediahouse.com/robert-paresi-hero-v1.webp
categories: Health
content_type: Profile
region: Illinois, Chicago
publication: Rich Health Magazine
about:
  - type: Person
    name: Robert J. Paresi Jr.
    description: Dr. Robert J. Paresi Jr., MD, MPH, is a plastic surgeon certified by the American Board of Plastic Surgery and the American Board of Surgery, and the founder of Contour Plastic Surgery and MedSpa in Downers Grove, Illinois. He trained in plastic surgery at Rush University Medical Center and in aesthetic surgery at Lenox Hill Hospital and Manhattan Eye, Ear and Throat Hospital, and his work centers on facelifts, neck lifts and facial fat grafting.
    jobTitle: Plastic surgeon
    worksFor: Contour Plastic Surgery and MedSpa
    sameAs:
      - https://contourplasticsurgery.com/about-us/dr-robert-paresi-md-chicago-plastic-surgeon/
      - https://healthcare.ascension.org/find-care/provider/1891902359/robert-paresi
---

In patients over 65, the fat a surgeon moves into the face during a facelift does not survive as well as it does in younger patients. Dr. Robert J. Paresi Jr., MD, MPH, a double board-certified plastic surgeon and the founder of Contour Plastic Surgery and MedSpa in Downers Grove, Illinois, now offers Renuva alongside facial fat grafting in his facelifts to improve how much of that grafted fat survives in older patients.

Renuva is an injectable allograft adipose matrix made by MTF Biologics from purified, sterilized donor fat tissue. It restores lost volume and prompts the body to grow new fat cells of its own. "The donor fat for Renuva is taken from younger patients, and can be used to enhance the facial fat grafting survival rate in older facelift patients," says Dr. Paresi.

## Facial Fat Grafting as Part of a Modern Facelift

Dr. Paresi traces facial aging to three causes: changes in skin quality, loss of volume and changes in the underlying structure. Anatomical studies have shown that the superficial fat pads of the face shrink with age, and a lift tightens the tissues without replacing that volume.

At Contour, microfat grafting to the face is part of 90% of facelifts. Dr. Paresi takes small amounts of fat, most often from around the navel or the inner thighs, purifies it and injects it at the end of the facelift into the areas that hollow with age. These are the cheeks, the nasolabial folds, the corners of the mouth, the temples, the area under the brow and the prejowl sulcus, the groove just in front of the jowls. Patients often notice that the texture of their skin improves where the fat has been placed.

## Why Fat Transfer to the Face Changes With Age

How well a fat graft survives depends on where the fat is taken from and where it is placed, and age affects both, so in an older face less of the volume restored in the operating room lasts. A [2019 Stanford study in Plastic and Reconstructive Surgery](https://pmc.ncbi.nlm.nih.gov/articles/PMC6438719/) found the same pattern in mice, where human fat grafted into young animals kept significantly more of its volume over eight weeks than fat grafted into older ones.

Dr. Paresi uses Renuva in two ways. For some patients it replaces their own fat as a stand-alone injection, and for older patients he can combine it with their own fat in the same procedure. He sees it as a strong option for facelift patients over 65 who want to get more from their overall result.

## Facelifts for Older Patients at Contour Plastic Surgery

Dr. Paresi's facelift patients are usually between 50 and 70, and most look five to ten years younger afterward. Patients in their forties have firmer skin, so their results may last longer, while older patients often see a more dramatic change. The practice's patient photographs include a 68-year-old woman who had a facelift elsewhere without fat grafting and came to Dr. Paresi seven years later for a second facelift with microfat to the cheeks, nasolabial folds and corners of the mouth. Another shows a 78-year-old woman who had fat grafted under the brows under local anesthesia.

His usual facelift combines SMAS plication, which tightens the layer of muscle and connective tissue beneath the skin, with a corset platysmaplasty that tightens the muscles of the neck. Correcting loose skin and muscle in the neck is, in his view, a crucial part of a good facelift result. For severe sagging, which is more common in older patients, he may use a deep plane facelift, which lifts the deeper layers of the face. He chooses the technique patient by patient.

