With so many nonsurgical options available—such as BOTOX®, dermal fillers, laser skin resurfacing, and skin tightening—you might wonder if a facelift is even necessary. While nonsurgical treatments can offer improvements, a facelift delivers more dramatic, long-lasting results. This post compares the pros and cons of surgical and nonsurgical facial rejuvenation to help you choose the best path for your goals.
Understand Your Goals and Why You’re Choosing Treatment
As you begin to explore the options you have, it helps to start by determining what your goals and objectives are. These are personal and can vary from patient to patient, even those of similar chronological age. First and foremost, potential changes you are exploring, whether they are office-based or surgical in nature should be considered and ultimately done for yourself. Patients who consider and have these procedures for another individual or even for a job and not for themselves, may not be happy with their outcomes. Assuming the former, one must also consider the downtime you are willing to accept and whether repeat treatments and their frequency are needed are important factors to consider.
Office Based Treatments: Lasers, Botulinum Toxin, and Fillers
While office-based treatments are associated with little downtime and ease of treatment, they can often produce milder and/or more subtle outcomes that are limited in improvement and longevity. Some have an excellent record and are quite reproducible when used appropriately. Let’s review just a few of them:
Botulinum Toxin – There are currently 5 FDA-approved products on the market.
BOTOX® Cosmetic and Other Botulinum Toxins
While they are all similar, there are subtle differences which may appeal to both the patient and provider. They act on the muscles, softening their effect and wrinkles and lines they cause. Most last approximately 3 months. One product may last longer. There is a gentle onset and return of function with these products.
Dermal Fillers
We are fortunate to have many injectable dermal filler products available to us in the United States. My preference continues to be using products made of hyaluronic acid (HA) due to their similarity with our own tissues and the fact that they may be more reversible than others. These products can help us “fill” or “plump” out an area and treat lines and wrinkles. The longevity of the products varies from 6 to 12 months depending on where they are injected and what product is used. Patients often ask or suggest from what they have heard that products can “lift” an area. I do not believe they do can lift (which is more unique to surgery).
Energy-Based Devices
This is a broad category that encompasses many of the devices we have in our practice. Specific to this discussion, there are devices that claim to be skin tightening or lifting devices, comparable to surgery. That simply is not true. There is no device that I am aware of that is comparable to surgery (or even close). Skin tightening devices include those using radiofrequency energy with microneedling and energy, other radiofrequency devices, and ultrasound. I have used many of these devices and while at times I have seen some improvement, I personally have not been able to get consistent reproducible results with most. That being said, in some patients it does help, and we have found that some technology can improve lines and wrinkles as well as acne scarring.
Facial Rejuvenation with Surgery
Despite what you may have read or heard about the above, facial rejuvenation with surgery remains the gold standard for predictability and longevity. On the surface, it is a bigger commitment from a financial and recovery standpoint. There simply is no comparison regarding outcomes. Patients have minimal pain and are back in public within the first two weeks depending on what procedure was done, whether it’s a facelift, neck lift, eyelid surgery, or brow lift. What most of my patients convey as their biggest concern when considering surgery is looking “overdone” and/or “not looking like themselves”. Unfortunately, what is seen in magazines and television is an exaggerated appearance which is distorting and not complementary. The biggest challenge with have with surgery and its predictability is the quality of the tissues. Simply put, we just don’t have the same quality of tissue that we had when we were in our 20’s and 30’s. A great analogy I heard from one of my friends:
If you set out to build a new home but
use old materials, the longevity and predictability of the final structure may
be uncertain and/or unpredictable.
Choosing the Right Plastic Surgeon
Both surgery surgical and nonsurgical options are safe and can be predictable if done in the proper hands with realistic expectations. Board certification in plastic surgery with a focused practice in facial rejuvenation is very important. Do not be afraid to see several surgeons to determine who may be the best option to help you achieve the goals you are looking for. Our practice is focused on facial rejuvenation, and we have the amazing facilities and staff associated with UT Southwestern.
Request a Consultation Today
If you’re considering surgical or nonsurgical facial rejuvenation, please contact one of my offices in Dallas or Frisco, TX. You can easily request a consultation online or call (214) 645-3112 (Dallas) or (469) 604-9120 (Frisco) to schedule your appointment.
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