Better Together: The Best Surgical and Non-Surgical Cosmetic Procedures To Combine

No longer exclusive to the dermatologist’s office, non-invasive procedures like injectables (i.e. Botox®, fillers, etc.) and laser treatments have made their way to plastic surgery practices as well. According to the American Academy of Facial Plastic and Reconstructive Surgery, four-fifths of all treatments performed by facial plastic surgeons in 2018 were cosmetic non-invasive (read: not surgical) procedures. So, why have so many plastic surgeons embraced non-surgical services? And, in turn, which procedures make perfect pairs?

“In my practice, non-invasive procedures are frequently done in conjunction with cosmetic surgery to improve the overall result or to provide a more efficient treatment plan for patients,” explains Dara Liotta, MD, a facial plastic and reconstructive surgeon in Manhattan.

One popular non-invasive and invasive cosmetic procedure combination in Dr. Liotta’s practice is the coupling of Botox® and upper eye lifts because "injecting while a person is sleeping keeps tension off the surgery incisions and improves the overall result."

She also frequently pairs lip fillers and nose jobs. “Lip filler is often paired with a rhinoplasty because tweaking the lip shape helps balance the new proportions of the face," she shares. "Also, injecting around the mouth can be painful, so doing it while a patient is under anesthesia helps save her from extra discomfort."

Melissa Doft, MD, a Manhattan plastic surgeon and clinical assistant professor of surgery at Weill Cornell Medical College, has a similar approach. "Dermal fillers are painful, period," she says. "So, doing them when you are already under sedation is appealing."

Dr. Doft regularly incorporates injectable fillers into cosmetic surgery — even if the filler is not necessarily complementary to the surgical procedure (e.g. lip fillers with a breast augmentation). She also adds lip fillers and PRP (platelet-rich plasma scalp injections that stimulate regrowth) to facelift surgery. “Many older patients who are ready for a facelift are often also suffering from thinning hair and lips," she explains. "So, many decide it is both efficient and painless to address them all at once."

Another popular "extra"? Laser resurfacing.

Both Dr. Doft and Dr. Liotta say lasers are a go-to non-invasive add-on to plastic surgery procedures that already require a considerable recovery period (think: eyelid surgery or facelifts).

“In addition to elevating the facelift result by improving the texture of newly lifted skin, lasering during surgery can save the patient extra downtime on the backend,” explains Dr. Liotta. “After surgery, most patients opt to stay out of sight for at least a week, so adding deeper laser resurfacing — which leaves the skin red and raw — saves the patient from two rounds of downtime. Post-op, they stay home and recover from both the surgery and lasering simultaneously.”

But it's not always about minimizing pain or maximizing downtime. Some effective combos are more spa-like in nature.

Dr. Doft says she frequently combines liposuction with a lymphatic massage — a non-invasive therapeutic treatment. “I work with an excellent masseuse who specializes in lymphatic drainage," she says. "I have found that having her massage a patient three to four times after liposuction makes the end result more uniform and it can significantly decrease post-op swelling, sometimes cutting recovery time by a third or even in half.”

Multitasking is a marvelous thing.