There has been considerable discussion in the media about the “Liquid Facelift”. What exactly is a liquid facelift? A liquid facelift is performed by injecting various substances into the face to decrease the signs of aging. These injections could be BOTOX and any of a number of soft tissue fillers such as collagen, Juvederm, Restylane, Perlane, Radiesse, Sculptra, silicone (Artefill and Aquamid) or fat.
So how do these injections work and how is this different than a facelift? First we need to understand the facial aging process. There are a number of changes that take place in our faces as we age. Some of these changes are easily recognizable and some are more subtle but they all contribute to the appearance of aging. The changes associated with aging include wrinkling of the skin, an increase in skin laxity, movement of some of the soft tissues in the face down, thinning of the collagen in the skin and the supporting structures and there is even some research that suggests that there are skeletal changes as well which contribute to the facial changes with aging. Further there is often a decrease in the amount of fat in the face as we age. It is the visual effect of these changes that give the appearance of aging.
A traditional facelift places hidden incisions in and along the hairline and around the ear. Through these incisions the loose skin of the face is lifted, the wrinkles are straightened and the excess skin is removed. At the same time soft tissues of the face which have dropped over the years are lifted up back to their original position. Modern facelift techniques may also include some fat grating in the face to replace some of the fat and fullness that is lost with aging. The incisions used for the surgery are carefully closed. When healing is complete the incisions are well hidden. Traditionally, one can expect a facelift to last about 10 years or so; although even after that time, the results will likely be better than if a facelift had never been performed. It is probable that you’ve been around many people who have had facelifts performed without ever being aware of their surgery.
The liquid facelift is not a true facelift. Instead it tries to camouflage or decrease the signs of an aging face. The changes that take place during aging such as deepening of the folds around the mouth, development of depressions around the lower eyelid (especially near the nose), creases that develop between the eyebrows, in the forehead and around the eyes, development of jowls, loss of fullness over the cheek bones and in the cheeks and pigmentation changes in the skin can all be addressed with a liquid facelift.
Very important in this process is a skin care regimen done under the direction of a physician. Facial skin is the first thing we see when we look at someone’s face and skin which appears old is a dead give-away to someone’s age. Quality skin care (which may include chemical peels and/or other skin resurfacing procedures) can improve the tone and texture, increase the skin collagen and overall skin quality giving it a more youthful and refreshed look.
Skin creases between the eyebrows, forehead and crow’s feet around the eyes can be treated with Botox, Xeomen or Dysport to relax the muscles under the skin in these areas and decrease the amount of wrinkling that occurs in these areas. These products may last 4 to 6 months.
Depressions around the mouth and lower eyelid can be softened by the injection of hyaluronic acid products (Juvederm, Restylane, Perlane) or collagen. These soft tissue filler injections can last 6 to 8 months.
More generalized augmentation of the soft tissues of the cheeks and camouflage of the jowls can be performed with poly-L-lactic acid (Sculptra) and/or calcium hydroxlapatite (Radiesse). These products often last many months.
The advantage of these products is that they may be injected in the office under local or topical anesthesia in a relatively short procedure. There is no real recovery period and the cost is relatively low. They are, however, temporary and they do not substitute for a facelift. They decrease the appearance of and camouflage some of the signs of aging.
Fat injections can also be used in these areas with some very good results. Fat harvesting and reinjection is, however, a longer more surgical type procedure. The ability of fat to survive in its new location is somewhat unpredictable although techniques are improving rapidly. Fat injection can offer very, very long lasting results.
In my opinion, the liquid facelift techniques and the surgical facelift are not mutually exclusive. Instead a well-planned combination of surgical procedures complemented with injectable products offers patients the opportunity to maintain a youthful, healthy, refreshed appearance for a very long time.