Cosmetic injectables such as dermal fillers are a staple of anti-aging aesthetic treatments because they involve little to no downtime, with results often lasting a year or more. At a certain point, however, the facial aging process reaches a point where a nonsurgical approach no longer produces the desired results, and people consider getting a facelift.
But is it OK to get a facelift after having dermal filler injections? As with many questions involving aesthetic plastic surgery, the answer is it depends. Understanding the factors involved and how facial aging occurs will help illustrate under what conditions it is—or isn’t—OK to proceed with facelift surgery after having fillers.
How Do Faces Age?
When people talk about “looking old,” they’re usually referring to wrinkles and sagging skin. Facial aging, however, is more complicated. Losing facial bone mass and fat plays a significant role that plastic surgeons started recognizing years ago. Gravity, genetics, and lifestyle choices are all factors that influence the pace at which your face begins showing signs of aging.
Plastic surgery techniques have come a long way in the last several decades. Cosmetic plastic surgeons once performed facelifts by simply pulling the skin tight and then removing the excess. That led to results that didn’t look natural because the technique didn’t address the underlying tissue and muscle—or the volume loss that occurs when a face loses bone mass and fat. Now, facial plastic surgeons focus more on comprehensive facial rejuvenation.
Today, virtually all types of facelifts incorporate techniques that address the SMAS (superficial muscular aponeurotic system), a layer containing connective tissue, collagen, and fibers that connect the face and neck muscles to the skin. Excess skin is still removed, but the SMAS is elevated and repositioned to create a more natural appearance without the overly tight, “windblown” look.
As you can see, facial aging involves more than wrinkles and sagging skin. The loss of fat in the temples and cheeks is also part of the aging process that a facelift alone won’t address. That’s often where dermal fillers come in.
When Should You Stop Getting Fillers?
Patients who have relied on fillers to restore facial volume typically come to a crossroads where they recognize that the loss of skin elasticity and the effects of gravity are picking up pace, and fillers alone no longer provide them with the results they want. But because fillers generally last for up to a year or more, they wonder about the timing of a facelift.
Whether someone can get a facelift soon after getting filler injections depends on multiple variables, including the type of filler used, where the fillers were injected, how much time has lapsed between the injections and the surgery date, and the type of facelift that your surgeon is performing. For example, if the facelift technique is targeting the lower face or neck and you have fillers in the cheeks, then moving ahead with surgery is likely OK. But if the surgery involves elevating the skin in the location where the filler has been placed (and the filler is still present), then you should postpone the facelift. You also have the choice of reversing hyaluronic acid-based fillers with injections of an enzyme called hyaluronidase.
Combining a Facelift With Fat Grafting
You may be wondering how surgeons address the loss of facial volume during a facelift if the procedure primarily focuses on tightening and elevating tissue and removing excess skin to reduce sagging. That’s an excellent observation. Some plastic surgeons use synthetic fillers as part of the surgery.
I prefer autologous fat transfer, which means taking a small amount of fat from the patient’s own body (usually from the abdomen, buttocks, or thighs) and re-injecting it into the face as part of the surgery. Your own fat is the gold standard for creating a youthful-looking volume that is long-lasting and looks natural. Fillers work well in some cases but are temporary.
Fat grafting produces results that last longer, and it’s a more natural solution. During facelift surgery, plastic surgeons often use fat grafting in areas such as the jawline, the upper lateral cheeks, and the nasolabial folds. These are areas where a facelift may not produce dramatic changes.
Why Choosing a Facial Plastic Surgeon Matters
As a double board-certified facial plastic surgeon, I focus my practice exclusively on patients who want to address concerns about their facial appearance. My training and experience provide the expertise that plastic surgeons who perform procedures on other areas of the body don’t have.
If you’ve been getting dermal fillers such as Restylane® products but are now considering facelift surgery, you can request a consultation to meet with me personally to discuss your concerns. You can also call our Denver, CO, practice at (303) 253-7686 to schedule an appointment.
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