Liquid Facelift vs Surgical Facelift: Weighing the Pros and Cons

Liquid Facelift

Many clinics now offer non-surgical ‘liquid facelifts’ with the promise of immediate results.

Reducing wrinkles and restoring volume without the downtime associated with traditional plastic surgery may sound appealing, but are these new techniques really that effective?

“In general, women start thinking about facelifts in their late forties to early fifties,” says plastic surgeon Dr. Michael Frederick from Palm Beach Gardens, FL.

“Around this age our facial features undergo significant changes,” he adds. “There is volume loss, and as the fat that’s left in the cheeks starts dropping down, this creates deeper nasolabial folds (the ‘smile lines’ that run from the nose to the mouth). Ultimately, this dropping effect continues down to the jowls, which squares off the appearance of the face.”

At first glance, the liquid facelift procedure may stack up as a lower-cost option to achieve your facial rejuvenation goals. However, facial plastic and reconstructive surgeon Dr. Jean-Paul Azzi from Palm Beach, FL, warns that “while the liquid facelift promises facial rejuvenation without any downtime and is very popular right now, there is a big catch: nothing can be ‘lifted’ with an injection, and that’s all a liquid facelift really is — injections.”

These types of misconceptions are exactly what we’re here to address. With the help of our four experts, you’ll learn about the pros and cons of a liquid facelift compared to a full facelift procedure.

Liquid faceliftFull facelift
Non invasive injections only
Invasive surgical procedure requiring incisions, removal/tightening of the skin/muscles, and sutures
No anesthesia required
Can be performed under local or general anesthesia
Best suited to patients in 30’s and 40’s
Best suited to patients 50+
Temporary -- touch ups are required every 6 months for best effect
Long lasting -- 8 to 12 years, then most patients request another minor tuck
Little or no downtime
Longer recovery period
Instant results in most cases, with up to 7 days for others
2-8 weeks to see the full results, depending on degree of swelling
Average cost $2,000 to $5,000, however, since this is temporary, over time the costs can add upAverage cost $15,000 to $20,000, but overall cost is lower in the long term
Limitations to how much correction can be accomplished
Achieve complete facial recontouring
Can look unnatural, frozen or puffed up
Achieves an elegant, refreshed, natural look
Good short term patient satisfaction
Higher patient satisfaction in the long term

What does a liquid facelift involve?

“A liquid facelift or filler facelift is a combination of well placed dermal fillers (such as hyaluronic acidJuvedermRestylane, or fat transfer) and Botox, resulting in a facelift effect without the need for anesthesia or surgery,” says Miami, FL based cosmetic dermatologist Dr. Christopher O’Connell.

“Depending on a patient’s facial type and age, dermal fillers are injected into the forehead, eyebrows, temples, cheeks, jawline, nasolabial folds, lips, chin and even the ear lobes,” continues Dr. O’Connell. “Botox can be injected into the forehead and crow’s feet to shape and elevate brows and eyelids, or into the neck and jawline for a lifting effect.”

What does a full facelift involve?

“A ‘full facelift’ is a procedure during which facial tissues are actually lifted to the position where they were before they started to fall,” says Beverly Hills plastic surgeon Dr. Marc Mani. “People tend to think it also involves pulling up the brows and forehead skin, which it does not; that’s a brow lift. Modern facelifts do not pull skin — they pull facial muscle, which is the layer gravity acts on. When done by the right surgeon, the effect is very natural and beautiful.”

Drs Frederick, Azzi, Connell and Mani

Drs. Frederick, Azzi, Connell and Mani.

Dr. Azzi further explains that when it comes to a facelift plastic surgery procedure, potential patients can be easily confused. “There are many different procedures performed by many different doctors of different specialties, yet almost all use the term ‘facelift.’ Even though a ‘skin-lift’ (that lasts for 1 year) and a ‘deep-plane submuscular lift’ (that lasts for over 10 years) are both called ‘facelifts,’ the similarities stop there,” he says.

Dr. Mani and Azzi, both specialists in the field of facial plastic surgery, are strong proponents for a deep tissue full facelift because the results are more elegant, natural and long lasting.

Who can benefit the most from a liquid facelift?

A liquid facelift is best suited for men and women in their 30’s and 40’s, and for candidates in their 50’s with mild signs of skin aging. It is only effective where moderate amounts of injectable fillers can add some volume to the face (on mild jowls, for instance). However, no amount of filler can reverse the effects of gravity. Over time, the jowls and nasolabial folds can become too pronounced to be concealed through such techniques.

“Most often, fillers are used in the cheeks, nasolabial folds, marionette lines and at the junction of the chin and jowl to mask the effects of aging,” says Dr. Frederick. “However, a liquid facelift can only do so much — it’s just a temporary way of camouflaging the problem. On the other hand, a facelift is a longer lasting change that truly restructures the face, putting everything back where it used to be.”

“As a general rule, if the patient’s problem is mostly gravity, then a liquid lift is not the best solution, since this only addresses volume,” adds Dr. Azzi.

How does recovery compare between the two procedures?

One of the liquid facelift’s biggest selling points is its almost instant results. “With a liquid facelift there is minimal discomfort and minimal downtime, with no missed work or social engagements,” says Dr. O’Connell. “With a surgical facelift the recovery includes swelling, significant pain, two to eight weeks of downtime, and the possibility of scarring that is noticeable for a few months to years — depending on the patient’s ability to heal well, and of course, on the skill of your surgeon.”

How long does a liquid facelift last?

“This really depends on the person, what area is filled, and what filler is used,” informs Dr. Azzi. “Something heavy duty placed in the mid face or cheekbones like Radiesse can last 9 to 24 months. Some products like Sculptra claim to last for several years.” In general however, most experts agree that some ‘touch ups’ are required every six months to achieve the best results.

Are there side effects or complications with the liquid facelift?

Patients can expect minimal complications — mild swelling and bruising are the most common side effects. Because dermal fillers are synthetic, for some patients they may cause allergies.

Dr. Mani also warns, “I have seen a lot of complications from liquid facelifts. Aside from the fact that they freeze the tissues and don’t look natural, in the long term they make the skin look very unhealthy because they have been placed between blood vessels and the skin they are supposed to nourish.”

Are there circumstances where you would advise against a liquid facelift?

“If a patient’s skin is significantly sagging or aged, the amount of filler needed to camouflage the deficiencies would be way too much and the cost would skyrocket,” says Dr. Frederick. “Filler is expensive — spending that much money on a temporary fix just wouldn’t make sense, especially when a facelift can solve the problem better and permanently.”

Dr. Mani advises that he does not recommend liquid facelifts, saying, “there will NEVER be another way to do a facelift besides an actual surgical facelift. A liquid facelift does not really reverse the effects of gravity. In fact, over time it actually accelerates them. I tell patients, if you have a bucket and you fill it with water, is it going to go up or down? The correct answer usually comes to them right away.”

How do Hollywood celebrities look so refreshed and youthful?

Even though it’s commonly assumed that Hollywood’s celebrities get their refreshed glow from having liquid injections, according to Dr. Mani, this is not the case.

“Most celebrities who look like they ‘never age’ have had a deep tissue facelift, not a liquid facelift,” informs Dr. Mani, “I know that because I’m one of the surgeons who has done many of them. In fact, I have had two different celebrity facelift patients who were offered very large sums of money to claim they’d had fillers only. To their credit, they refused.”

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