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October 29th, 2013

Questions and Answers with Dr. Burns


Q: I Want to Get a Facelift. I Had Sculptra Last Year Will That Be a Problem?

A: Face lift and fillers

To answer your question simply, it should not be a problem. Ideally I love to do the face lift first then assess volume issues later the practical reality is that as common as fillers are, we do facelift in filler patients all the time.

Many patients who want to hold off or even avoid a facelift use fillers as a substitute. However, I always tell patients to remember some basic logical principles. Fillers simply add volume, so they are best utilized where volume loss occurs. That usually occurs in the temples and cheeks as we age.

The reason that smile lines get more pronounced is by gravity causing the cheek to fold over the upper lip and mouth area.Smile lines are not caused by having volume loss limited to this area.  Placing filler in this area will certainly lessen the line but causes more volume in this area which has never been there before. Just know that if you change areas instead of restore areas you will, by definition, look differently. That may or may not be desirable but you must consider it, at least. If small volumes are placed subtly then a desired improvement can be achieved, but at some point the smile and animation movements in the cheek begin to look “different”. Friends and family can pick up these changes and if severe, anyone can tell. I say this only to caution other readers to “be careful” about overuse of fillers.

I prefer to do a facelift and get the structures returned to the appropriate natural position, then if the volume loss that occurs with aging is significan’t then it can be addressed by fillers in the cheek and temple. This gives a natural, youthful appearance.

Good luck with your surgery. The filler issue can be overcome. I would encourage you to find a good board certified surgeon that you can trust and communicate with.