Facelift After Fillers: What We Told Our Colleagues, and What It Means for You

By Dr. Motakis & Dr. Salsberg

Last month, we were invited to present a virtual lecture to a group of colleagues titled "Facelift After Fillers: Separating Myth from Evidence." It's a topic we think about often at AvenueMD, and one that comes up in almost every surgical consultation we have with patients who've had years of injectable treatments before considering a facelift.

The talk grew directly out of research we published earlier this year: Does Prior Treatment With Facial Injectables Increase the Risk of Rhytidectomy Complications?, in Dermatologic Surgery. 

We reviewed 106 deep-plane facelifts and found that patients with a history of injectables — hyaluronic acid, Sculptra, Radiesse — had no higher complication rate, and no longer surgical times, than patients who'd never had filler.

That finding runs against a fair amount of received wisdom in our field. Recently there has been increasing debate about what prior filler "does" to the tissue planes a facelift depends on. Presenting the data directly to colleagues, and separating what's actually been studied from what's simply been assumed, felt like the natural next step after publishing.

Studies like this one don't happen by accident. They come out of the way our practice is built. One of us is a board-certified dermatologist, the other a board-certified plastic surgeon, and we work under one roof rather than referring patients back and forth between separate practices. That's still fairly unusual in aesthetic medicine.

Practically, it means we're both in the room — literally and figuratively — for a patient's entire path, from their first filler treatment through to a surgical consultation, if and when that's the right next step. Through our constant collaboration, we also bring the best of our specialities to each other which in turn helps inform our approach with patients.

It also means we can look at our own combined patient data and ask research questions that neither a dermatology practice nor a surgical practice would typically be positioned to answer alone.  

Teaching, and staying part of the conversation

We lecture to and with colleagues regularly as we feel that constant learning and sharing continues to move our specialty forward. Aesthetic medicine moves quickly, and a lot of what circulates as "common knowledge" among practitioners isn’t always evidence based. We think the field is better served by evidence than by convention, and we'd rather contribute data than opinion where we can.

Presenting to other physicians also keeps us engaged in the pursuit of learning. Every lecture brings questions from people managing similar patients, making the same judgment calls we are — and that ongoing exchange with colleagues shapes how we practice as much as anything we read in a journal.

What this means if you're considering a facelift

If you've had filler over the years and have been holding off on a facelift consultation because you weren't sure whether that history would count against you, our research says it shouldn't — at least for the deep-plane technique we perform at AvenueMD. Your injectable history is part of your aesthetic story,  and doesn’t need to dictate your future options.

We're always glad to talk through where you are in that story and what the right next step looks like. Book a consultation here.