Can Injectables and Facelifts Coexist? Early Data Suggest Yes

Facelift surgery remains a foundational procedure for facial rejuvenation, but it may not fully correct age-related volume loss, skin quality changes, or dynamic rhytides. As a result, injectables and energy-based devices are frequently incorporated before and after rhytidectomy, despite limited data on their potential impact on surgical outcomes.

A retrospective chart review published in Journal of Cosmetic Dermatology evaluated real-world patterns of minimally invasive treatments among patients undergoing facelift surgery and explored whether prior or subsequent injectable use was associated with adverse outcomes. The single-center pilot study included 20 patients with documented histories of neurotoxin, dermal filler, biostimulator, or energy-based device treatments who underwent rhytidectomy. Analyses were descriptive and exploratory, reflecting the study’s limited sample size and retrospective design.

All patients had received neurotoxin injections before surgery, while 90% had been treated with hyaluronic acid fillers and 55% with biostimulators, including poly-L-lactic acid or calcium hydroxylapatite. Following facelift surgery, all patients resumed neurotoxin use, and 60% received filler treatments within the first postoperative year.

No significant surgical complications attributable to prior filler or biostimulator use were reported. Patient-reported satisfaction with facelift outcomes was high, although standardized outcome measures were not detailed. The authors noted that the small cohort and lack of comparative controls limit the ability to draw definitive conclusions regarding safety or risk.

“Within our small, retrospective cohort, prior injectable or energy-based device use was not associated with an increased risk of observable adverse surgical outcomes,” the authors wrote. “However, the limited sample size precludes definitive assessment of safety or risk.” 

They added that larger, prospectively designed studies are needed to better define best practices for combining surgical and nonsurgical facial rejuvenation.