The Liquid Facelift

As we age we lose collagen and elastin in the skin of the face. There is volume loss to the underlying soft tissues. This volume loss results from a loss of facial bone and fat. With time muscle loses tone. With age the skin loses its ability to hold water and becomes the dehydrated. Aging is a progression, the older we get the less renewal occurs. As a result we start to look different and some people say they’re getting to look more like their parents. For years plastic surgery has focused on pulling, stretching, lifting and repositioning the skin. The paradigm has now advanced. In addition to repositioning and tightening skin the aesthetic community has now addressed volume losses.

Various products are now available to augment or fill the soft tissue loss from ageing. With the aid of 3-D imaging and analysis of the aging face we can now quantify the changes of age. An easy way and less technical, is to look at pictures of yourself when you were younger and compare them to the way you look at the present time. If you are objective, you may see volume loss, changes in skin quality, increase furrows, fine lines and wrinkles. You may notice changes in texture, tone and color of your skin. In addition you might see excessive skin in the regions of the neck and along the jaw line. There is loss of facial definition. With time you also may see a poverty of expression. People may say you may look tired, angry or worried.

So how can we reverse some of these changes? What can be done? There are a variety of procedures that can be used to make your face look more youthful. These procedures can be used in combination or alone, depending on the degree of aging.

So what is the liquid facelift?

The Liquid Facelift is a nonsurgical marketing term that rejuvenates the aging face. The liquid lift encompasses the use of neurotoxins (Botox, Dysport, and Xeomin) to weaken dynamic muscles, and soft tissue fillers (Juvederm Voluma, Restylane, Perlane, Belotero, Sculptra,Radiesse ) to fill or add Volume to the face. These products are liquids or gels – no wonder it is called The Liquid Facelift. Dynamic muscles are muscles of expression that cause lines or wrinkles. By injecting Botox and other neurotoxin’s into the muscles, the muscles are temporarily weakened or paralyzed to reduce wrinkles of expression. Botox and other competing products are best used for wrinkles of the upper face. Upper face wrinkles include wrinkles of the forehead, the 11 lines between the eyebrows, and the crow’s feet that are seen to the sides of our eyes. With advanced injection techniques Botox also can be used to treat vertical lip lines so-called lipstick lines, the gummy smile, raise the corners of the mouth, raise the tip of the nose, lift the center of the lip and treat muscular bands of the aging neck. It stands to reason that Botox has its limitations there are some muscles which we need to express ourselves and therefore cannot be injected. For example Botox and other neurotoxins should not be injected into the muscles that allow us to smile.

Botox does not address volume loss. What can be done?

There are a number of FDA approved available soft tissue fillers (Juvederm Voluma, Restylane, Perlane, Belotero, Sculptra, Radiesse) that address volume loss. Some fillers are best suited for injections that are deep and require soft tissue augmentation. Other fillers are formulated to be injected superficially into fine lines and wrinkles. The aesthetic physician has the opportunity to evaluate the needs of the patient and choose various fillers to give an optimal aesthetic outcome. Medical laser and light treatments can be used when necessary to improve the texture, tone and color of facial skin. The HydraFacial and skin care regimens can restore luster by replacing water loss to the skin.

As with all aesthetic procedures a consultation is required. At the time of your consultation your surgeon will review your medical history. Your concerns and expectations should be discussed. Your preferences regarding surgical versus nonsurgical treatments should be addressed. An aesthetic plan should be outlined with your cosmetic goals in mind. The procedure should be customized for your individual needs. The cost of the procedure should be known to you. Your expectations should be realistic.

With a nonsurgical facelift it is important to understand that in order to maintain the result, a maintenance program is required. In some cases depending on your aesthetic concerns, surgery may be your only option. Your own transferred fat may be offered to you as an option. Fillers and Injectables can be used in addition to surgical treatment to enhance the overall aesthetic outcome. Risks and complications should discussed by a qualified physician. The entire face can be enhanced or one or two areas of concern may be treated.

The aesthetic eye of your injector as well as your cosmetic plan will directly affect your outcome. Too much product in the wrong place or not enough product in the right place will dramatically alter your results. It is important that you discuss with your physician what your expectations are. The most common reasons why patients are unhappy with liquid lifts are, not enough product being used to accomplish a full correction, too much product being used in the wrong place, and trying to accomplish your aesthetic goal by selecting a nonsurgical approach when surgery is indicated. It is prudent to know that even though competent physicians use FDA approved products these products may at times be used off label to accomplish the desired result. Non-surgical Liquid lifts have their limitations. Surgical procedures have their limitations, each accomplish different goals. Both surgical and nonsurgical procedures have possible complications. Fortunately they are rare.

How does an expert injector choose what Injectables/Fillers to use and where?

Different fillers are used at different depths and give different outcomes. Some fillers last longer than others. Most Injectables/Fillers work immediately others need time to work. Some Injectables/Fillers are more predictable and easier to use. To make matters more confusing different manufacturers offer competing products that are used to treat the same clinical problems. Some injectors are more comfortable using particular products since they use them all the time. Certain manufacturers give discounts or have different pricing for a particular Injectable/Filler. Some products have been around longer and have more published clinical data. Some manufactures offer better technical support. An experienced injector may be able to use different fillers for the same clinical application and obtain comparable results.

It is important that you ask your physician what the benefits and differences are between the various Fillers and Injectables. Some patients leave the choice up to the injector, since the injector should have the most experience. Asking questions should be encouraged. This helps you understand your aesthetic procedure and avoids confusion.

I hope this information has helped you with the many options available to treat the aging face.

Information on this page is not a substitute for medical consultation or advice. Please contact us to schedule an appointment to discuss the best treatments for you.