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Dear Dr. Kelly:

With all of the wonderful results I see on Instagram achieved through facial injectables alone, why would anyone get a facelift?

Dr. Kelly. Injectables are wonderful and they have transformed our approach to aesthetic treatments. Botox and other neuromodulators allow us to relax facial muscles and reduce fine lines that occur with aging. Fillers are used to restore volume that has been lost in the deep fat pockets of the face with the passage of time.

Facial rejuvenation done with only an injection is often like a magic wand that erases the effects of time. So why would anyone ever want cosmetic facial surgery anymore?

This is a frequent topic of conversation in my office. In my experience, there are two reasons why patients still turn to facial surgery to improve the signs of aging. The first is that cosmetic surgery tends to be more effective and longer lasting than injectables.

I see patients who have been happy with their injectables, but want a more lasting result. Frequently, I will recommend a face and/or neck lift combined with fat grafting. The grafted fat will eliminate the need for frequent filler injections, it looks more natural, and the stem cells present in fat will make the patient's skin look better with time.

Patients are happy with the long-term result, and appreciate having reduced or eliminated their need for filler going forward. It can also be more cost effective to have fat grafting once, rather than fillers every 6-12 months.

The other reason that patients turn to surgery is to improve their neck. As one plastic surgeon said to me, “I treat patients with injectables until they can't stand their neck any more, then I do their surgery.” The reality is that non-invasive treatments like Ultherapy only work for early neck aging; we really don't have an effective non-invasive solution for most patients with aging of the neck.

The only reliable way to treat sagging neck skin and muscles is with surgery, through a scar hidden behind the ear. Again, patients are thrilled with the results because they are tired of having a rejuvenated face and an aged neck. The surgical results are lasting and effective.

I love injectables. I use them every day to improve the appearance of my patients and they love the results. Nonetheless, when they reach a point where they want a longer lasting result, or they just can't stand their neck anymore; that is the time to consider surgery.


About Dr. Kelly

Dr. Kelly is a board-certified Plastic Surgeon and partner in both Miami Plastic Surgery and MPS MedSpa. He has been in practice over 25 years and has been recognized by his peers both nationally and internationally as one of the best plastic surgeons in the United States.

In addition to being an expert on Cosmetic Surgery, his practice encompasses the entire spectrum of non-invasive treatments such as Botox, fillers, CoolSculpting, ultrasound, lasers and radio-frequency. He also believes in giving back to our community, having served on the Village Council for eight years and volunteering as a coach for our youth sports programs. You can email him questions at mkelly@miamiplasticsurgery.com.

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