Who is the best candidate for a face lift or fillers?
The gold standard procedure for facial rejuvenation has always been a facelift. In the past decade, the introduction of injectable fillers has ushered in a new alternative for facial rejuvenation. These fillers are characterized by a high success rate and few complications. However, they are not ideal for every patient. The purpose of this blog is to help determine who the best candidates are for either solution.
Younger candidates who only show early to moderate signs of aging are best suited for fillers. Fillers can nicely soften wrinkles and creases, and augment the soft tissue where desired (the cheek bones, for example.) When facial aging is more advanced, skin becomes lax, tissues collapse and wrinkles deepen. Older patients exhibiting these features are not the best candidates for fillers: I have seen patients with so much fillers pumped into their faces that they simply don’t look like themselves. Fillers are not a universal “magic tool” that can restore an aging face to a youthful one, as much as we would like to believe them to be.
But the alternative, a face-lift, can also have drawbacks. There is a greater risk of complication because it is a major procedure, involving anesthesia and a considerable recovery period. The cost of face- and neck-lifting procedures can be very significant with surgeons in high demand because of the skill and artistry required and the sensitivity of the area being treated. It should be noted, however, that the cumulative cost of filler treatments could also get very expensive and quickly surpass the cost of a face-lift. I have seen many frustrated patients who wish they had undergone a face-lift procedure rather than spend a lot of money on fillers that simply couldn’t have achieved the same result. It’s hard to believe that a face-lift can be a cost effective alternative!
The neck is one of the first areas to reveal signs of aging. The thin skin, the abundance of muscles, and the frequent movement eventually results in deep creases, muscle laxity, visible neckbands and excess fullness from fat accumulation. For some, genetics can play a role too. Perhaps they simply inherited an unflattering, poorly defined neck. Fillers don’t have much of a role in the neck other than to soften creases. The injection of chemicals into the fat of the neck will offer some degree of improvement in people with good skin, but the results are limited. Neck-lift procedures continue to be the best treatment option.
If you were to focus on age as the primary criteria, most folks under 40 would certainly benefit from fillers, while those older than 50 generally benefit from a face-lift. Patients in the 40-50 year old range can be suitable for either option, depending on individual circumstances. The ultimate decision is obviously based on the desires of individual patients, their goals, the limits of work and recovery time, their comfort with a surgical procedure and their financial condition. Combining both fillers and a surgical procedure is not uncommon, as the results of both are more than either alone could achieve.
One of the most common questions regarding a face-lift is durability — how long do results last? The simple answer is that it lasts forever: you will always be better at some future point in time compared to not having the procedure, but your new face will continue to age. For most patients, a face-lift lasts 15-20 years before he or she might consider a “touch up.” Fillers last for several months before they are absorbed by the body, and the effects are lost. Repeat injections are needed to restore the benefits. Filler companies are working hard to come up with the ideal injectable that works well and lasts longer.
If you are considering improvements in your face and/or neck, I recommend that you consult a reputable plastic surgeon with experience in both fillers and surgical alternatives so that you can discuss your concerns and goals to identify which option is best suited for you.