The Surgeon Minute

Is it Time to Move from Fillers to a Facelift?

Is it Time to Move from Fillers to a Facelift?

Facial aging can sometimes feel as if it happens overnight, but in reality, it is a process. For most, the earliest signs of aging show up on the face in our 30’s. Figuring out the best modalities for addressing these issues can be confusing for many patients. Injectables such as fillers can work wonders, but they don’t lift the skin. How do you know when it’s time to move from just fillers to a facelift? Board certified plastic surgeon Dr. Jason Cooper of Jupiter, FL responds.

Fillers vs. Facelift: Starts with the Consultation

One of the reasons that it is so important to see a board certified plastic surgeon is that he or she has the full spectrum of tools for rejuvenating the face. Often, patients will arrive at their facial aging consultation saying “I think I just need a little bit of filler.” Sometimes, especially early on, this kind of self-diagnosis may actually be the case. After a certain point when the fillers are not quite as effective as they used to be, what a patient may need to graduate to is a facelift.

“A big misconception with fillers is that they lift and fill,” explains Dr. Cooper. But there are really two major things going on with the aging face. One is deflation while the other is descent. Fillers do a great job of addressing the deflation component of facial aging, but they don’t really do anything for the descent. The only thing that can lift skin that is heading south is a facelift.

For surgeons such as Cooper, it is important to take the time to really evaluate each patient in order to understand who they are and what they are looking to do. For example, if a patient comes in really needing a facelift, and hasn’t yet done so then why? Is it because of:

  • Lack of knowledge?
  • Fear of surgery?
  • Financial reasons?
  • Prior medical issues that would preclude surgery?

Without a deep understanding of a patient’s whole story, including his or her medical history, a surgeon might offer a suggestion that simply isn’t feasible.

Time to Move from Fillers to Facelift

What are some of the signs that it’s time to move on from fillers to a facelift? The media has no shortage of stories following people who have gone to far with filler. Their cheeks are overly puffy and not congruent with the rest of the face and they usually have overplumped lips. While some of this is the product of too much filler poorly done, sometimes the treatment is just no longer viable.

When a patient exhibits deflation in the entire mid-face area, it’s probably time to move on to surgery. The mid-face covers a lot of real estate from the medial portion of the cheek next to the nose to the lateral portion of the cheek next to the ear. It may also include the marionette lines next to the mouth. Whenever there are multiple areas that need to be addressed, a patient will most likely get the best result from a facelift as opposed to hyaluronic acid-based fillers, Sculptra or fat.

No Set Age for a Facelift

The time for a facelift can vary for patients. One of the things that Dr. Cooper has learned “is not to age discriminate at all.” He doesn’t even like to know his patients’ age because he feels that this may create an inherent bias. When a patient comes in for a consultation, the surgeon only needs to focus on an analysis of the skin and structures of the face, what that patient has had done and what she or he is looking to achieve. “It’s all about individualizing the treatment to the patient and understanding their anatomy and their goals,” explains Cooper.

The nice thing about seeing a plastic surgeon is that he or she can take you through every stage of your facial aging. Dr. Cooper, like most of his colleagues, feels that it’s best to start with things that can be reversed, such as HA fillers. As Father Time marches on and the patient’s face becomes more deflated, then he will discuss adding more intense volume in the form of a thicker filler or fat.

Finally, when your face reaches that point where fillers alone won’t do the trick, then he will discuss the face and/or neck lift. If you are looking to turn back the clock, the facelift is the most powerful way “to achieve harmony and balance in your mid-face,” explains Cooper. “To achieve the appearance of what you may have looked like 10 or 15 years ago.”

A good plastic surgeon will always strive to create natural contours and smooth lines for patients so that they simply look like a better version of themselves. “I want patients to look like the best version of themselves, but I want them to look like their vision of themselves,” says Cooper.

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