For Newton Centre, Mass.-based plastic surgeon Joseph Russo, MD, going under the knife is just the first step to sustaining a desirable facial aesthetic. The next part—and what he argues is perhaps the most important to long-term maintenance—is embracing nonsurgical treatments, such as fillers.

“When we’re talking about enhancing or maintaining a facelift, a lot of it is based on the fact that we’re all born with different genetics and some of us are born with different skin thickness than others,” says Dr. Russo, who adds that patients with thinner skin may need more help maintaining their surgical results with skin tightening procedures as they don’t have as much dermis. “The number-one thing is to determine what your skin type is—if it’s a thicker dermis it will do well with many different treatments. If it’s thinner, it can get easily damaged.”

Dr. Russo adds that skin starts to age the second your surgical procedure is done. “So, a lot of the devices now have been invented to create collagen synthesis, because the loss of collagen as you age makes the skin thin. All the common devices like lasers, radiofrequency and ultrasound procedures are trying to do the same thing: create an injury in the skin and create more collagen, making the skin thicker and therefore tighter.”

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