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Someone comes in and they say, "What do you think about Botox and fillers? What can I do with that?" And I'm looking, and I say, "Well, you know, we can do a little bit with this. We can do a little bit with that." But there are certain people who have enough change and the elasticity of their skin or in the structure of their face that it's just not worth trying to fill them up with regular fillers.

And so someone needs eight vials of filler, you know, because they need to fill here and they need to fill the marionettes, and they have nothing in their cheeks, and they have no volume. Well, then, you have to think something larger, fat injections, or should you just go ahead and do a face lift with fat, either with or without fat to a face lift, because at some point, the jowl is pretty heavy, the neck is just too wrinkled and creased. It has the bands, and you just know Botox or fillers just are not going to be enough. You would have to do so much every three to four months that it wouldn't be worth it.

But there are some people who are amenable to the surgery. But there are always some people who say, for one reason or that they are never going to do a surgery and then you have to try to work with them and say, "Okay, well what can we do with Botox or fillers to make you better?" But there really are definitely some people who we'll just say, "You're wasting your money. It's putting a Band-Aid on this for three months, and then you still, you'll get a little bit of improvement but not enough."

Is It Time For a Facelift? How to Know If Botox and Fillers Are No Longer Enough

Fillers and Botox work wonders for awhile. But as Dr. John Martin explains, they may come a time when the discussion should turn to surgical options.