There is no single correct answer to your question. Without pictures and more medical history and information that would come from a face to face consultation with a ASAPS member, any advice would be speculative. Both pathways you have offered will work for the "right" person. In general, facial implants are more lasting in terms of the "volume fill." There is always a regression of volume fill with fat injection over time. So, the best answer for you is to find a ASAPS member in your area and go over these options.

This can be very disconcerting. A leak in saline implants usually results in a very dramatic change in appearance, not just a "reshaping." I did have a patient with a "partial" leak but this is rare. For a patient to have bilateral "small leaks" would even be more rare. To evaluate a leak, you should have an MRI. This will provide an objective basis for your decision process going forward. In terms of your warrantee, you can find the answer by contacting the company that manufactured your original implants. Most implant companies are very helpful in terms of providing a new implant and or helping defer the costs for a true sponteaneous deflation correction given the constraints of the company policy at the time of your implantation, 2000. How you will resolve your concerns going forward will be determined by the answers to the above. Hope this helps.

The cost of a fat transfer depends a great deal on your expectations. In general, augmenting one's buttocks from unwanted fat from the stomach and love handle region can provide a nice improvement. However, when you "buy" anything, you probably need to see what you are buying, "right?" So, look for ASAPS members in your area and seek their opinions. These doctors will be able to provide you their experience and cost for this treatment based on their examination with you.

Great questions! In terms of timing, a facelift would not have a significant impact on deep wrinkles around your mouth. Thus, they can be performed in any order or you could have laser resurfacing at the same time as your facelift. In terms of how to bet deal with the deep wrinkles around your mouth, a great deal depends on how much "sun damage" you have on your face. Any treatment modality - chemical peel, dermabrasion, laser ablation (CO2, erbium, fraxel ablation, etc.) can provide a significant improvement in the wrinkles around your mouth. BUT.....it will also make the skin around your mouth lighter in color. Often, patients that are in your age group with deep peri-oral wrinkles have a brown discoloration of the skin around the mouth and also on the adjacent facial skin. All of the above treatments will make the skin around the mouth lighter in color. While improving the wrinkles around the mouth, you may be unhappy with the difference in the skin color of the mouth area vs. the untreated adjacent skin of the face. Thus, while not a lasting solution, skin fillers may provide a temporary improvement in the wrinkles around your mouth. Please consider this information when you seek consultation with your ASAPS Board Certified plastic surgeon.