Can I have a facelift if old filler remains in my face?
Old filler remaining in the face does not necessarily prevent a facelift.
However, lifting sagging tissue alone when substantial filler remains may provide inadequate lifting or make unevenness more noticeable after surgery.
Should old filler be removed before a facelift?
A facelift is possible with residual filler, but filler or foreign material that may affect the result is best removed first to the extent feasible.
Old filler may spread into subcutaneous tissue or between fat layers, or move downward with gravity, rather than remaining only at its original injection site.
Sagging may be particularly noticeable after repeated large-volume injections into areas such as the front and sides of the cheeks and the nasolabial folds.
If only the skin and SMAS are lifted without addressing residual filler, the weight of the remaining filler together with aging may accelerate sagging.
If the filler is encapsulated, granulation tissue has formed, or inflammation is present, a facelift without removal may worsen inflammation or carry a risk of other complications.
In these cases, combining removal with a facelift may be a useful approach.
Fibrosis and adhesions caused by a foreign-body reaction around old filler can also make normal anatomical dissection planes difficult to identify.
This can impede adequate tissue movement or fixation in the desired direction. If granulomas or inflammatory nodules coexist, symptoms such as swelling, a firm foreign-body sensation, and pain may persist after surgery.
How is old filler removed?
Removal requires an approach based on the location and depth of the remaining filler.
UVOM Plastic Surgery's approach
Locating foreign material with ultrasound
Before surgery, ultrasound is used to assess the location, depth, and spread of residual foreign material.
We assess whether only injected material remains or whether capsules, fibrosis, calcification, granulomas, or inflammatory tissue are also present before planning the incision and extent of surgery.
Surgical removal while preserving normal tissue
Old filler and foreign material may be spread irregularly between normal fat and muscle rather than remaining as a single mass.
Rather than pursuing complete removal at any cost, we preserve nerves and normal tissue as much as possible while separating as much removable material as feasible that is causing excessive volume, inflammation, or tissue deformity.
If fibrotic tissue, granulomas, or nodules have formed along with the filler, these inflammatory tissues are removed as well.
Why combining filler removal and a facelift may help
Capsules, fibrosis, granulomas, or adhesions around old filler can affect the dissection and tissue movement needed for a facelift.
Addressing sagging skin remaining after foreign material removal
When the volume occupied by foreign material is reduced, excess skin or downward sagging of the cheek tissue may become apparent.
Combining a facelift can correct sagging that may occur after removal by repositioning the sagging SMAS and soft tissue upward, rather than only excising loose skin.
Creating a dissection plane that allows adequate SMAS movement
A facelift involves dissecting the SMAS and repositioning sagging tissue upward, rather than simply pulling the skin.
If old filler has spread between subcutaneous fat layers or caused fibrosis and adhesions, normal dissection planes may become unclear and movement of the SMAS and soft tissue may be restricted.
Addressing filler and altered tissue that impede lifting may help establish the necessary dissection plane and allow smoother tissue movement.
Repositioning tissue to suit the face after foreign material removal
Facial volume and excess skin may differ before and after filler removal.
It is therefore important to anticipate the remaining volume and skin sagging after removal when deciding the direction of SMAS movement and the extent of skin excision.
However, foreign material removal and a facelift do not have to be combined for every patient.
The surgical method should be chosen after assessing the amount and extent of remaining material, skin elasticity and sagging, and inflammation and adhesions in surrounding tissue.
If substantial skin and soft-tissue sagging is expected after removal, or sagging cheeks, jowls, and loss of jawline definition are already present, combining foreign material removal with a facelift
may help create a more natural, refined facial contour.
Frequently asked questions (FAQ)
Q. Can I have a facelift even if a large amount of filler remains in my face?
A. Yes. However, if the remaining filler may affect the result, it is advisable to remove it first to the extent feasible before proceeding with the facelift.
Q. What happens if I have a facelift without removing the filler?
A. The weight of remaining filler together with aging may accelerate sagging, and encapsulation or inflammation may increase the risk of complications.
Q. Must filler removal and a facelift always be combined?
A. No. The surgical approach depends on the amount and extent of remaining material, skin elasticity, and the condition of inflammation and adhesions.
Q. Can old filler be located accurately?
A. Preoperative ultrasound is used to assess the location, depth, and spread of foreign material before planning incisions and the extent of surgery.
Old filler remaining in the face does not make a facelift impossible,
but its condition can affect the outcome and safety. Whether to combine foreign material removal with a facelift should be decided after assessing the remaining filler volume, inflammation, and degree of skin sagging together.
If your face looks heavy or saggy after facial filler years ago, or you would like to know whether a facelift is possible with residual filler, call 02-545-3700 or contact UVOM Plastic Surgery on KakaoTalk.