E. Ronald Finger, MD

Savannah Plastic Surgeon

The non-surgical liquid facelift combines the power of the popular dermal fillers, such as Juvederm, Restylane, Artefill, and/or Sculptra with the wrinkle smoothing power of Botox to create a refreshed appearance that can take years off your facial features. This strategic combination of lifting, contouring, and wrinkles reduction produces great results without the risks present with surgery, and with no downtime.

The innovative liquid facelift procedure can be performed in just one visit, with full results apparent not long after your session.

If you are not familiar with the amazing effectiveness of BOTOX, it is an injectable botulinum toxin serum that minimizes the look of lines and wrinkles by relaxing the facial muscles that cause wrinkling. Typically it is used for the frown lines and Crow’s feet, but can be used effectively in many other areas as well.

Juvederm and Restylane are advanced dermal fillers that add hyaluronic acid, a natural component of the skin, to fill in areas that need help, like the lips, smile lines and marionette lines, and more. Fullness, texture, and elasticity are improved almost instantly with results that last six months or more.

Artefill is PMMA, polymethylmethacrylate, combined with bovine collagen.  Artefill is FDA approved for the nasolabial lines, but is used off label in many other areas. The PMMA microspheres remain for many years, but they also stimulate your own production of collagen and thus volume. This injectable will last from 5 to 10 years. Due to the collagen component, a skin test is needed.

Sculptra is Poly-L-Lactic acid and is FDA approved for various deficient areas of the face. I have used vast amounts of this product. It stimulates the production of your own collagen. It takes two or three sessions to achieve full results and the build up of collagen may take a couple of months. It lasts for up to 2 years.

You may benefit from a liquid facelift if you wish to reduce the look of lines and wrinkles, a more youthful, rested look, and a gentle lift. Your liquid facelift can be personalized to correct the specific issues that are inhibiting your youthful look.  For example, sunken cheeks can be filled and lifted, your eyelid bags and underlying circles can be improved, drooping eyelids can be refreshed, forehead wrinkles can be diminished, laugh lines can be softened and lips enhanced.

If you would like to learn more about the non-surgical liquid facelift, please call to schedule a complimentary consultation.

E. Ronald Finger, MD, FACS

www.fingerandassociaites.com

912-354-4411

The answer is another question: What is the primary problem?

Let’s examine the physiology of looking older. Everyone knows that we lose some elasticity, but another primary cause of looking older is loss of volume. Simply put, our faces deflate as we age, unless, of course, we are excessively over-weight. So, in time both problems of loss of elasticity and loss of volume must be addressed. A facelift pulls the tissues upward and diminishes the sagging, but the result, while greatly improved, is a tighter face while still being the shape of an older person.

An example is the cheek, which is a simple round disc in youth. It generally starts at the lower lids and going clock-wise, goes to the nose, then down to the level of the lips, and then circles back to the eyes. Eventually, there is a depression, called the tear trough, which starts at the inner aspect of the eye and goes downward and outwardly. The result is the elevated roll just outside of the smile lines, then going laterally, the depression called the tear trough, and back up to what is left of the cheek. Eventually, the once round, full cheek becomes quite small. This loss of volume is corrected with injectable fillers mentioned above.

So the answer to the questions is, both a facelift and fillers can help immensely, but often given enough time both are necessary to look your best and youngest. Often when one starts seeing a plastic surgeon at a young age, the fillers are used first, and this may delay a facelift for many years. However, if the sagging is advanced or someone has lots of sun exposure and skin damage, it may be best to start with a facelift first, understanding that fillers will probably be a good addition at a later date or even during the face lift. Everyone is different and their problems should be addressed according to many variables.

Facial volume loss: one of the reasons you look older

First, think about what happens when you age. Everyone knows that we lose elasticity as we get older and skin sags, but few realize another primary cause of looking older: facial volume loss. Inevitably, our faces deflate – less so, if we’re considerably overweight.  In fact, isn’t it ironic that as we get older we lose the fat around our face and usually gain it around the middle and other places?

A facelift pulls the tissues upward and tightens sagging. The result: the face looks tighter but the shape still isn’t that of a youthful person.

Just consider the appearance of a young person’s face. Their cheeks are plump and circular. In a youthful person’s face, the cheek usually starts at the lower lids, goes to the nose, down to the level of the lips, and then circles back to the eyes.

With time though, a depression in the tear trough forms and deepens. The tear trough starts at the inner area under the eye, goes downward and spreads outward on the face. As a result, the once round, full cheek is deflated and becomes smaller. We also get hollows underneath the lower eyelids and depressions and shadows in various areas of the face. This is where fillers come in: they restore the lost of volume. Often times the result is dramatic, so much so that many plastic surgeons refer to injectables as a ”liquid facelift.”

There are many injectable filler options, such as Restylane, Juvederm, Artefill, and Sculptra. As part of the overall procedure, these products are often used in conjunction with each other and in addition to Botox. These products are best used in different ways and in different places, and their specific applications vary somewhat, too.

Surgical Facelift: When a Liquid Facelift is Not Enough

With the passage of enough time, you’ll need to address the problems of lost volume and skin elasticity.

And given enough passage of time, both fillers and a facelift are necessary to look your best and youngest.  

Often when one starts seeing a plastic surgeon at a young age, the fillers are used first, and this may delay a facelift for many years. However, if the sagging is advanced or someone has excessive sun exposure and skin damage, it may be best to start with a facelift first, understanding that fillers will be an excellent complement at a later date or even during the actual face lift. Of course, as I said at the start, everyone is different and their problems should be addressed according to their needs.

Sculptra changes the shape of the face back to the fullness seen in younger people. I’m sure most everyone has noticed that in the twenties a friend or acquaintance loses their “baby fat.”  Unfortunately, they will continue to lose it through out life.  This loss of volume is from loss of fat, thinner skin, and even loss of bone, especially around the mouth region and usually from less than the best dental hygiene.  The name Sculptra is prophetic, because one can literally re-sculpt the face back into a more youthful shape and volume, for example, cheeks and chins can be made larger.

The use of Sculptra requires a trainer to demonstrate to either a plastic surgeon or cosmetic dermatologist “hands on” instructions to assure proper assessment of the face regarding the lost volume and how to restore the volume with the most natural appearance.

The patient must be assessed in the sitting position to see the effects of gravity, which is imperative, because people appear quite different in the supine or reclined position. Surprisingly, most people including some plastic surgeons are not alert to the small nuances of differences in a young face and an older one. This is part of the instructional training session. Then the actual technique of injecting is demonstrated.  The product must be injected in exactly the proper quantity to prevent complications such as small nodules.  These are very rare, but can occur if too much is injected into one area or if it is injected into certain muscles, such as around the lower eyelids. If the Sculptra is injected in the right plane, just below the dermis, it will build collagen and thus volume, but if injected too deep the product is wasted because very little buildup of collagen will occur.

Now that there are more trainers, the product is being used much more, and we are seeing many more happy patients.

The problem with the aging face is loss of volume in addition to the well known loss of elasticity.  Replacing volume deficiencies can sometimes correct deficiencies better than an actual face lift. If non-surgical rejuvenation is desired, the loss of elasticity can be treated with the Fraxel lasers or a deep peel, such as a Croton oil peel. It is also often needed in someone who has had a face lift but needs additional volume. This is usually apparent after the swelling has subsided. The difference in a youthful and older face must be appreciated in these cases as well to achieve a natural look.

I applaud Sanofi-Aventis, the parent company of Sculptra Aesthetics, for limiting the product to those who have had training and those with a cosmetic surgery background.