Facial Fillers vs. Facial Surgery — Who Needs Cosmetic Surgery?

Injectable fillers or plastic surgery– how does one decide? Dallas-based Board-Certified Plastic Surgeon, Ramsey J. Choucair, M.D. presents his viewpoint in this post. 

Injectable fillers or Cosmetic Surgery? I am often asked if the injection of facial fillers eliminates the need for cosmetic surgery of the face. Unfortunately, the premise that injectable fillers may achieve similar rejuvenation of the face is misleading and potentially leads to abnormal looks. Facial fillers can beautifully restore lost volume associated with facial aging, however, repositioning sagging jowls and loose neck tissues requires lifting procedures (lower face and neck lift) to re-establish a natural, youthful facial appearance. The misguided attempt to “overfill” the deflated, aging face results in distorted and unnatural looks that are increasingly identified in the media and everyday life.

What are the cosmetic surgical options for the aging face? Ironically, often a well planned, customized lower face and neck lift can restore a smooth jawline, eliminate sagging neck skin and “turn-back-the-aging-clock” with less swelling, and bruising than facial fillers. There is a limited benefit that may be achieved with facial fillers. Beyond a certain rational and artistically determined point, fillers may become the problem instead of the answer.

Can injectable fillers replace surgery? Of course presented with the option, anyone would logically select a non-surgical treatment over surgery. The allure of an office visit enhancement with local anesthesia, minimal downtime, lower cost and immediate results is obvious. However, regardless of the convenience factors associated with facial injectable fillers, if a patient’s expectation can only be reached with surgical options, then consideration of any number of nonsurgical choices becomes irrelevant. The idea that fillers can replace facial rejuvenation surgery is simply false.

Are fillers a realistic option to plastic surgery? Injectable fillers have provided a benefit that was unavailable 10-15 years ago as we can now fill fine lines and replace volume deficits associated with aging in an efficient and safe manner. These non-surgical filler options are truly “complementary” to surgery, not exclusive of aesthetic surgery. Restoring volume does not reposition loose jowls and lax neck skin. The idea that filling the face “enough” will elevate loose skin is illogical.

Is cosmetic surgery the best option for facial rejuvenation? Expertly planned and executed facial rejuvenation surgery using current surgical techniques can restore a natural, youthful appearance with limited convalescence. In many cases, surgical recovery is often associated with less bruising and swelling than with soft tissue fillers.

It is best for individuals thinking about aesthetic enhancements to consider a consultation with an experienced, board-certified plastic surgeon with expertise in analyzing the unique characteristics of the aging face and skilled with injectable fillers and also current surgical rejuvenation techniques.