Transitioning From Fillers and Botox to Plastic Surgery: When is it time?

Food and Drug Administration-approved facial fillers and Botox can help restore a youthful appearance without surgery, but there comes a time when they are no longer effective and surgery should be considered, says a UT Southwestern plastic surgeon who’s an expert on the science of facial aging.

“As we age, we lose facial fat, and that contributes to making us look older,” says Rod Rohrich, M.D., Chair of Plastic Surgery at UT Southwestern. “Fillers can mimic and restore the volume lost by fat and work well through our 30s, 40s, and even into our late 40s and early 50s. But when you see the transition to sagging skin and jowling, that’s when you need to think about a transition to a lift-and-fill type of facial rejuvenation. Fillers fill, but they don’t lift.” According to Dr. Rohrich, continuing to use fillers beyond the point they are effective leads to an unnatural, overdone look that can make a person appear puffy.

The lift-and-fill facial rejuvenation technique he pioneered at UT Southwestern avoids that condition by using a combination of fillers and your own fat, as well as an individualized facial reshaping procedure. The technique, he says, allows patients to return to a youthful, non-operated, natural appearance. “We fill the central face with fat and lift the outer layers,” explains Dr. Rohrich. “It’s been an epiphany in modern facial rejuvenation, resulting in a refreshed appearance, versus one that looks pulled or windswept.”

Having a board-certified plastic surgeon with expertise and understanding of the science of aging are key components to achieving a natural, youthful look, he says. “You have to be able to do both fillers and surgery. Then you can treat patients during a continuum of aging – from being young in their 30s to being 70 and older. You have to be able to transition with patients as they age.”

Request an Appointment

To schedule an appointment with Dr. Rohrich or any of the plastic surgeons at UT Southwestern, call 214-645-8300.