Permanent Filler Removal with Extended Deep Facelift and Neck Lift

Generally, the body naturally breaks down absorbable (temporary) fillers over time. However, non-absorbable permanent fillers can remain in the tissues indefinitely and may cause granulomas, facial deformities, infections, and reactions to these foreign substances.

When injected by a qualified and trained doctor, fillers can achieve very natural results. However, filler injections may carry risks. Many of these issues can be easily resolved—for example, absorbable fillers like hyaluronic acid can be dissolved with an enzyme injection. Other absorbable fillers may be diluted and flushed with saline solution.

However, complications from permanent fillers tend to be more complex. If complications arise from permanent filler use, surgical removal becomes the only option, as silicone is undoubtedly one of the most difficult substances to remove. It spreads within and adheres to tissues. Permanent filler removal surgery requires expert knowledge of facial anatomy, which is a specialty of Dr. Tarek Zahra, Consultant Plastic Surgeon.

Permanent filler removal is a procedure designed to eliminate or reduce the effects of long-lasting dermal fillers. Even after several years, the chemical substances used in fillers can be removed, freeing you from scarring and restoring your natural look. Since permanent fillers are by nature long-lasting, the only way to remove them is through surgery, often performed during an extended deep face and neck lift, especially when abscesses or scar tissue have formed around them.

Fortunately, there is no specific age range that is ideal for this procedure; however, good overall health, including psychological stability, and realistic expectations are essential for the success of the surgery.

•  Fever.

•  Excessive swelling.

•  Persistent bruising.

•  Infection.

•  lumps.

•  Asymmetry.

•  Firm or hardened areas.

•  Fat necrosis.

Some clients choose to remove permanent fillers for various reasons, including:

• Undesirable results: Many people find that the filler did not give them the desired appearance, especially in the under-eye area, which is considered a sensitive area, and they feel that the filler created an unusual appearance or did not match their aesthetic goals.

• Complications of permanent fillers: Troublesome side effects can lead to the decision to remove fillers. The most common include:

    o Lumps or asymmetry: An uneven texture develops over time, making the skin appear uneven and bumpy. This is particularly noticeable on the lips and cheeks, especially when smiling, where a smooth, natural look is desired.

    o Vascular occlusion: Occlusion occurs when the filler obstructs blood flow through a nearby vessel.

    o Filler migration: Permanent fillers may not remain localized and can migrate from the injection site. Sometimes, they spread from the injection site to unexpected areas, creating a distorted or abnormal look. 

    o Adverse reactions: Mild bacterial infection may develop around foreign material.

    o Excessive fullness: Aesthetic standards for facial volume can change over time. What was once considered the "ideal volume" may now appear excessive. Permanent fillers can leave you with a fuller look that no longer matches your current preferences.

• Aging-related changes: As you age, your facial features may change, making fillers look unnatural.

• Natural Preference: Some clients simply decide they prefer their natural look without the added volume.

• Allergic reactions: Some individuals may experience allergic reactions to certain types of permanent fillers. Symptoms can include redness, swelling, itching, and even granulomas (small lumps produced by the immune system).

The consultation for permanent filler removal with extended deep facelift and neck lift begins with a comprehensive evaluation by Dr. Tarek Zahra, Consultant Plastic Surgeon. This essential initial session allows Dr. Tarek Zahra to thoroughly analyze your condition and determine whether removing or reducing the filler along with a facelift and neck lift is the ideal solution for you.

He will also carefully review your relevant medical history and current medications, while considering several factors, such as: the injection site, the type of filler used, the time elapsed since the injection, whether any complications have occurred, whether it interacts with the body in any way, and how the filler appears on an MRI scan, which gives a clearer picture of the situation.

Some patients assume that anything seen on imaging means surgical removal is necessary, but this is not true. Complete surgical removal is typically reserved for cases such as tumors, where total excision is necessary.

1.  Preserving facial nerves.

2.  Avoiding impact on facial muscles.

3.  Maintaining aesthetic appearance.

4.  Removing as much filler as possible safely.

Surgical excision for dermal filler removal is a precise procedure that ensures safety and targets aesthetic improvement. It is performed under general anesthesia to allow nerve monitoring using a nerve stimulator, especially in cases involving fibrosis around nerves. Dr. Tarek Zahra follows the latest surgical techniques, using fine incisions to reduce the risk of scarring and restore the natural facial appearance. Often, tissue grafting is used to treat facial hollows, along with a deep facelift and neck lift to restore facial harmony.

Sometimes more than 95% of the filler can be removed, but reaching 100% removal is not possible, because some residue is extremely small and invisible to the naked eye, even under magnification, and usually causes no issues.

During the extended deep facelift and neck lift procedure, Dr. Tarek Zahra works beneath the muscles and releases the nerves. Some types of fillers injected in clinics can be mostly removed. However, fillers injected in non-medical settings like salons or homes are more adhesive to tissues, and are less likely to be removed.

If the patient has undergone previous filler removal attempts, such as suction, squeezing, needling attempts, or aggressive manual manipulation, these methods often cause the filler to spread further into the tissues, making surgical removal more difficult.

•  Filler with poor blood supply.

•  Filler prone to infection.

•  Filler that has caused facial deformity.

This is the type of filler that will be removed. Afterward, Dr. Tarek Zahra reconstructs the area using precise medical techniques.

After permanent filler removal, following the specific post-care instructions is essential to ensure the best possible results and minimize complications. Dr. Tarek Zahra’s most important post-op guidelines include:

•  Minimize touching the treated area for at least 6 hours.

•  Apply ice packs to reduce swelling.

•  Keep your head elevated to prevent swelling.

•  Use sunscreen to protect the skin from UV damage.

You may notice some immediate changes, but full results can take several days or weeks to appear as swelling and bruising subside. The quality of results depends on the type of filler used, the removal method, and individual skin characteristics. A follow-up appointment may be needed to assess the outcome and determine if additional treatment is required.

•  Restoring the natural shape and features of the face without long-term commitment.

•  Improved facial tissue health.

•  Removal of undesirable or unacceptable results from previous treatments.

•  Correction of functional issues, such as difficulty opening the mouth or weak eyelid closure.

•  Reduced risk of age-related complications or side effects.

•  Avoidance of ongoing allergic reactions, easing pain, inflammation, and discomfort.

•  Increased flexibility for future cosmetic treatments and choices.

•  Enhanced skin texture and appearance.

•  Opportunity to examine and update aesthetic goals.

•  Improved comfort and confidence with a more natural look.

•  Prevention of filler migration or hardening.

Dr. Tarek Zahra has gained extensive experience and achieved positive results through an increasing number of permanent filler removal cases. He has developed a specialized surgical technique to safely and effectively remove permanent fillers from the face, followed by a precise facial lifting and reconstruction process. This ensures both healthy and aesthetically pleasing results by combining permanent filler removal with a facelift and fat grafting in a single procedure.

Combining permanent filler removal with a deep facelift and neck lift has shown highly satisfactory aesthetic and functional outcomes. The procedure duration depends mainly on individual skin characteristics and the severity of the condition.

If you have concerns about permanent filler, there’s no need to worry. Dr. Tarek Zahra, Consultant Plastic Surgeon, specializes in removing permanent fillers and performing deep facelifts in the same procedure. He can assess your unique case and create a customized treatment plan that meets your needs and helps you achieve a natural, harmonious appearance. Don’t hesitate to schedule your consultation now.