Evaluating the Use of Surgical and Non- Surgical Adjunctive Therapies in Facelift Surgery: A 10-year review of 6,320 patients
Isha Joshi*2, Andrea R. Hiller1, Cathy Henry1
1Plastic Surgery, Milton S Hershey Medical Center, Hershey, PA; 2Plastic Surgery, Penn State College of Medicine, Hershey, PA
The number of facelifts performed in the U.S. between 2000-2022 increased by 75%. Advances in our knowledge of facial aging have led to the use of adjunctive modalities, including soft-tissue fillers and skin resurfacing procedures. These adjuncts can enhance cosmetic outcomes without adding to patient morbidity. Although use of adjunctive procedures is a common practice, there is limited data on which adjuncts are most commonly used at the time of facelift or as a secondary procedure following facelift. In this study, we identified the most common adjunctive procedures used simultaneously with facelift, as well as after surgery.
A retrospective cohort study was conducted using a national electronic health record database, TriNetX. All patients who had undergone a facelift from January 2010 to December 2020 were identified using Current Procedural Terminology (CPT) codes. CPT codes were then used to identify the most common adjunctive procedures performed concurrently with facelift as well as after surgery.
Out of 76,484,371 patients, 6,320 underwent a facelift from 2010-2020. The majority of patients were white (87%) and female (83%). Surgical adjuncts (40.6%) were more commonly performed than non-surgical therapies (8.8%) at the time of facelift. The most common surgical adjuncts were blepharoplasty, followed by rhinoplasty and brow lift, respectively. After facelift, it was more common for patients to receive non-surgical adjuncts (9.1%) than additional surgical procedures (4.4%). The most common non-surgical adjuncts performed were injection of filler, chemical peels and dermabrasion.
Our current study shows that patients undergoing facelift are more likely to receive adjunctive therapies at the time of surgery compared to as a secondary procedure. It was more common for patients to undergo surgical adjuncts at the same time as facelift than nonsurgical adjuncts. Additional studies are needed to evaluate what combination of therapies will provide the most optimal aesthetic outcome as well as long-lasting results.
| Total # of procedures | % of population | Same day procedures | % of population | Post- operative procedures | % of population | |
| NON- SURGICAL | 1129 | 17.86% | 554 | 8.77% | 575 | 9.10% |
| Filler | 643 | 10.17% | 264 | 4.18% | 379 | 6.00% |
| Peel | 277 | 4.38% | 161 | 2.55% | 116 | 1.84% |
| Dermabrasion | 154 | 2.44% | 104 | 1.65% | 50 | 0.79% |
| PRP | 24 | 0.38% | 15 | 0.24% | 9 | 0.14% |
| Electrolysis | 21 | 0.33% | 0 | 0.00% | 21 | 0.33% |
| Fractional CO2 laser | 10 | 0.16% | 10 | 0.16% | 0 | 0.00% |
| Cryotherapy for acne | 0 | 0.00% | 0 | 0.00% | 0 | 0.00% |
| SURGICAL | 2842 | 44.97% | 2566 | 40.60% | 276 | 4.37% |
| Blepharoplasty | 1972 | 31.20% | 1855 | 29.35% | 117 | 1.85% |
| Rhinoplasty | 415 | 6.57% | 361 | 5.71% | 54 | 0.85% |
| Brow Lift | 397 | 6.28% | 329 | 5.21% | 68 | 1.08% |
| Otoplasty | 30 | 0.47% | 21 | 0.33% | 9 | 0.14% |
| Fat grafting | 28 | 0.44% | 0 | 0.00% | 28 | 0.44% |
| UNLISTED PROCEDURES OF THE FACE | 589 | 9.32% | 420 | 6.65% | 169 | 2.67% |
| Total | 4560 | 72.15% | 3540 | 56.01% | 1020 | 16.14% |
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