Facelift and/or fillers with melasma. Will it cause the melasma to flare? (Photo)

Similar to the sun, medical procedures that result in heating, redness or inflammation of the skin can exacerbate or worsen melasma (e.g. certain lasers, BBL, etc). On the other hand, surgical procedures and injectables are quite unlikely to have a significant effect.  Occasionally, surgical bruising can result in a more transient type of pigmentation know as inflammatory pigment or PIH. Unlike melasma, inflammatory pigment is not a chronic condition and is relatively easy to treat.As an aside, we now treat melasma with the Q-switched Nd:YAG laser on low energy settings.  We have seen remarkable results across the board, including those patients that were previously hard to treat . Best wishes.

I think it is very unlikely fillers would aggravate melasma. If there was a significant inflammatory response to the filler which is extremely unlikely it might. In my practice that is not been a complaint.

Either procedure could be safely performed. While any inflammatory process could induce hyper pigmentation, I feel the risk is low. Both the advanced facelift and fillers can both be performed safely if desired.  Additionally, good medical skin care can help long term with your melasma. 

Significant bruising of the skin can stimulate the pigments cells and cause deterioration of melasma but it will not be likely. The reality is that your melasma can be treated with laser at the same time of facelift or another time. You should consult a surgeon who specializes in both of these areas. Your laser treatment, if you decide to proceed with it, is going to require adequate experience because of the type of skin that you have.Good Luck

In your photos, the melasma does not appear to be very severe at all.  Did it come with pregnancy as we usually see?  If it is hormonal melasma, there should be not connection between injections, surgery, and the pigmentation.  If it is post-inflammatory hyperpigmentation as opposed to melasma, your surgeon will need to be a bit more careful, but there are certainly very effective ways to control the pigment.  Best Wishes.

"Injectables" such as fillers or Botox won't affect your melasma and I really don't see anything in your photos that suggests that you need a facelift either.  Try some fillers -- don't do too much at your first go or it may turn you off to the idea.  For melasma, there are several products in addition to hydroquinone that you may use.  Good luck!

A facelift or fillers should not impact your melasma.  Good luck with your decision to move forward with these procedures.

Melasma  present on your cheeks, eyebrows and upper lip should not be affected by a facelift with incisions placed in front and behind the ears.  Temporary filler placement in the cheeks should not  affect melasma. Permanent cheek implants  are placed through an intra-oral approach, so that should not affect the melasma   either. Cheek implants are used when patients have hollowing of the cheeks and desire a permanent correction. Cheek implants are manufactured in a variety of sizes and shapes which is best determined at the time of the consultation. For many examples, please see the link and video below

Yes it is a possibility. But best to ask your treating dermatologist if surgery or fillers will cause a flare up... 

Every patient heals differently, but in general, neither fillers nor a facelift should cause a flaring of melasma. Melasma may require ongoing treatment to keep it under control no matter whether or not you have procedures performed.Following the advice from a surgeon on this or any other
website who proposes to tell you exactly what to do based on limited 2
dimensional photos without examining you, physically feeling the tissue,
assessing your desired outcome, taking a full medical history, and discussing
the pros and cons of the operative procedure would not be in your best
interest. I would suggest you find a plastic surgeon who is certified by the American Board of Plastic Surgery
and ideally a member of the American Society for Aesthetic Plastic Surgery
(ASAPS) a  that you trust and are comfortable
with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla,California