menu_book Indications • 10 min read

Facelift vs Fillers: When Is Surgery the Best Option?

Fillers or facelift? Understand filler limits, when surgery is indicated, and how treatments can complement each other.

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Dr. Roberio Brandao

Creator of Modern Face

Updated December 17, 2024

The Modern Rejuvenation Dilemma

We live in the age of fillers. Hyaluronic acid, biostimulators, facial harmonization — the promise of rejuvenation without a scalpel is seductive. And for many patients, it works very well… for a while. The problem arises when fillers reach their limits. When increasing volumes are needed. When the face starts looking “swollen” but still aged. When structure is sagging and no amount of volume will fix it. This is where advanced techniques like [Endomidface and Deep Neck offer real structural solutions.

“Fillers add volume. Facelift repositions structure. They’re different tools for different problems — and often complementary.”

  • — Dr. Robério Brandão

Direct Comparison

Aspect Fillers Facelift

Mechanism Adds volume Repositions tissues

Corrects ptosis? No (camouflages) Yes (resolves)

Duration 6-24 months 8-12 years

Recovery Minimal (days) 2-3 weeks

Single cost Lower Higher

10-year cost High (repetitions) Moderate (single)

Reversible? HA yes, others no No

Naturalness Depends on volume Depends on technique

When Fillers Are Sufficient

✅ Good Indications for Fillers

Isolated volume loss — flat malar, hollow temples, without significant ptosis

Mild to moderate grooves — early nasolabial or tear trough

Young patients (30-45) — with early aging

Not surgical candidates — by preference or contraindication

Post-facelift maintenance — complement in specific areas

When Facelift Is the Best Option

🎯 Indications for Facelift

Significant tissue ptosis — descended malar, jowl, platysmal bands

Increasing filler volumes — without satisfactory lasting result

Loss of structural definition — jawline, cervicomental angle

“Swollen but old” appearance — sign of excess volume

Desire for lasting result — patient tired of repeating procedures

Frequently Asked Questions

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Cost-Benefit Analysis

An honest comparison of long-term investment between fillers and surgery.

Biostimulators Guide

How collagen stimulators affect facial tissues and future surgery.

Result Duration

The reality about how long each treatment’s benefits will last.

For surgeons: Learn to master the transition from injectables to surgery in our [education programs.

Learn to Indicate Correctly

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Frequently Asked Questions

Can fillers replace facelift?

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Not completely. Fillers add volume and can camouflage grooves, but don't reposition ptosed tissues. In cases of significant ptosis, excessive filler creates a 'swollen' appearance without resolving the structural problem.

When do fillers become insufficient?

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When there's significant tissue ptosis (descended malar, jowl, platysmal bands), when increasing volumes of filler are needed to maintain results, or when the face is losing definition despite treatments.

Can I get fillers before deciding on facelift?

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Yes, fillers can be a step along the way. Many patients start with injectables and eventually opt for surgery when fillers are no longer sufficient. The important thing is not to overdo volume.

Does facelift eliminate the need for fillers?

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Often reduces but doesn't always eliminate. Facelift repositions tissues; fillers add volume. After facelift, less filler is needed, but some patients still benefit from supplementation in specific areas.

Is it true that too much filler makes facelift difficult?

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Yes. Biostimulators and excessive filler volumes can create fibrosis and alter anatomical planes, making surgical dissection difficult. The Modern Face technique was developed to deal with this reality.

What's the long-term cost-benefit?

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Fillers require frequent maintenance (6-18 months). After 5-10 years of regular fillers, accumulated cost often exceeds that of a facelift lasting 8-12 years. Analysis should be individualized.

I'm 45 — facelift or fillers?

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Depends on anatomy, not age. At 45, if there's significant ptosis, facelift may be indicated. If there's volume loss without ptosis, fillers may be sufficient. Evaluation is individual.

Can I do both?

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Yes, and it's often the best approach. Facelift corrects ptosis and fillers (in smaller quantities post-facelift) add volume where needed. Treatments are complementary, not competitive.

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