Knowing When It’s Time to Have Surgery

Most people would prefer an affordable, scarless, no-downtime, minimally invasive, and relatively painless procedure instead of undergoing cosmetic surgery. That’s why lunchtime lifts, injectables, and laser skin tightening are trending. Still, there comes a point of diminishing returns when a surgical option is the best choice. 

When you reach that pivotal moment when non-surgical treatments can no longer substitute for surgical correction, do you pull the trigger? Clinging to minimally invasive processes may lead to what many patients fear most – a distorted, unnatural appearance that makes them look “overdone.” 

So, how can you tell when it’s time to have cosmetic surgery? Let’s find out.

Is It Time for a Facelift?

The best way to decide if surgery is best for your cosmetic concerns is to speak to a professional. While board-certified plastic surgeons make their living helping women and men look their best through surgical procedures, most offer non-surgical therapies too.  

Because most non-surgical cosmetic treatments focus on the face, let’s start there. Botox, dermal fillers, and laser technology have been part of aesthetic medicine for several years now. Many see it as a way to keep a youthful appearance without the risk or aggravation of going into an operating room. But let’s look at the stark differences between the two methods at the midface. 


Gravity’s long-term influence becomes visible when facial tissue beneath the cheek area begins to descend to the lower face. This phenomenon leads to wrinkles around the mouth, also known as parentheses lines and marionette lines.

Dermal fillers are an excellent option to combat premature signs of aging, minimizing wrinkles and hiding a loss of cheek volume. However, it is crucial to understand the cheek tissue did not disappear – it moved lower on your face, causing a squared-off chin and jawline. Using dermal filler injections to correct this problem leads to overfilling and an unnatural look. 

When you realize it takes more and more filler to achieve the desired effects, it is time to speak to a plastic surgeon about a facelift. The high SMAS facelift repositions the cheek volume back where it should be, treating the cosmetic concern’s cause and effect. Now, let’s look lower at the jawline.

Lower Face

When you look in the mirror and see pronounced jowls, it’s time to consult with a surgeon. 

During early jowl formation, dermal filler injections can hide them. However, surgical intervention is necessary when this problem progresses in severity. A facelift will reposition jawline tissue for a more youthful facial appearance.  


The signs of aging hit the eyes early on. Excess fat and skin in the upper lid create a hooding that makes you look tired and worn. The lower lids may experience an accumulation of excess fat, causing circles, bags, hollows, and a fatigued look. 

What are your non-surgical options? Early on, Botox can subtly lift the brow by forcing contracted muscles to relax. Fillers can add volume to the lower lids, minimizing prominent tear troughs. However, these results are only temporary.

Ultimately, blepharoplasty is the best solution. Temporary fillers and neuromodulators get the job done for a while, but when the battle becomes constant, talk to your plastic surgeon. 

But When Do You Know?

This post has provided a lot of practical information, but does it fully address your concerns? The best way to understand when to choose surgery over temporary, non-surgical treatment is to talk to a skilled plastic surgeon. 

Dr. Eric Pugash has 30 years of experience helping his patient look their best for the long haul. His exceptional training includes two years in Paris, France where he learned an elegant and understated approach to facial rejuvenation. If you are considering aesthetic correction and would like more information about cosmetic surgery, contact him today. 

If you’d like to learn more about when to choose cosmetic surgery over non-surgical treatments, please contact us online or call us at (604) 522-5199. Dr. Pugash and his staff would be happy to meet with you for an enlightening consultation to discuss your needs and recommended solutions.