Fillers vs. Facelift: What’s the Difference?

A woman receives injectable treatment.

Have you reached a point where the fine lines you once overlooked are increasingly difficult to ignore? Does your contoured jawline look softer and your cheeks droopier? Do you find yourself trying to camouflage your neck? This is the point at which many women and men start to consider getting a facelift or dermal fillers at our Boston, MA, practice.

Are fillers the right choice, or would a facelift yield better and longer-lasting results? That’s a question many patients ask during consultations. The answer usually involves listening to the patient describe their concerns and goals and physically examining their facial structure and the quality of their skin.

To help patients better understand why one option may be preferable to another, it’s helpful to know exactly when a nonsurgical approach—such as filler injections—is the correct path compared to when a facelift is best.

What Are Fillers?

Injectable fillers—sometimes called soft tissue fillers—restore volume and smooth out lines and deeper wrinkles to create more youthful-looking contours. Most fillers are gels of various consistencies that are composed of synthetic forms of natural substances. What type and consistency of filler is used depends on the treatment area and the patient’s needs.

Most FDA-approved fillers feature hyaluronic acid as the active ingredient. These fillers include JUVÉDERM®, Restylane®, and BELOTERO®. In addition to restoring volume to areas such as nasolabial folds and under the eyes, these fillers are also used for lip augmentation and rejuvenating the back of the hands.

RADIESSE® uses calcium hydroxyapatite to add volume and help the body produce more collagen. Sculptra® Aesthetic is not exactly a filler, but a collagen stimulator that does not immediately add volume, but produces it over time by regenerating collagen. These products are injected deeper into the skin than hyaluronic acid products.

Fat drawn from a patient’s body is also used as a facial filler in certain cases. The fat is purified in a centrifuge before it’s reinjected.

Unlike facial plastic surgery’s long-term results, dermal filler’s results are temporary and only last about 6 to 24 months. Therefore, fillers require more maintenance than a facelift.

Are Fillers Right for You?

An ideal filler candidate typically wants to ward off early signs of aging or wants to avoid or delay having plastic surgery. Even though fillers don’t provide permanent results, some products last up to 2 years and can be a viable option for people who may consider cosmetic surgery later in their lives.

Dermal fillers soften unwanted lines, minimize sagging skin, and create attractive contours without having to commit to permanent results.

Most dermal filler patients are younger patients who have mild or moderate skin concerns. Although patients in their 20s may want lip augmentation fillers, most filler patients are 35 or older and want to get a head start on reducing wrinkles.

Fillers are also an appealing option for patients who want quick results. You’ll see changes in your appearance after a single filler treatment session, although there may be some temporary bruising and swelling.

What Is a Facelift?

There comes a point when the skin’s laxity requires surgical intervention in order to turn back the clock. Facelift surgery tightens loose skin around the lower face and jawline and repositions underlying facial tissues and muscles to create smoother, more youthful contours on the mid to lower face. It can also reduce sagging neck skin. Modern facelift techniques are designed to leave patients looking like themselves but about 10 years younger.

Facelift techniques have evolved significantly during the past 20 years, with various incision locations and some procedures requiring only a local anesthetic and twilight sedation, rather than general anesthesia. I specialize in a technique called the deep-plane facelift at my Boston practice.

When performing a deep-plane facelift, a surgeon frees the deep layers of connective tissue and fat below the skin and repositions them to a more youthful location. The “lifted” appearance occurs at these layers, preventing tension on the overlying skin, which the surgeon then re-drapes to create a natural look. The lack of tension on the skin prevents the “wind-blown” results that occur with “skin-only” lifts.

Because facelifts only address the lower portion of the face, surgeons often recommend combining them with a brow lift, eyelid surgery, or even dermal fillers to create an overall facial rejuvenation.

Is a Facelift Right for You?

There are 3 elements that good facelift candidates share. These include:

  • Skin elasticity: Yes, a facelift is designed to tighten the skin, it’s important that the patient’s skin retains some of its natural flexibility. The skin’s elasticity helps it take on the new contours created during the procedure as it heals. Skin elasticity can be affected by several factors such as heredity, sun exposure, or personal habits.
  • Strong bone structure: Well-defined cheekbones and chin help boost the results of the surgery. This underlying structure can prolong the effects of the facelift. Patients whose features are less distinctive can still benefit from a facelift but may want to combine the surgery with facial implants, fat transfer, or dermal fillers.
  • Good health: It’s critical that patients are in good health to ensure a positive surgical outcome and minimize the chance of complications. Facelift patients must eat a healthy diet, be at a healthy BMI,  and stop smoking.

It’s also important that facelift patients have realistic expectations about what plastic surgery can accomplish and follow the surgeon’s pre- and post-operative instructions.

If you’re looking for a plastic surgeon in the Boston area with whom you can discuss your concerns about facial aging, contact us using the online form to request a consultation or call us at (781) 740-7840 to schedule an appointment.

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