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

I'm 44 & thin. I have nasolabial folds, significant hollowing in my cheeks & under my eyes, sagging jowls & very loose skin above my jaw line. I would like to have treatment to correct some/all of the issues but concerned because I have melasma on my cheeks, between my brows & above my upper lip. Just recently got it under control so I'm extremely concerned that if I have facelift &/or fillers it will cause the melasma to flare. I would greatly appreciate professional opinions on best options.

Doctor Answers 14

November 17th, 2014

C an I have face lift and fillers with melasma

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Thank you so much for your question about a face lift and/or fillers with melasma.

Excellent question.
Yes, any facial treatment can make the melasma in the area of treatment darken  but the good news is, this can be prevented.

Have your plastic surgeon give you a prescription for 4% hydroquinone or buy it from your surgeon if s/he carries it. Most do.

Apply 2xday to the melasma starting 2 weeks before the surgery or fillers.
It puts the skin color cells temporarily at rest - so you should not get darkening from treatment.

Be sure to see a Board Certified Plastic Surgeon.
Here’s hoping you find this helpful. Have a great day!
Elizabeth Morgan, MD, PhD
November 16th, 2014

Facelift, Fillers and Melasma

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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.

Learn more: http://ridenourplasticsurgery.com/Procedures/Facial-Cosmetic-Surgical-Procedures/Face-and-Neck-Lift

Brock Ridenour, MD

Brock Ridenour, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 125 reviews

November 21st, 2014

Go for the fillers!

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"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!
Robert S. Houser, DO
November 17th, 2014

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

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Your melasma should not be affected by either fillers or a facelift. You need to be vigilant though in using sun protection from now on since you have gotten it under control.
Julio Garcia, MD
November 17th, 2014

Melasma should not be aggravated by fillers.

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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.

Learn more: http://www.zubowicz.com/procedures/facelift/

Vincent N. Zubowicz, MD
November 16th, 2014

Melasma and a facelift

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

Learn more: http://www.stevenwallachmd.com/procedures/facelift-new-york/

Steven Wallach, MD
November 16th, 2014

Face lift/ fillers/ or cheek implants with melasma

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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

Learn more: http://www.chincheekimplantsseattle.com/

William Portuese, MD
November 16th, 2014

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

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It is unlikely that fillers or facelift surgery will have an effect on your melasma.  Discuss Laser and chemical peel with your surgeon as a treatment for the melasma.  Best wishes!
Robert E. Zaworski, MD
November 16th, 2014

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

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Yes it is a possibility. But best to ask your treating dermatologist if surgery or fillers will cause a flare up... 
Darryl J. Blinski, MD
November 16th, 2014

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

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Based on the first photograph you appear to need volume in the mid face region which can be treated with dermal fillers.  It is unlikely that fillers will have an effect on your melasma.  However in most cases patients with melasma need continued follow-up and treatment to keep it under control.

Please see a board certified plastic surgeon.

Learn more: http://www.bostonplasticsurgeryspecialists.com/services/face/facelift/

Brooke R. Seckel, MD, FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.