Choosing between Surgical and Non-Surgical Facial Rejuvenation

As we get older, our face changes. Genetics, weight change, sun damage, stress and aging all take a toll. Is a surgery or a non-surgical treatment the best choice? A usual rule of thumb is that non-surgical treatments are temporary and have to be repeated every three to six months (although FaceTite lasts for 3-5 years), whereas surgery gives a permanent or semi-permanent result. Non-Surgical treatments last more or less time depending on the procedure. For instance, Botox™ and Fillers are single treatments with effects lasting three to six months. Forma or Emsculpt NEO, with HIFEM® Technology, comprise an initial series of four to six treatments with a maintenance treatment every month thereafter.

The older you get, the more likely you are to benefit from surgery versus a non-surgical solution. In middle age, non-surgical treatments may be the simplest and most cost-effective solution with minimal down-time. As we get older, the cost benefit analysis makes a 180 degree turn and non-surgical options often only fail to give the desired result but are also more expensive as compared to a surgery. Also, surgery can create results and correct signs of aging that a non-surgical treatment will never achieve.

The big question is when to switch from non-surgical to surgical treatments.

There is no magical age when you reach the maximum benefits of non-surgical treatments. The age varies, depending on your genetics, your history of sun damage, weight change and smoking, stress as well as your expectations. Some anti-aging procedures are not even age related. An example of this is the endoscopic browlift which is a favorite of models and the Kardashians. Another is the lower eyelid fat bag removal in young women and men. Other surgeries such as a cheek fat removal, chin enlargement, nose-jobs and lip augmentation, are effective either as standalone cosmetic enhancements at any age or as anti aging procedures. Cheek or Bichat fat pad removal can be used to create the ‘waif’ look and also to reduce jowls around the angles of the mouth. Chin implants are done at the same time as a facelift to sharpen the jawline and fill an aging deflated chin. Rhinoplasties lift the tip of the nose and can smooth out small humps. Lip enlargement is a procedure for all ages for naturally small lips or lips that have lost volume over time.

The most common non-surgical facial rejuvenation procedures, by far, are Botulinum toxin (Botox) and hyaluronic acid fillers such as Juvéderm Ultra Plus, Juvéderm Ultra, Voluma, Vollure and Volbella. There were five million Botox treatments and 1.5 million filler treatments in the U.S.A. in 2019.

If your doctor isn’t a surgeon then she or he can only offer a non-surgical treatment. Hence, terms like liquid facelift and chemical browlift. A non-surgeon rarely suggests surgery because that means she or he may lose you as a patient, although most reputable physicians will recommend what is best for their patient and a reputable surgeon will return the patient to the referring physician after the surgery is done. A Plastic Surgeon is uniquely qualified  to evaluate all of the options. If surgery is not the best option, then he or she can recognize that, based on experience and training which only a Plastic Surgeon possesses. And the opposite also applies. I will often tell patients not to waste their money on a non-surgical procedure when they have reached the limit of what they can achieve without surgery.

Common non-surgical facial rejuvenation procedures

Here are a few of the non-Surgical treatments available for the face: Botox, Fillers, Forma, FaceTite/AccuTite, Fat Injection, Morpheus8, Intense Pulse Light, Laser rejuvenation (LaserGenesis) and TCA chemical peels.

FaceTite/AccuTite and fat Injections are half-way procedures between surgery and non-surgery. They are minimally invasive procedures that are more invasive that most non-surgical therapies, but  the recovery is only measured in days and not weeks.

Surgical facial rejuvenation procedures

Surgical options depend on the area being treated, whether it is the forehead, eyes, cheeks, face, chin, or neck. Common facial surgeries are endoscopic browlifts, eyelid lifts,  facelifts, neck lifts, chin implants, upper lip lifts, nose rejuvenation and deep chemical peels.

When you have a discussion with your Plastic Surgeon about the best treatments for you, ask about the pros and cons of each treatment and whether non-surgical treatments or surgery is a better choice.


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Plastic Surgery Practice in Norwalk CT with clients from CT, NY, NJ – Manhattan, Northern New Jersey towns, surrounding areas of Greenwich, New Canaan, Stamford, Westport, Darien, Wilton, Weston, Easton, Fairfield, Bridgeport, Trumbull, Ridgefield, Danbury, Monroe, Milford, Bedford, Armonk, Mt Kisco, Bedford Hills, Rye, Harrison, New Haven, Mamaroneck, Larchmont, White Plains, Scarsdale, Westchester County, Fairfield County. New York and from around the world.

*Disclaimer: results are not guaranteed, may not be permanent, and can vary per individual. Before and after photographs of surgical results are of procedures performed solely by Dr. Kirwan.  Some images on this web site are of models, not actual patients. Please see our full disclaimer.

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