Should You Choose a Facelift or Fillers? 4 Signs It’s Time for Surgery

Woman touches her face while looking in the mirror. (model)

When patients come to my office to discuss a facelift vs. fillers, they often confess that they have been thinking about coming in for a consultation for a long time but had to get up the nerve. Considering any type of plastic surgery is a very personal decision, but even more so when it involves the face. 

Usually, they start by saying they just want a “little” something to look better but not anything too drastic. I think we all have a secret fear that doing anything will change how we look so dramatically that we will feel unrecognizable, even to ourselves!! And although many women and men struggle with aging facial skin and wrinkles, they do not know what their options are. Can they be treated with injectable options, or is the better answer a traditional surgery? 

With the rise of so many options for injectable treatments and non-invasive skin tightening modalities, it can be very confusing for the patient. Many people try dermal fillers and laser treatments to see if they can achieve their goal look without surgery. Unfortunately, fillers, neurotoxins, and skin tightening machines cannot create the changes a facelift can provide. 

In this blog post, I will cover the 4 signs you can look for that will indicate that you are better suited for the surgery than the other options. 

Sign #1: Fillers Fall Short 

As I talked about in a related blog post, it’s often best to take baby steps and try fillers first. But, the easiest sign that it’s time for surgery is that you have been doing fillers for quite some time, and they do not seem to provide the result they used to.

Fillers are a popular and easy way to add volume to:

  • Nasolabial folds
  • Marionette lines
  • Midface hollows

But a few syringes of filler are not going to lift the sagging skin of the jawline and jowls. The filler simply camouflages the contour deficit by raising the surrounding tissue and skin up to the level of the sagging cheek or jowl.

After a while, the area gets injected full of filler, making the upper lip and chin area look oddly full. This is called chasing the contour deformity with filler when the better option is to do the traditional surgery and lift the deeper tissues back up to the higher place on the cheek. The pull of gravity causes the deeper tissues to sag, and with the surgery, these tissues are released, elevated, and sutured up to provide a real change—not just “smoke and mirrors.” 

To be honest, It can be a difficult conversation to have with a new patient, but my established patients understand that I have known them for decades and will help them come to the right decision. A few have decided they do not want to ever have surgery. And in that case, we will optimize their result with the injectables and other modalities. Still, I often do tell them that they would be better off doing nothing and saving their money versus continuing to chase the wrinkles with fillers. For my patients who are open to surgery, it is a natural progression really. And even after the facelift, fillers and neurotoxins help maintain the result. 

Sign #2: Oval to Square: Shape Changers 

Another sign that you might be ready for surgery is the shape of your face is changing. When we are young, and the skin and deeper layers are elastic, and gravity has not been pulling down for as long, the shape of the lower face is rounded, in an oval, or like an egg with the smaller side at the bottom. However, as we age, the shape changes to more of a square shape. Or said another way, the egg flips orientation, and the larger side is down. Again, trying to address this type of situation without surgery is futile. The aging process at this point is well beyond what can be addressed with the injectables. But again, some patients can be in denial and need time to come to grips with this information. In this case, we try some fillers for a while, but in the end, the optimal result is with surgical treatment. 

Sign #3: It’s Time to Turn Back the Clock 

Another tell-tale sign that you are ready for surgery is that you are looking for a more permanent result. Dermal fillers provide a quick, easy fix, but the results are short-lived, measured in just months. And for many with fast metabolisms, the fillers require constant upkeep with repeated injections every few months. Facelift surgery is a long-term solution that turns back the clock about 10 years. Of course, the world keeps spinning and aging continues on, but after surgery, you are permanently 10 years younger looking than before. And with proper skin care and injectables to add fullness and enhance and maintain the result, many patients only require one facelift in their lifetime.  

Sign #4: Time for You 

Another more subtle sign you are ready for surgery is that you are able to take some downtime for a few weeks. When we are younger and raising a family or busy with starting a career, taking a few weeks off is quite difficult. Dermal fillers provide an option that can fit into this type of hectic lifestyle. But as things quiet down, our nests become empty, and our careers are stable, taking a few weeks off for ourselves is finally doable. And enjoyable! The recuperation after a facelift is not painful, but with the support garments, it is challenging to get out of the house for a week or so. After surgery, you can sit and work on a computer at home or just binge some Netflix—either way, the option is yours, and the time is yours. 

The decision to proceed with a facelift is highly personal, but consulting with a board-certified plastic surgeon specializing in facial rejuvenation will help you navigate this journey.  

At Aesthetica, we have the A-team staff—all familiar with this journey. When you are preparing for surgery, we ask that you start with an appointment with our “Vickies!” My nurse Vickie has had a facelift and eyelid surgery and is an invaluable resource for you. And our aesthetician Vickie, who has also had her eyelids done by me, will meet with you to discuss your skincare regime to get your skin in the best shape possible for the surgery. 

Ready to get started? Call my Columbus plastic surgery office at (614) 569-2649 to schedule an appointment or use our online form to request a consultation. We can’t wait to meet you and serve you on this exciting step in your journey. 

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