Sagging After a Face Lift

Typically, face lifts look great at about the third month. The swelling of the face from the surgery, however, adds to this great appearance. At a year or so, the swelling has subsided, and even though the patient may have an excellent result, the loss of volume from the swelling adds years to the patient’s appearance. Many surgeons use fat transfer (grafts) during the procedure to reduce this loss of volume. Sometimes it works and it’s always worth doing (I performed fat grafts in every face lift procedure), but fat grafts are inconsistent, unpredictable, and usually have a life of less than a year.

So what do you do to revolumize the face? Many injectable products can help, especially in specific wrinkles, such as the smile lines, and the marionette lines (also called puppet lines). The most commonly used products are the HA’s (hyaluronic acid) such as Restylane and Juvenderm. These can also be used to inflate other areas of the face, such as the tear trough, and they can do a good job. They last anywhere from 6 months to a year, according to the product and the area injected. They last longer in areas of less animation.

For generalized revolumization, one of my favorite products is Sculptra. This scan be used to literally inflate any part of the face from along the jaw line to the hollow part of the cheeks that occurs in front of the ears, to the hollows under the eyes. This product increases the volume gradually by stimulating your body to produce collagen, and it lasts for two years or so. Due to this characteristic, one of the most common patients to receive Sculptra is a patient who has had a face lift in the past. Typically, they don’t sag, so they don’t need another face lift, but they still look too old from the various shadows and hollows in the face. This is where the various inflating products mentioned above do a great job with little to no down time. They can also be performed during a routine office visit.

Other uses are in patients who don’t want a face lift, those who don’t have the time for recovery, or in people who don’t want to invest in a face lift procedure. In either case, injectables are usually very satisfying to the patients.