Surgical Lift and Fill versus Nonsurgical Lift and Fill

Yes, fillers are easy to do, but the term “Filler Fatigue” is alive and well in today’s cosmetically- conscious world. Plus, fillers are expensive and do NOT provide the best replacement for our own lost tissues seen in normal aging. Volume loss is a natural part of facial aging, and added to that, the rapid increase in popularity of the use of weight loss drugs like semaglutide…and voila! The term “Ozempic Face” was born. Fillers are the quickest and easiest way to restore lost facial volume, but the saying “enough is enough” comes to mind here… when is it time to use less filler and rely more on other options to restore and maintain facial volume?

In our practice, my nurse injectors and I will probably never stop using fillers, but what most patients need as they begin to see volume loss and laxity in the face and neck is a long-term volumization plan, meaning using collagen-stimulating injectables to entice the body to produce more of exactly what is being lost – collagen – in a product like Sculptra, which lasts twice as long as a filler! And we need lifting if we are really going to challenge the surgical facelift result.

Hyaluronic acid is a building block of collagen and is what most fillers consist of…but Sculptra makes the body produce its own collagen, and that lasts longer and makes a face look more lifted than filled = PRETTY. Then, with a longer lasting volumization plan in place (like Sculptra once a year), we can rely on fillers for the “quick fix”…like when you have a class reunion or a wedding coming up. But the use of fillers only is really not the best long-term plan by itself due to cost as well as the risk of creating the look of an “overfilled” face. Even when we place fillers in the high cheekbone area for that “lifted” look, we know that fillers won’t last as long as Sculptra and have many other limitations. It takes 3 – 4 syringes of filler to use in the midface and lower face (even more if you do lips) while it only takes 2 vials of Sculptra to create a lifted look in the face. Sculptra lasts up to 2 years (because it’s YOUR BODY’S tissue that Sculptra is stimulating to form…ie, collagen), and fillers last 9 – 12 months, tops. Add to that, what we need is LIFTING of the face, not just filling, and all of a sudden, you get it…Filler Fatigue. Most really knowledgeable injectors also see all that filler literally falling in the aging face, if that’s all you do. That leads to the exact opposite of a youthful facial contour (the heart-shaped or angular face) and starts to make the overfilled face look too boxy and bottom-heavy. Ugh.

If a patient wants a good alternative to a surgical facelift, I usually offer a Profound treatment (long-pulsed microneedling with RF, single treatment, one week of bruising and swelling, no anesthesia) OR the Surgical Lift and Fill option (still one step, but usually requires IV sedation, and 3 tiny hidden incisions, plus one week in a neck strap). If the patient desires no anesthesia and a totally non-invasive approach, we now have the Nonsurgical Lift and Fill.

The Surgical Lift and Fill procedure is liposuction of the lower face, jowls and neck for contouring, plus Renuvion or FaceTite for skin tightening of the neck, Accutite for skin tightening of the lower face and a single session of Morpheus8 or Exion Fractional RF (microneedling) and 6 wks later, some filler. This requires IV sedation in a 3 hour procedure, one week of wearing a neck strap 24/7 and a second week of wearing the neck strap just during the day. If no excess fat exists, we just remove the liposuction part of the procedure and do the skin tightening and microneedling in the first step, and later add the filling with either Sculptra or fillers.

The Nonsurgical Lift and FIll is the newest option in our office menu of services and is a combination of EMFACE for lifting, EMFACE Submentum to treat a double chin and jowls, plus Exion Face which plumps the tissues like a “natural filler”, because it creates the production of hyaluronic acid, that building block of collagen. Exion Face can be done around the mouth, lips and nasolabial folds, or around the eyes to add brow-lifting to EMFACE and to fill the hollow areas under the eyes and to treat crow’s feet. If desired, we cam also add Exion Fractional RF for a skin smoothing alternative to laser resurfacing (which has more downtime). For the nonsurgical Lift and Fill there is no need for anesthesia and no downtime (unless we are adding Exion FRF, the microneedling option). These are no needles – no downtime – 20 minute treatments – in the spa. Now THAT’S a natural filler!!! We are seeing as much plumping of face and lips and eyes with the Exion Face (3 treatments) as with 3 syringes of filler, AND get this…it’s also cheaper than those 3 syringes of filler! And no needles.

Soooooo…our favorite option and alternative to a surgical facelift is either the Surgical Lift and Fill or the Nonsurgical Lift and Fill + long-term volume via Sculptra (via collagen stimulation) + the occasional filler for the “quick fix”.

You’ll look lifted rather than filled, and you’ll love it!