Perlane filler before Facelift. Any suggestions?

If I have a filler like perlane prior to facelift could the filler move during the facelift / with swelling or will it make no difference? Confused about the different layers the filler gets placed in and the areas that are moved around during surgery. Would prefer to try fillers before fat transfer and would rather get them before than having to wait till after surgery for swelling.

Doctor Answers 5

Filler before face lift

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Thank you for your question.   I would recommend waiting to have filler once you have completely healed from the face lift.  It will move some of the filler most likely.

Nashville Plastic Surgeon
4.8 out of 5 stars 56 reviews

Restylane Lyft before Facelift

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If you are having a facelift soon after the planned filler, you will probably lose some of the filler. You can try saline injections to see if volume looks good on you. This would be cheaper and not affect surgery.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

If I have a filler like perlane prior to facelift could the filler move during the facelift / with swelling or will it make no d

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 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  I frequently use a dermal filler (Restylane Lyft previously called Perlane) to shape the cheeks during a facelift procedure.  Dermal fillers like Perlane are meant to be injected into the fatty layer of the face however, the area of dissection for all but the most invasive type of facelifts will not go over the entire cheek area so any filler placed there will remain undisturbed.

 Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions and no incisions extend or are placed within the hair.
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op

I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Sometimes It Is More Advantageous To Postpone Filler Injections Until After A Facelift

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It is not uncommon to encounter patients who have had filler injected into the skin and soft tissues of the face when we are performing a facelift.  The effect of the facelift on the filler is really a function of the type of filler used, the depth at which it is injected, the anatomic area in which it is injected, and the type and the extent of the facelift performed.  
For example, if the filler is injected into the nasolabial folds, we ordinarily would not dissect that far medially, so the filler would be left intact, although its position might shift somewhat due to the upward pull on the SMAS.  On the other hand, a filler injected along the lower jawline may be disrupted, depending, again, on the variables cited above.  
In general, if a patient is contemplating a facelift within the next six months, we encourage them to postpone injecting fillers into their face until after their surgery.  This prevents the fillers from dissolving prematurely, or being shifted out of position, and allows for greater precision in targeting the filler after the soft tissues of the face have settled into their final position.

Peter Lee, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

Face lift and fillers

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Thank you for your question because it is so relevant in today's world.  If you think about it carefully, I’d like to rephrase your question as, “What will make me look my best, last the longest, be safe and cost effective.”   Even most experienced surgeons and aesthetic doctors that we teach to use advanced fillers or perform surgery have a hard time differentiating the procedures from the outcome they are trying to achieve. Today, most people in my practice really don’t require surgery and attain a more natural result from other combination modalities including adding contour with fillers or collagen stimulators, neurotoxins, tightening devices etc. To answer your question, Perlane can be used prior to facelift surgery and will not effect the result because it can be dissolved within 24 hours and it doesn’t create scarring in tissue planes.  Most of the time, when face lift surgery is performed or upper face /brow and eyelid surgery is preformed, there is still a need for volume and we often will use longer lasting fillers such as Radiesse at the time of surgery or the patients own fat, if appropriate.  In my view, if you can have a natural appearing improvement with fillers and other such devices, surgery is usually not needed and may look unnatural.   Neither should be thought of as consumer items to buy though and what you want is to look terrific, so seek out a specialist surgeon who is also an expert using fillers and review your options. Remember, the results of surgery are not permanent either, and can be long-lasting and attractive only if performed in an appropriate manner and then maintained with other modalities usually fillers, or Sculptra or devices as your face and body continue to change from year to year.  Both modalities are appropriate and your surgeon should be able to explain which is best for you.
I hope that’s helpful.  

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

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.