Most of his facelift patients have a short-scar incision. To keep the scar hard to see, Dr. Paresi makes a zig-zag incision in the temporal hairline, cut in the direction of the hair so that it grows back through the scar. He hides the incision in front of the ear along the inner edge of the tragus, the small flap of cartilage in front of the ear canal, and he places a stitch in the earlobe so that it is not pulled down into what surgeons call a "pixie ear."

Patients having a facelift on its own can choose local anesthesia with tumescent fluid and an oral sedative, provided they are comfortable with the injections and with lying on their back for about four hours. Otherwise the operation is done under general anesthesia at an accredited surgical facility. It takes three to four hours and is usually an outpatient procedure, although some patients stay overnight. Bruising, swelling and tightness ease within a few days, and the final result takes several months to appear.

## Dr. Robert Paresi's Training and Background

Dr. Paresi is certified by both the American Board of Plastic Surgery and the American Board of Surgery. He earned his MD at St. George's University School of Medicine and a Master of Public Health at the University of Rochester. He completed a five-year general surgery residency at Monmouth Medical Center in Long Branch, New Jersey, and a plastic surgery fellowship at Rush University Medical Center in Chicago, followed by an aesthetic surgery fellowship at Lenox Hill Hospital and Manhattan Eye, Ear and Throat Hospital in New York.

He has traveled to Guatemala twice as a medical missionary, in 2004 and 2008, to operate on children with cleft lip and palate, hand deformities and burns. His publications include 13 peer-reviewed articles, among them a study of 97 patients who had radiofrequency-assisted liposuction under local anesthesia, and book chapters on jaw and midface surgery. He has reviewed papers for the journal Aesthetic Plastic Surgery since 2011 and is an active member of the American Society of Plastic Surgeons.

Dr. Paresi founded Contour Plastic Surgery and MedSpa to offer safer, more affordable and more personal treatment. The practice on Butterfield Road in Downers Grove offers everything from minimally invasive treatments under local anesthesia to full operations under general anesthesia, and its MedSpa provides injectables, hair restoration and skin treatments. He has 10,000 procedures to his credit and is affiliated with Ascension Alexian Brothers Medical Center in Elk Grove Village.

**About Robert J. Paresi Jr.**
Plastic surgeon, Contour Plastic Surgery and MedSpa

Dr. Robert J. Paresi Jr., MD, MPH, is a plastic surgeon certified by the American Board of Plastic Surgery and the American Board of Surgery, and the founder of Contour Plastic Surgery and MedSpa in Downers Grove, Illinois. He trained in plastic surgery at Rush University Medical Center and in aesthetic surgery at Lenox Hill Hospital and Manhattan Eye, Ear and Throat Hospital, and his work centers on facelifts, neck lifts and facial fat grafting.

**About Contour Plastic Surgery and MedSpa**

Contour Plastic Surgery and MedSpa is a plastic surgery practice in Downers Grove, Illinois, founded by double board-certified plastic surgeon Dr. Robert J. Paresi Jr. It performs facelifts, neck lifts, facial fat grafting, body contouring and breast surgery at an accredited surgical facility, and its MedSpa offers injectables, hair restoration and skin treatments.

[Website](https://contourplasticsurgery.com)

## FAQ

**Q: Is 65 too old for a facelift?**
Not in Dr. Paresi's practice. Most of his facelift patients are between 50 and 70, his patient photographs include women aged 68 and 78, and older patients often see a more dramatic change than younger ones. For patients over 65 he can add Renuva to the fat grafting to help more of the restored volume last.

**Q: Is Renuva better than fat grafting?**
Dr. Paresi uses the two together rather than choosing between them. Renuva can replace a patient's own fat as a stand-alone injection, and in older patients, whose own fat survives transfer less well, he can combine it with their fat in the same facelift.

**Q: How long does facial fat grafting last?**
Grafted fat that survives the transfer stays in place for the long term, while some of it is reabsorbed in the first months. How much survives depends on where the fat comes from, where it is placed and the patient's age, which is why Dr. Paresi adds Renuva for older facelift patients.

**Q: How long does it take to recover from facial fat grafting?**
On its own, facial fat grafting takes about an hour, often under local anesthesia with optional sedation, and patients are usually back at work in under a week. When it is done as part of a facelift, recovery follows the facelift. Bruising and swelling ease within a few days, and the final result takes several months to show.