Will You Need Filler After a Facelift? You Can Bet on It

There’s a misconception amongst some facelift patients that the surgery is the last venture into the wild west of aging. Get a facelift, and you’re done with routine treatments like fillers, injectables and even lasers. Well, that’s not exactly the case.

A facelift doesn’t resolve every age-related concern. Plastic surgeons make it their duty to educate patients on the benefits of maintaining their results via noninvasive treatments, but some patients choose to swear off injectables and fillers forever. Here, we’re sharing every reason why it’s important not to call it quits with injectables and fillers after a facelift.

Facelift Facts

Even if you think a facelift will erase every last line and wrinkle and reinflate flat cheeks, it probably won’t. New York plastic surgeon William Lao, MD shares that “no plastic surgery procedure can stop the effects of gravity and aging. We can only restart the clock but never stop it.”

Although the surgery tightens the skin by elevating it to a more youthful position and can improve sagging cheeks and jowls, deep-set folds and a heavy neck, it can’t fully smooth out movement-related wrinkles like neuromodulators do or add volume like fillers (unless when using fat). Nevertheless, Vero Beach, FL, plastic surgeon Alan Durkin, MD says, “facelifting is the most comprehensive approach to facial aging. While it generally reduces overall maintenance procedures, it doesn’t make fillers, injectables, laser or skin care obsolete.”

As for the skin itself, Fort Myers, FL, plastic surgeon Ralph R. Garramone, MD says, “a facelift will not address or change the character of it, so a resurfacing procedure may be necessary.”

Why You Can’t Give Up Injectables and Fillers

Aging isn’t one-dimensional, and neither are its solutions, which is why most plastic surgeons tell patients that fillers and injectables are likely to be part of their post-procedure anti-aging routine. Surgery may be the pinnacle in terms of options, but often a long-term solution of various products and treatments that nips signs of aging in the bud needs to be implemented. Dr. Lao adds that “patients continue to age and lose volume even with a facelift. Fillers and injectables help reverse that effect and provide maintenance.”

Plenty of surgeons advocate for fat grating at the time of a facelift, but not everyone is a candidate—that’s where volumizing fillers come in. Even when fat grafting is a component of a facelift, some patients necessitate filler post-surgery for natural fullness. “It comes down to how much fat was absorbed and what remains,” Dr. Lao explains. He prefers injecting facelift patients with Juvéderm fillers, most commonly Voluma, “because it has the best effect for deep soft tissue filling and lifting for aged patients. It also lasts the longest.”

Remaining Wrinkles: What’s That About?

The goal of a facelift is to rejuvenate the deep planes of the face, which in turn improves the skin’s position. “That’s the core concept of facelifting,” Dr. Durkin shares.

Still, despite removing wrinkled, loose skin, wrinkles can remain once the face heals. According to Highland Park, IL, plastic surgeon Steven P. Bloch, MD, a 50% correction in lines and wrinkles is realistic post-facelift. That’s because wrinkles themselves are not the target of the procedure. Once the deep plane is in the optimal position, Dr. Durkin explains that excess skin reveals itself for removal, eliminating many deeper-set wrinkles. “What’s left behind, most times, are fine lines and wrinkles, typically treated with adjunctive laser, fat grafting or filler to correct age-related volume loss.” But, Dr. Durkin adds, “if the volume is not replaced over time, there will be a youthful foundation, but the patient may look gaunt as they age.”

So when is the right time to get back in the saddle with filler after a facelift? Everyone is different, and clearance from your surgeon is a must before resuming injectables and fillers (usually around the three- to six-month mark, but it’s variable) since swelling needs to subside. “Otherwise, there isn’t an accurate estimate of the current facial volume with all the swelling around,” Dr. Lao adds.

In any event, post-facelift filler may equate to injecting less product. “Many patients “spot treat” areas, like the corner of the mouth where lines can be quite resistant,” says Dr. Garramone. Often, patients need to continue with their regular dose of neuromodulators to keep forehead lines and crow’s feet at bay.

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