When should you Botox and Filler and when is it time for a Facelift ?

When Should You Try Botox and Fillers?


As we age, we start to lose fat in our face. This leads to wrinkles, sagging jowls, dark circles beneath our eyes, and other common signs of aging. Usually, the aging process begins in our 30s, becoming ever more apparent as we age, in large part due to facial fat loss especially in the central face.

In our 40s and 50s, we begin to lose significant amounts of fat beneath our eyes, in our cheeks, and around our temples. As a result, when we reach middle age, we often start considering Botox and facial fillers. For those with early signs of aging or jobs that require frequent public appearances, treatments might begin earlier, even as early as mid-20s to early-30s.

Remember: treatments depend on the individual. Your treatment might look vastly different from a friend who’s the same age simply because each of you ages differently and one of you may take better (or worse) care of his or her skin than the other.

The most important consideration: Who’s injecting!

When trying Botox or fillers for the first time, the most important thing to consider is who is injecting them. There are fourteen FDA-approved facial fillers in the U.S., and all of them are safe unless the person injecting them does not understand how to administer the treatment. It’s essential that you go with a board-certified plastic surgeon or a board-certified dermatologist with the expertise or  experience in exactly how and where to administering Botox or specific fillers. They will not only know how to inject the filler or Botox correctly, they will also be able to answer your questions about the proper use and specific timing of when you should do cosmetic plastic surgery for your unique face.

How long do treatments last?

These FDA-approved hyaluronic acid filler treatments are temporary, and that’s good because it means they have minimal to no long-term side effects. How long the treatment lasts depends on what part of the body is treated and what type of filler injection is used, but most individuals can go about six months between treatments, with some waiting as long as a year to fifteen months between treatments, especially if the filler is done under the eyelids or on the nose. Botox, on the other hand, usually lasts three to four months only when injected for cosmetic reasons in the face to reduce facial and eyelid wrinkles or reshape the eyelids or brow.

When Do I need a facelift, fillers, or Botox?

While early signs of aging and moderate signs of aging can be treated with fillers or Botox (from the 30s to the mid- or late-40s), when you see excessive skin sagging or facial jowling and facial fat loss, then it may be better treated with a facelift, which will restore the facial tone and your youthful face. A facelift uses your own fat for the central face and a deep layer “lift and fill” procedure for your neck.

More questions? Want a consultation?

 I’m here to answer your pressing questions about plastic surgery and how to stay looking your best. My top priority is performing safe procedures that provide the best outcome no matter your age! Don’t rely on faulty information — get the correct information .

And if you’re looking for a  board-certified plastic surgeon with the expertise and experience to give you a complete and honest assessment of what you may need or benefit from plastic surgery, contact Dr. Rohrich’s office to set up a consultation!

Dr. Rod J. Rohrich is an internationally known and respected plastic and cosmetic surgeon operating in the Dallas, Texas area. He is board certified by the American Board of Plastic Surgery and has led most of the key professional organizations in plastic surgery in the USA. He has received numerous honors and awards in plastic and cosmetic surgery, both nationally and internationally. In addition to his extensive surgical expertise and talent as a gifted surgeon, he is a Clinical Professor and the Distinguished Teaching Professor and Founding Chair of the Department of Plastic Surgery at UT Southwestern Medical Center. He has authored hundreds of innovative academic publications in the field as well as serving as the editor of the leading plastic and reconstructive surgery journal — the Journal of Plastic and Reconstructive Surgery.  Dr. Rohrich has also performed philanthropic work as a civic leader of organizations such as the March of Dimes, American Cancer Society and Save the Children and has established the Rod J. Rohrich, M.D. Foundation, which supports medical students in his native North Dakota. He is also a founding member and President of AiRS, the Alliance in Reconstructive Surgery, which serves to support education and treatment for Breast Cancer Survivors, regardless of financial status. Dr. Rohrich has been featured in a number of notable publications such as Texas Monthly and on television shows including Oprah, the View and Good Morning America and is currently working to provide a reliable source of public-centered information in the fields of plastic and cosmetic surgery as well as other areas of medicine.


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Rod J. Rohrich, M.D. - Dallas (Texas)

Fantastic Dr. Rohrich! Thank you for the excellent synopsis for our patients.