SMAS impact by heat energy procedures - should I avoid this if I want a Facelift later on?

Question

I’m interested in hearing from facelift surgeons. I’m considering a facelift (deep plane) at 55 or 65 ish. I’m starting to hear that heat energy non-invasive procedures such as ultheraphy, themage and RF micro needling really impact the SMAS such that’s it harder to get a good facelift later on. Is that true and so should I avoid these procedures in my mid 40s (now) if I want a facelift later on?

Stephen Prendiville, MD · Answer

Great question, and thank you for answering.  With the presence and prevalence of energy procedures over the last 15 years, I am seeing more and more patients who are seeking facelifts after having had such procedures performed. We specifically ask this question during consultation, because we are now reclassifying pricing for facelift procedures for such patients as "revision facelifts".  The reason for this is that dense scar tissue is encountered, the SMAS layer is frequently attenuated/ weakened, without the actual benefit of having had a previous facelift.  In other words, it's a much tougher procedure to perform in terms of time. I utilized Ultherapy in my practice for a number of years but discontinued it due to lack of patient satisfaction; in other words, about 60-65% of patients were happy, too low for my practice.

Brian K. Machida, MD, FACS · Answer

There should be no problem with doing any noninvasive procedure and performing a surgery years later.  However, why wait for surgery?  Your results with surgery will be much better than any non invasive technique and will last longer.  You can end up spending a significant amount of money on procedures which might last a year.  Plus if you wait on surgery until you're really loose,  you cannot be improved as much as if you had the surgery done sooner.  Its something to think about.

Kerem Sami Kaya, MD · Answer

Hi You can apply non-invasive procedures, they does not pose an obstacle for facelift surgery. However, I do not know how much these types of procedures can improve your complaints, because their level of effectiveness is very limited compared to the surgical procedure. As additional information, if you are considering facelift surgery, I do not recommend thread lifts before surgery.Have a nice day

Ronald J. Edelson, MD · Answer

I can answer your question quite simply. Having one of those non invasive procedures will not affect a facelift later on. However these non invasive procedures do little to nothing so I advise against wasting the money. Just get a real facelift when you are ready

Ran Y. Rubinstein, MD · Answer

Having non surgical skin tightening procedures will not affect the result of your facelift but it can potentially reduce the blood supply to the skin and therefore increase the risk of skin flap necrosis post op.  It is for this reason that I like to see my deep plane facelift patients the day after surgery.  If I see any  signs of possible reduced blood supply I won't hesitate to send my patients in rare instances for a hyperbaric oxygen treatment.  Usually just 1 or 2 treatments are needed.

Michael I. Echavez, MD · Answer

In my opinion, it would be fine to have a heat energy based procedure and have a facelift years later.  There should not be a problem with performing the facelift after these procedures.

SMAS impact by heat energy procedures - should I avoid this if I want a Facelift later on?

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