When it comes to facial rejuvenation, fillers and facelifts dominate the conversation. Both techniques offer unique benefits, but they are far from interchangeable.
As highlighted in Episode S05E98 of Three Plastic Surgeons and a Microphone, featuring Dr. Sam Jejurikar, Dr. Sam Rhee, Dr. Lawrence Tong, and Dr. Salvatore Pacella, understanding the nuances between these procedures is key for patients seeking the most natural, effective results.
“Fillers are awesome, facelifts are awesome, but fillers and facelifts may not always be so awesome,” Dr. Sam Rhee stated at the episode’s opening, encapsulating the complexity of choosing the right procedure. Fillers are ideal for younger patients with minor volume loss and good skin elasticity, often providing quick, non-invasive enhancements. Facelifts, however, address deeper structural issues like sagging skin, making them a better fit for individuals with advanced aging signs.
Dr. Lawrence Tong offered a critical distinction: “If you need a facelift, meaning something is sagging on your face, then you’re going to generally need surgery. Fillers mostly just volumeize.” The misunderstanding that fillers can replicate the lifting effects of a facelift often leads patients astray, resulting in less-than-optimal outcomes. For older patients with significant skin damage or sagging, investing in surgery is often the more effective, long-term solution.
Challenges in Overusing Fillers
While fillers have revolutionized the aesthetics industry, their overuse has created unforeseen complications. Injectors without specialized training often rely too heavily on fillers, sometimes distorting a patient’s natural facial anatomy. “Many providers are not that honest,” warned Dr. Salvatore Pacella. “They’ll just pump patients up with fillers, even when they know it’s not going to help.”
Overuse can result in lumpy, uneven areas and even permanent scarring in the soft tissue. According to a study published in the Aesthetic Surgery Journal Open Forum, 52% of surgeons reported difficulty performing facelifts on patients with a history of extensive filler use. “We’ve all had patients who come in looking like youthful aliens,” remarked Dr. Jejurikar. “They may look youthful, but they don’t look human.”
The challenges extend beyond aesthetics. Scar tissue from excessive fillers can make future surgical procedures, such as facelifts, significantly more complex. Dr. Jejurikar shared a vivid example: “I’ve done facelifts on patients and seen soft tissue filler spilling out like toothpaste. It’s quite gross and illustrates how much distortion fillers can cause.”
To mitigate these risks, the podcast experts emphasized moderation. A limited amount of filler can effectively address specific areas like marionette lines, lips, or temples without overwhelming the face’s natural contours. However, as Dr. Jejurikar pointed out, many injectors lack the training to understand when to stop. “If your only tool is filler, you’ll use it for everything, even when it’s not appropriate,” he said.
Facelift Considerations: Timing, Technique, and Alternatives
For patients whose aesthetic goals go beyond what fillers can achieve, facelifts provide a more comprehensive solution. A facelift not only removes excess skin but also tightens the underlying facial structures, restoring a youthful appearance. However, for patients who have previously relied heavily on fillers, the path to surgery can be fraught with challenges.
“Scar tissue from fillers often complicates facelifts,” noted Dr. Sam Jejurikar. “It distorts the soft tissue and creates additional hurdles for surgeons.” Preparing for surgery may involve dissolving filler using enzymes like hyaluronidase, but even this process is not without complications. As Dr. Lawrence Tong explained, “Hyaluronidase doesn’t always work because filler is placed in so many layers, and some of it may be encapsulated by scar tissue.”
An alternative to fillers for volume restoration is fat transfer, a procedure that uses a patient’s own fat to enhance facial contours. “The beauty of fat augmentation is that it’s organic and predictable when done correctly,” said Dr. Pacella. However, fat transfer requires more downtime compared to fillers and involves a surgical component, making it a less appealing option for patients seeking a quick fix.
Dr. Rhee added that fat transfer is especially effective when performed alongside facelifts. “I almost never do a facelift without including some fat transfer. It enhances the overall results and provides a more natural look.” For patients considering a facelift, the surgeons emphasized the importance of addressing both structural and volumetric concerns to achieve a balanced, youthful outcome.
Finding the Right Provider: What Patients Need to Know
Selecting the right practitioner is critical, whether for fillers or surgical procedures. Patients must ensure that their injector or surgeon is not only qualified but also aligned with their aesthetic goals. “If you walk into a practice and see that the staff or injector themselves look unnatural, that’s a red flag,” warned Dr. Tong. “If you don’t like how they look, why would you trust them with your face?”
Dr. Jejurikar echoed this sentiment, urging patients to choose providers who prioritize a natural appearance over excessive enhancements. “Ultimately, we’re trying to restore what has been lost, not create a distorted or fake look,” he explained. Patients should also be wary of injectors who lack the ability to refer them to surgeons for more advanced treatments. As Dr. Rhee pointed out, “If your injector has no affiliation with a surgeon, it’s a sign they might be over-relying on fillers to solve problems that require surgery.”
When deciding between fillers and a facelift, consultation with a board-certified plastic surgeon is invaluable. Surgeons can assess a patient’s facial structure, skin quality, and aging concerns to recommend the most appropriate course of action. “Each patient is unique,” Dr. Jejurikar emphasized. “It’s not about fillers versus facelifts—it’s about finding the right solution for the individual.”
Wrapping It Up
The interplay between fillers and facelifts is complex, and the decision to pursue one over the other depends on factors like age, skin quality, and personal goals. While fillers offer a quick and non-invasive option for younger patients, they can only go so far. For patients experiencing significant sagging or structural concerns, a facelift remains the gold standard.
The key takeaway from Three Plastic Surgeons and a Microphone is the importance of balance and expertise. Whether considering fillers or a facelift, patients must seek providers who prioritize natural, personalized results. As Dr. Jejurikar aptly put it, “We’re not just improving appearances—we’re restoring confidence, one face at a time.”
Read more:
Fillers vs. Facelifts: Insights from Dr. Sam Jejurikar on Choosing the Best Option for You