Product Description

With accessibility and advancement in science and technology, the use of non-invasive (facials, light peels, and microdermabrasion) as well as minimally invasive techniques (botulinum toxin type A and filler materials, invasive lasers, energy-based devices [radiofrequency (RF) and ultrasound (US)], and thread lifts) are becoming quite popular for dealing with signs of aging. However, repetitive use of these procedures can create scars, can cause fat loss or in a worse scenario, can affect the blood flow. This consequently will create complications while performing the Facelift surgeries. This study demonstrates the common difficulties that plastic surgeons encounter when performing facelifts on patients who have previously undergone those procedures. The authors highlight, with specific procedures, the specific concerns are associated, like loss of cheek fat, scar tissue formation with energy equipment, while granuloma and incising problems with a large volume of injectable. Therefore, the author stresses the need for careful pre-surgical evaluations, history taking and making adjustments accordingly to tackle these challenges. This study also focuses on proper training of the surgeons to deal with the difficulties that are evolving with the use of these procedures, for ensuring efficiency, safety and effectiveness of the performed surgeries.

The Accreditation Council for Continuing Medical Education (ACCME) accredits ASPS to provide educational activities and material with Category 1 CME credits. As an official CME provider, ASPS must comply with all ACCME standards, as outlined in the ACCME Standards for Integrity and Independence in Accredited Continuing Education.

Faculty

Faculty: George Skouras, MD; Athanasios Skouras, MD; Elena Skoura, MSc

Plastic and Reconstruction Surgery®Editors:

Editor-in-Chief: Kevin Chung, MD

Co-Editor: Amy Colwell, MD

Section Editors: Bernard Markowitz, MD

ASPS EdNet - Aesthetic Work Group Faculty: Sachin M Shridharani, MD, FACS (Senior Faculty), Shekhar M. Shrestha, MD 

Intended Audience

This educational activity is intended for plastic surgery practitioners, residents, and other healthcare professionals interested in translating expanded knowledge into practice for the improvement of patient outcomes in plastic and reconstructive surgery.

Learning Objectives

After viewing this course, the participant should be able to:

1. Recognize the typical complication and difficulties that arise when conducting Facelifting procedures on patients who have previously undergone minimally invasive treatments including the use of energy-based devices, thread lifts, and aesthetic injectable treatments.
2. Explain the impact of previous energy-based treatments (like radiofrequency and ultrasound) on facial anatomy. This includes knowledge of cheek fat atrophy, scar tissue formation, and decreased blood supply, and how these will affect the surgical planning and their outcomes.
3. Formulate plans to mitigate the complications caused by use of non-invasive (facials, light peels, and microdermabrasion) as well as minimally invasive techniques (botulinum toxin type A and filler materials, invasive lasers, energy-based devices [radiofrequency (RF) and ultrasound (US)], and thread lifts) while performing Facelift Surgery. This could be the use of preoperative management (e.g., dissolving hyaluronic acid with hyaluronidase) and intraoperative modifications.  

Accreditation

The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation

The ASPS designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Recognition Statement

The Continuing Medical Education (CME) credits offered by this activity are enhanced by ASPS Learner Credit Reporting for learners who have opted into this reporting. Successful completion of this CME activity enables active American Board of Surgery (ABS) members the opportunity to earn credit toward the CME requirement of the ABS's Continuous Certification program when claimed within 30 days of completion of the activity.

Participants in ASPS-accredited education who want their CME credits reported to certifying and state licensing boards must opt-in to reporting and add their NPI as well as state license ID and/or collaborating board ID(s) before claiming credit.

Disclosure Policy

The American Society of Plastic Surgeons (ASPS) requires all instructors, planners, reviewers, managers and other individuals in a position to control or influence the content of an activity to disclose all relevant financial relationships or affiliations. All identified conflicts of interest must be resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity and appropriateness of patient care recommendations. ASPS also requires faculty/authors to disclose when off-label/unapproved uses of product are discussed in a CME activity or included in related materials.

Disclaimer: All relevant financial relationships for planners, faculty and others in control of content (either individually or as a group) are reviewed by the ASPS Continuing Education Committee and have been mitigated, if applicable.

The following planners/faculty members/reviewers have the following disclosures:

Kevin C. Chung , M.D. receives funding from the National Institutes of Health, book royalties from Wolters Kluwer and Elsevier, and a research grant from Sonex to study carpal tunnel outcomes.

Drs. Eberlin, Evans, Mercer, Greenberg, and Styron are paid consultants of Axogen Corporation, a producer of peripheral nerve repair technologies discussed in this review. However, the authors of the article had complete and final control of the data collection, analysis, and manuscript composition. Dr. Lans has no financial interests to declare.

The following planners/faculty members/reviewers have no relevant financial relationships or affiliations to disclose:

Kevin C. Chung , M.D. receives funding from the National Institutes of Health, book royalties from Wolters Kluwer and Elsevier, and a research grant from Sonex to study carpal tunnel outcomes.

Sachin M. Shridharani, MD, FACS is a consultant for Allergan, Galderma, Prollenium, Revance, and Apyx Medical.

The following planners/faculty members/reviewers have no relevant financial relationships or affiliations to disclose:

George Skouras, MD; Athanasios Skouras, MD; Elena Skoura, MSc; Shekhar M. Shrestha, MD



AMA PRA Category 1 Credit^TM: 1.0

Media: Journal Article, video

Release Date:  04/02/2025

Expiration Date: 04/02/2028*

Estimated time to complete this course: 1 hour

*Course access ends on course expiration date

Directly provided by the American Society of Plastic Surgeons® (ASPS®)

Product Code: 43967