Plastic Surgeon Shares 5 ‘Risky’ Cosmetic Treatments He Would Avoid If You’re Over 40: ‘Long-Term Problems’

1. Thread lifts

While thread lifts do offer a visible lift, the results are usually temporary—often lasting only 6 months to a year. For women over 40 whose skin is losing elasticity, this can mean the lift may not hold well or may require frequent repeat procedures.

“Many of you don’t know this, but I have received a thread lift in the past. While thread lifts can work, if only for a short time, there are a few concerns worth mentioning. Whether dissolvable or permanent, threads can provide the lifting and shaping that patients are looking for. However, the duration of results and the long-term effects on the patient are often called into question,” he reveals.

Furthermore, he says it can cause "irregularities, asymmetry, and it doesn’t last that long."

2. Ultherapy

One of the most commonly reported complications with Ultherapy is fat atrophy. While it's meant to target deeper layers of skin to stimulate collagen, in some cases it can break down facial fat, especially in thinner or more mature skin. This can lead to a hollowed, aged appearance, which is the opposite of the youthful effect most people are looking for.

“Ultherapy advertises itself as ‘the only technology that goes deeper than any other FDA-cleared ultrasound device.' While that sounds impressive, there’s evidence suggesting that going deeper isn’t necessarily better,” he says. “Similar to Morpheus 8, this treatment can be risky in the wrong hands. While good results are possible with a highly trained provider, these devices are becoming increasingly powerful, and inadequate training could lead to undesirable results.”

“Ultherapy melts the fat under your skin and causes the fat to shrink and also causes a scar,” adding that “it’s very difficult to do facelifts on people who had ultherapy,” he adds.

3. Permanent fillers

As your face naturally changes with age—losing fat, elasticity, and bone density—permanent fillers don’t adapt. What once looked balanced at 40 might look unnatural, lumpy, or distorted at 50 or 60, since the surrounding tissue has shifted while the filler has stayed put.

Dr. Sadati reveals, “Most of you will never encounter or be recommended permanent fillers, but they are still used in less reputable, ‘fly-by-night” clinics that promise cheap and quick results. One example is ArteFill—unlike standard fillers that can be dissolved, permanent fillers harden into an almost bone-like material, making removal extremely difficult. If anyone offers you permanent filler—run!” All of this can cause "long-term problems."

4. Facelift with fillers

To mimic the lifting effect of surgery, large volumes of filler are often used. This can lead to an unnatural, overfilled look — commonly called “pillow face” — where the cheeks and midface appear puffy or distorted. This not only looks artificial but can age the face in the long run by stretching the skin.

“I would never go to somebody to get my face filled up with fillers to have my jowls and neck lifted. You don’t want to have cheeks full of filler to get your lower face lifted,” he warns.

5. Non-board-certified surgeon

Board-certified surgeons have completed years of specialized training and education, ensuring they possess the necessary skills to perform complex procedures safely and effectively. Non-board-certified surgeons may lack the same level of expertise, and their skills might not be up to the industry standard. Without proper knowledge, they may make mistakes that can affect the procedure's outcome or lead to complications.