The person seeking facial rejuvenation today has every reason to be perplexed and feel confused as to whether a surgical or nonsurgical treatment would be best for them. The media message often appears to be, “You don’t have to have surgery and a long recovery. You can have “X” nonsurgical treatment and be back at work the next day.” Although there may sometimes be a bit of truth to this, it is often mythical thinking.

In general, a nonsurgical treatment like neuromodulators (e.g. BOTOX® Cosmetic injections, Xeomin®, Dysport®), dermal fillers (e.g. Juvéderm®, Restylane®) or light peels will turn the aging appearance clock back any given number of years. When the temporary effect (e.g. three months for neuromodulators and one or more years for facial fillers) wears off, you are back to where you would have been, and can have further treatments to obtain the same effect again. So… you have no surgery (but may still get some bruising and swelling), but you do require repeated treatments. Furthermore, as certain peels and laser treatments are increased in intensity to achieve a better result, downtime of several days for each treatment can also occur.

Compare this with a surgical procedure such as a facelift or eyelid lift (blepharoplasty). These procedures turn the clock of aging back forever and definitively, and usually never need to be repeated. They do usually require about two weeks of downtime from professional or social activities due to resolution of bruising and swelling. But they usually are not associated with much pain, and you are up and about the second week. Follow-up appointments are required, especially initially, but after that the job is done and long-term care is not required.

Sometimes the very best aesthetic outcome is achieved by combining the two modalities. In general, facelift and blepharoplasty operations are best to achieve lift, whereas fillers are best to replace volume. Neuromodulators improve the longevity of the fillers as well as modifying muscle actions where desired.

If you just want to “get the job done,” choose surgery. If you wish to avoid surgery and don’t mind repeat visits, you might prefer to go the nonsurgical route. Fortunately, with few limitations you can choose whatever works best for you, combining surgical and nonsurgical procedures to achieve your ideal look.