Non-Surgical vs. Surgical Facial Rejuvenation: Which is Right for Me?

Facial Rejuvenation OptionsOver the past several years there has been an explosion of options to help your face look better and younger. Fillers, toxins (e.g. Botox®), stem cells, facelifts, fat grafts, skin tightening, and the list goes on and on. With so many options, how can you know what is right for you? Is surgery better, or will non-surgical treatments help you achieve your goals? Do the treatments even work? As you consider your options, understanding a few general principals can help simplify the decision.

First, it’s important to understand that surgery and non-surgical procedures sometimes do different things, but sometimes they do the same thing in different ways. For instance, deepening of the nasolabial folds (the creases from the side of the nose toward the corners of the mouth) can be softened by dermal fillers such as hyaluronic acid (e.g. Juviderm®, Restylane®). This type of injection is performed during an office visit and only takes a few minutes. Surgery, however, can also diminish the folds. Fat grafts can be utilized to soften the folds much like fillers, and often the most dramatic improvement to the folds is when a face lift is combined with fat grafting.

Second, while non-surgical or minimally-invasive treatments are easy to undergo and recover from, they are typically temporary and will need to be repeated to maintain the effect. Neurotoxins (e.g. Botox®, Dysport®, Xeomin®) do a great job of softening wrinkles between the brows, in the forehead, and by the side of the eyes, e.g. ‘crow’s feet’. These injections take only a few minutes to complete, but they typically last about 3 or 4 months and then need to be repeated to maintain the effect. On the other hand, surgical procedures tend to be more long lasting and may never need to be repeated. A brow lift can treat the wrinkles between the eyebrows extremely well, and this improvement is generally permanent.

Third, there are some aging changes that simply can’t be adequately corrected by non-surgical treatments, at least at this point in time. If you have developed significant jowling, only surgery can reliably address this issue. If the brow position is quite low or there is a significant amount of loose skin of the upper eyelids, only eyelid and brow surgery can reliably reposition the brow or eliminate the loose skin of the upper lid. If there is significant skin laxity in the neck, minimally-invasive treatments will not fully correct the looseness, and a neck lift will be required for full correction.

It is also very important to understand that often non-surgical and surgical treatments represent a continuum of effectiveness. Office chemical peels, mechanical treatments, or facial lasers can do a great job if the degree of skin changes and wrinkling is relatively limited. More aggressive lasers or surgical chemical peels, however, can produce more dramatic results when the skin has more established aging. Very often, minimally-invasive treatments are a great option for less severe changes, while surgical treatments are the best for more severe changes. If you are older and have more advanced aging concerns, surgery is more than likely the answer for you, but if you are in your thirties or forties, very often the non-invasive treatments such as fillers, Botox®, and good skin care is the best strategy.

Finally, and most importantly, marketing and hype doesn’t mean that something works. As much as we are always hoping for great, new options, some of the marketed treatments have little or no proven effect. For example, although the potential of stem cells to treat many conditions – including facial aging – is significant, at this time there are not sufficient studies to show that the currently marketed treatments are either safe or effective. Also, just because a treatment is approved by the FDA doesn’t mean that it is better than the older, simpler, or less expensive procedures. The old adage is upheld: If it seems too good to be true, it probably is.

As you work to figure out your best combination of options, remember that the doctors at the Emory Aesthetic Center are trained in both non-surgical and facial surgical solutions to address your aging concerns, and can help you figure out what strategy is best for you. In addition, we can help you develop a long-term, integrated plan to keep your face looking its best, incorporating good skin care along with non-invasive and surgical treatments when the time is right.

Join us for a live chat on Facial Rejuvenation –Surgical and Nonsurgical Solutions on Tuesday, November 11th at Noon to hear more about this topic. Dr. Foad Nahai, cosmetic surgeon, will be available to answer all of your questions. To register for the live chat, click here.

About Dr. Eaves

Felmont Eaves, MDDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

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