When Is Surgery a Better Option Than Non-Surgical Treatments?

Most people need some combination of non-surgical and surgical treatments to achieve optimal results and reach their aesthetic goals. For example, fillers and laser are great preventative treatments that still play an important maintenance role after a face or neck lift.

If your goal is to prevent aging with natural-looking outcomes, it’s best to start early and stay consistent — but it’s never too late for improvement! When deciding which treatments are best for you, consider your desired results, budget, and whether you’re ready for the downtime after surgery.

Check out Dr. Greer’s answers to these common aesthetic questions to make choosing surgical and non-surgical treatments even easier!

Will filler improve the wrinkles and folds around my mouth, or do I need a face lift?

Lines around the mouth are caused by gravity pulling down the tissue in our cheeks as we age. Filler is a great option for softening these wrinkles and folds, but it won’t eliminate them completely. If you have prominent jowls (i.e., sagging skin along the jawline), a surgical face lift is the best way to correct them.

At what point do my regular filler appointments become “too much”?

In terms of filler, the rule of thumb is one syringe of filler for every decade of life. This is based on how much volume our faces lose and how many lines and wrinkles form as we age. Even though I’m only in my 40s, I could easily use four syringes of filler on myself and look very natural. When considering the transformation you desire, keep this rule of thumb in mind!

For instance, if you’re in your 50s, that could equate to 5 syringes of filler every 9 months, adding up to roughly $3,000. This is for an optimal correction, meaning the very best results I can create using filler. You may be happy with less, but you can see how a face lift quickly becomes financially equivalent!

When should I consider facial surgery to maintain natural-looking results?

Everyone has a slightly different timeline for when they want to consider surgery. I generally advise that getting a face lift and neck lift earlier will mean a less drastic transformation, but it will help prevent loose skin around the jawline and neck as you age. Waiting longer means a more dramatic result, which also means more people may notice.

So, timing depends on whether you want to prevent signs of aging or wait until they bother you, as well as your comfort level with friends and family knowing you had something done.

Can BOTOX® “lift” my brow and make my eyes appear more open, or do I need eyelid surgery?

Neurotoxins like BOTOX®, Xeomin®, and Dysport® can lift the brow about 1-2mm. Injecting a little neurotoxin at the arch of the eyebrow weakens the muscles that close your eyes tightly, causing your forehead muscles to pull your brows higher. So, this only works if you aren’t treating forehead wrinkles with neurotoxins at the same time.

If your eyebrows are at or below your brow bone, it’s probably time for a lift. The great news is that newer techniques mean that, with only a short incision at each temple instead of across the entire forehead or scalp, you’ll still get the same long-lasting results!

My face looks “sunken.” Would you suggest volumizing filler, or should I seek surgery?

Volume loss progresses as we age. The rule of thumb is one 1ml syringe of filler for every decade of age (more filler than some people expect) to create an optimal result. At most, longer-lasting fillers, such as Sculptra®, allow me to add overall volume that lasts up two years.

Face lift surgery restores facial volume to its youthful position, and I may add fat grafting to bring back some lost volume for a smoother, youthful look.

I’ve heard a lot about thread lifts — is this a shortcut I can take before choosing surgery?

Thread lifts come into vogue about every 10 years, and each time they have the same issues. Threads can create weird contour irregularities, asymmetry, or even visible nodules. And once they’re in place, they are very difficult to remove. For these reasons, I do not recommend thread lifts.

I’m 55, and I’ve never had BOTOX®…. am I too late?

Although neurotoxins work best as preventative wrinkle treatments, they can still create great results with deeper wrinkles! Patience is key: it will take about a year of regular neurotoxin treatments for your skin to remodel and soften those lines.

Depending on the location of the wrinkles, you may be able to speed this process along with skin resurfacing in the form of laser or chemical peels, or with a one-time filler treatment.

My eyes just don’t look the same anymore, and the bags under my eyes are so apparent in pictures. Can filler help them look better?

Filler is great for tear troughs — that deep shadow right between the lower eyelid and cheekbone. But if you have true “bags” under your eyes (meaning the tissue of the lower eyelid is pushing out above the tear trough), the best way to correct this is with an eye lift.

Depending on your anatomy, you may be able to get some improvement with filler. If you don’t want surgery but you’re not sure if filler can help, we can send photos via email to give you a better idea of what these treatments can do for you.

Where did my jawline go? Do I need surgery?

Filler can add definition to a poorly defined jawline, or one that is just barely starting to show signs of aging. If you’re to the point where you have loose skin along the jawline, however, a face lift is your best option, because there aren’t any filler or skin tightening treatments that offer a comparable result.

What do you suggest for “turkey neck”? Any shortcuts to make that area look better?

Turkey neck, meaning that loose skin along the front of the neck, is a common complaint. And it tends to run in families, so my patients always know which parent to blame!
There are some skin tightening treatments on the market that claim to improve turkey neck — including Thermage®, Ulthera®, and Facetite™ — but only a small number of people get a truly good result, they’re mediocre for majority of patients, and it’s impossible to predict who will see a good result. I greatly prefer surgery because I can deliver consistently good improvements for each patient.

Greer Plastic Surgery is Here to Help!

We hope this helps you decide which of our aesthetic treatments are best for you. If you have additional questions regarding our surgical and non-surgical procedures, please feel free to reach out to our caring staff. We look forward to answering your questions and helping you achieve stunning results!