Effect of More Radiesse or Juvederm Prior to Lower Facelift?

I am considering a lower face/neck lift in early 2010. I had Radiesse injected into my cheek area in April 2009 and another .5 syringe in June 2009. There seems to be a flattening of the effect especially in the orbital bone area where I see loss of volume.

I was considering either more Radiesse or Juvederm in this area only. What is the downside if any to having a dermal filler in this area prior to a Facelift? Thank you.

Doctor Answers 17

Radiesse prior to facelift

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If you are only addressing your lower face for your facelift procedure, then the placement of dermal fillers into the cheek area should not preclude you from proceeding with your intended facelift surgery. The enhancement you will see in this area will really improve the results of your facelift. One thought, however, is that you discuss with your surgeon their feelings with regards to fat injections to these areas. If you are already undergoing surgery, fat is my preferred filler substance in the cheek and mid face area over other dermal fillers.

Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Fillers Prior to or Following Face Lift Makes Sense for most

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Fillers prior to or following a face lift makes perfect sense. This is because you age by three factors - sagging (through gravity and time), loss of volume (counteracted by fillers), and skin texture (determined by environmental and genetic factors). Your fillers should enhance your effect of the lifting if placed appropriately by addressing one of the causes of aging..Most often one of these factors are more out of balance than another and therefore your procedures should customize for what is most needed. Often fillers alone can "stall" the inevitable as they only correct one aspect of aging.
Facelift and Skin resurfacing procedures (laser, Ulthera or Thermage ) and fillers are synergistic so as long as you wait until the Sculptra injection site is soft you should do fine. Not a problem and there is no problem with the timing for a facelift. Sculptra, Radiesse, Jeuvederm, Restylane and other fillers address volume issues, resurfacing procedures corrects surface flaws associated with aging and face lifting addresses the sagging loose skin. Resurfacing procedures address skin texture, color variation (e.g. sun spots)- so all three are synergistic and complementary. It is very common in my practice to do all three approaches to rejuvenation at the same time

Wrinkle Fillers Before or After a Facelift

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Fillers are used as a "finishing touch" on stable depressions or wrinkles. It would be MUCH preferable to have the Facelift first and then judge where IF anywhere to put fillers rather than place fillers and then have the Facelift move those areas where they will look awkward or worse.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Dermal filler for cheeks prior to facelift.

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There is no down side to having either one of the dermal fillers placed prior to a face/neck lift procedure. The orbital area over the zygomatic arch is actually augmented at the time of the face/neck lift, whereby the SMAS is rotated upwards and gives a very small 3-mm augmentation of the cheekbone at the time of the procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Wait until after the Facelift to get fillers

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As one of the busiest facelift surgeons in the country, my suggestion would be to hold off on fillers for now. I perform about 35-50 facelifts each month and some of my patients have filler in place. It really does not affect the outcome but it seems like a waste of money to do fillers if you are going to get a facelift. Some people do benefit from fillers after a lift but for now, just wait .

Good Luck.

Robert F. Gray, MD, FACS
Bay Area Facial Plastic Surgeon

Fillers and Facelift Surgery

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I suggest having the facelift surgery first. Many lower facelift techniques will will not alter the cheeks significantly. Make sure your surgeon is aware of the previous filler injections. After the facelift, fillers such as Radiesse, Juvederm, or fat can be used to refine the result of that surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Fillers may cause inflammation

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Fillers might cause inflammation, which would make you more susceptible to bleeding during your facelift surgery. Hold off until 3-6 months after the surgery. Good luck!

Consider fat grafting at the time of your facelift

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I would recommend that you defer any injections and instead plan on proceeding with fat injections to these areas at the time of your facial procedure to produce a longer lasting, and probably more cost effective, outcome.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Have facelift first then see if fillers are necessary post-op

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A deep plane facelift will elevate the tissues of the midface and restore volume to the areas which concern you. I would suggest having the facelift first and see if the fillers are even necessary post operatively.

Good luck.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 130 reviews

Filler prior to facelift

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As the other doctors have pointed out, why would you have you have temporary filler injected prior to a surgery? It can distort the anatomy, and you miss a perfect opportunity to place more lasting material into areas of hollowness. Fat injection is commonly performed, and we prefer LifeFill (R) grafts, nontraumatized grafts from the patient's own tissues.

However, if you are just having the face done, it probably wouldn't hurt to have filler in that area. You probably know my feelings on Radiesse around the eyes from other posts, so I won't belabor the point (would prefer you used hyaluronic acid filler).

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 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.