Fillers and surgery - do I need to dissolve them first?

No, you don't need to dissolve the fillers prior to your facelift. Fat transfers will work at this time but realize only 50% of the fat takes for each injection.

In most cases, existing cheek fillers do not significantly interfere with fat grafting, but it depends on the type, amount, and placement of the filler. If there is a large volume of filler or it’s in the exact plane where fat is to be placed, it may reduce graft survival or create irregularities. Your surgeon may recommend dissolving the filler beforehand to create an optimal environment for fat integration. A thorough examination will guide the best decision.
Erman AK, Dr. MD, Plastic Reconstructive & Aesthetic Surgeon

If you have had any recent fillers (generally within 6months to a year) of surgery in the area you are treating it is generally recommended to dissolve the fillers. There are many factors to consider as to the volume of product used, the type of filler, the location of filler placed and the procedures you are undergoing. I generally review all of this with the patients at their pre-operative appointment one month prior to the surgery. At that appointment all questions are answered and the filler can be dissolved at the that time.

As long as you only had fillers that are hyaluronic acid (Juvederm, Restylane, Volume etc) then I don't think the fillers will cause a problem. The dissection, the swelling, the healing, and all the inflammation from the facelift surgery usually cause the fillers to be absorbed anyway. However, there are some cases where patients have had SO MUCH previous filler that there is facial distortion and edema from excessive fillers. If this the the case I'm sure your surgeon would have some reservations about doing your surgery. Some fillers such as Sculptra and Radiesse can cause a little fibrosis and in my opinion I think it best to wait at least 6 months before surgery because these products make the facelift dissection very cumbersome.

If you are having fat transfer and a lift, it is a good idea to consider dissolving facial fillers prior. Patients tend to have less edema, swelling and recover faster. It also allows your surgeon to place fat grafting throughout the face. Fillers don't cause fat to not take but your surgeon may not place enough fat which is considered more desirable than facial fillers. Be safe!!

Thank you for your query. It is not always necessary to dissolve fillers before a facelift, especially if the quantity of filler remaining is less and it is away from the field of dissection. Fat augmentation, too, can be done in addition to fillers. If you have a lot of filler still present, however, then do have it dissolved. Please discuss this with your Plastic surgeon a few days before your planned surgery. All the best!

Yes, it would be best to dissolve the fillers so your surgeon can apply fat grafting as actually needed.

It'd be better to get the HA fillers dissolved before the surgery and the fat transfer. Fat transfer would be good. The heaviness of the cheeks would decrease, and we can see the excess skin better after dissolving the fillers.