Optimizing Aesthetic Facial Surgery Outcomes Following Minimally Invasive Treatments: Guidelines for Perioperative Management

Abstract

Background: The rise in minimally invasive treatments (MITs) in aesthetic medicine has introduced new complexities for subsequent facial surgeries such as facelifts. Despite their popularity, there are limited data on how these treatments impact surgical outcomes.

Objectives: The authors of this paper explore the impact of MIT modalities on subsequent facial surgeries and provide guidelines for perioperative planning and management to optimize outcomes for patients with a history of MITs.

Methods: An expert panel of 7 plastic surgeons and 1 dermatologist conducted a comprehensive review of existing literature, combined with author surveys and case-based discussions, to develop perioperative recommendations for patients with previous MITs. Consensus was reached for each recommendation with a ≥75% agreement threshold.

Results: The authors of this paper present recommendations for perioperative planning, surgical techniques, and postoperative care for patients with previous MITs. Complication risks were found to vary by MIT modality: biostimulatory injectables, temporary fillers, and superficial energy-based devices (EBDs) generally present lower risks, whereas permanent fillers, deeply delivered EBDs, and recently placed temporary fillers or threads were associated with increased risks. The recommendations highlight strategies to support both aesthetic and functional surgical outcomes.

Conclusions: Patients with previous MITs can be candidates for facelift surgery if perioperative strategies are followed to mitigate risks associated with plane distortion and vascular compromise. These guidelines provide a framework to support aesthetic providers in enhancing surgical outcomes and patient satisfaction. Given the limited literature on MIT-related surgical implications, the authors emphasize individualized approaches to mitigate risks associated with previous MITs until further research is available.

Figure 1.

Overview of the consensus process.

Figure 2.

Image of a calcified nodule from a 55-year-old female patient 24 months status post calcium hydroxyapatite injection.