A recent article “Getting Injectables Now Could Complicate a Facelift Later”, posted in Allure, the beauty journal, discusses the consequences of injectables like Sculptra, and their impact on future facelift surgeries. Plastic surgeons are increasingly encountering challenges during facelift procedures due to the effects of previous injectable treatments. Dr. L. Mike Nayak’s Instagram post comparing tissues of patients who had received hyaluronic acid fillers and Sculptra garnered attention, highlighted the potential impact of injectables on surgical outcomes.
Injectables like Sculptra and Radiesse, which stimulate collagen production, can create scar tissue and uneven collagen distribution, making the tissues stick together and complicating surgical separation during a facelift. Deep-energy treatments such as Ultherapy and radiofrequency microneedling can seal off blood vessels and cause fat loss, leading to delayed healing and increased risk of complications during facelift surgery. Thread lifts, when improperly placed, can also lead to scarring and unnatural tethering of tissues, making subsequent facelifts more challenging. However, when threads are placed appropriately, some surgeons find them beneficial as they provide additional tissue thickness for sutures.
bodySCULPT®’s Dr. Spero Theodorou, MD, partook in a discussion about the potential complications of injectables, thread lifts, and deep-energy treatments on future facelifts. These procedures can sometimes lead to scarring, tissue damage, and altered collagen distribution, making subsequent facelift surgeries more challenging.
Morpheus8, that has a long history of safe use in surgery, targets specific temperatures in the dermis to induce dermal contraction and collagen remodeling internally, resulting in ideal skin tightening without the adverse effects seen with other non-targeted energies. In his comment, Dr. Theodorou emphasized the importance of proper application and targeting specific temperatures to avoid adverse effects. He highlighted the significance of proper application to prevent unwanted side effects. Dr. Spero also suggested dissolving the filler before surgery to minimize these risks.
This is what Dr. Theodorou actually said, “radiofrequency energy has been used since the inception of modern-day surgery, so its safety profile is unparalleled. While there is always an element of ‘scarring’ when utilizing any procedure to enhance collagen production, the key is on how the energy is applied and to what effect. Our patented bipolar RF technology targets specific temperatures in the dermis to cause dermal contraction as well as internally for collagen remodeling. This allows for ideal tightening without the side effects that other non-targeted energies display. From what we have seen over 15 years of our doctors utilizing [Morpheus 8 and our family of RF products] in the field, [they] have no bearing on future aesthetic operations.”
Overall, the consensus among experts is to be cautious with nonsurgical cosmetic procedures if a facelift is a potential future consideration. While past procedures cannot be undone, being mindful of treatment choices can contribute to a safer and more effective facelift outcome in the future.
In January 2024, Dr. Theodorou had conducted a study related to concerns regarding dermal fillers.
What Can Be Done? Experts Speak
Based on the insights provided in the article, here are some tips for surgeons to perform facelifts with minimal complications and improved outcomes:
- Preoperative assessment: Before the surgery, thoroughly assess the patient’s medical history, including past cosmetic procedures such as injectables, thread lifts, and deep-energy treatments. Understand the potential implications of these procedures on the facelift surgery.
- Communication: Have open and honest communication with the patient about their past procedures and potential risks associated with them. Educate them about the possible impact on the facelift outcome.
- Treatment planning: Tailor the surgical plan based on the patient’s unique anatomy and previous treatments. Consider adjusting the surgical approach to accommodate any scarring or tissue changes caused by prior interventions.
- Skill and precision: During surgery, exercise precision and skill to navigate through tissues that may have been altered by previous procedures. Carefully dissect tissue layers, taking into account any scarring or adhesions.
- Adaptability: Be prepared to adapt the surgical technique as needed based on intraoperative findings. Address any unexpected challenges that arise due to previous treatments with flexibility and expertise.
- Collaboration: If necessary, collaborate with other specialists such as dermatologists or injectors to optimize preoperative preparation and postoperative management, especially in cases where filler dissolution may be required.
- Postoperative care: Provide thorough postoperative care instructions to minimize complications and ensure optimal healing. Monitor the patient closely for any signs of delayed healing or adverse reactions, particularly in areas where previous treatments were performed.
- Continued education: Stay updated on the latest advancements and techniques in facelift surgery and nonsurgical cosmetic procedures. Continuously educate yourself and your team to provide the best possible care for your patients.
By incorporating these tips into their practice, surgeons can perform facelifts with greater confidence and minimize the potential downsides associated with previous cosmetic interventions.