As we age, we loose thickness in the structures and tissues that support and fill out facial skin. Loss of fat and subcutaneous tissue results in hollows, shadows and sagging skin. To further add to the structural aging changes of our face, the bones of our face change. The eye sockets get larger and deeper leading to a sunken eye look and hollow temple. The lower jawbone loses length and width resulting in loss of the angle of the jaw and worsening jowl appearance. The loss of these support structures of the face means the same amount of skin is stretched over less volume thus letting facial features droop and sag much like a deflating balloon. Facial fillers are substances injected into the deep tissues of the face to restore facial volume.
I am very skilled in what is known as a “Liquid Facelift” – restoring full facial volume to lift the skin, smooth lines and return a natural contour to the face. Don’t be fooled by others claiming a liquid face lift. A true liquid facelift addresses all aspects of volume loss in the face in order to fill and thus lift sagging skin. Only a physician with extensive understanding of the anatomy and structure of the face as well as extensive experience injecting fillers can achieve a true liquid facelift.
Results can be long lasting – up to 2 years or longer – and most importantly, look natural and healthy. An approach to filling and re-contouring the face is critical to a natural and youthful look. It is important to me that we correct the overall signs of aging in order to achieve a youthful appearance. It is not just about sticking filler in the lines in the middle of your face (nasolabial folds – sometimes referred to as “parentheses”) – we must address the issues that cause to lines – loss of volume in the central and lateral cheeks and in the temple.
Prior to injection, I spend a good bit of time moving and compressing the skin to detect areas of volume deficit and areas that create lift. I also do a lot of drawing and planning and reassess our progress frequently during the injection session.
I aim to lengthen jawlines by injecting the lateral lower cheeks and angle of the jaw as well as the chin area. This helps correct loss of jaw angle with aging that can be accentuated by facelift procedure, improves jowls, and can help lift sagging neck skin.
Filling the lateral cheeks, temples and lateral forehead can result in lifting of the eyebrow and cheek and a restoration of natural cheek convexity.
One of our favorite substances for full facial volume restoration is Sculptra®. Sculptra is made up of poly-l-lactic particles suspended in saline and lidocaine solution. I like to think of these particles as grass seeds. The goal of this procedure is to carefully and very precisely and evenly lay these seeds in the tissues of your face that produce collagen – the dermis (deep skin) and near the bone. Over time, as these particles are absorbed, your own skin and bone produces collagen– much like a nice even lawn growing – resulting in increased skin thickness and fullness in the areas treated. Think of this collagen as a new scaffold or structure for your skin –thus lifting skin and filling hollows.
Other substances can be used for full face filling but often the price is prohibitively expensive because of the amount of product that is needed. I often use fillers in combination with each other. For example, I may use Sculptra for most of the face but use a hyaluronic acid filler for under the eye area. I may recommend Sculptra for increased skin thickness but use Artefill deep, next to the bone for a permanent volume boost. I liken this to a large tent such that would set up for a wedding reception – the Artefill is the tent poles and Sculptra forms the canvas that is placed over the poles.
For patients that do not need full face volume restoration, a variety of injectible products can be used including the hyaluronic acid fillers such as Restylane and Juvederm, Radiesse, and the permanent filler Artefill. I often will use Sculptra just in the temple area and then a little bit of Restylane or Juvederm for the cheek or nasolabial folds.