Needle vs Knife
What has changed in the last decade with facial rejuvenation

By Babak Azizzadeh, MD, FACS
Beverly Hills, California, USA

Many people want to look younger and more refreshed, but are scared to go under the knife. Recent advances in aesthetic medicine have allowed doctors to perform facial rejuvenation without surgery and with limited downtime. This is often referred to as the ‘liquid facelift‘ and it has truly changed the face of facial rejuvenation.

Liquid facelifts usually require the use of one or more injectable products to reduce wrinkles and hollows as well as create a more youthful shape to the face. The products that are most commonly used in our Beverly Hills Center include Restylane, Juvederm, Radiesse, Sculptra, Botox and Fat. Different products are usually required to address various issues but the most important factor is the correct placement of the product after careful facial analysis. The analysis of the face is the most important aspect of deciding what product would best serve
each patient’s needs.

We typically look at four regions of the face and try to create a well-balanced outcome – Eyes, midface, lower face and neck. For the wrinkles around the eyes, we typically use Botox or Dysport to reduce dynamic wrinkles. Botox and fillers can be used to elevate the eyebrows and improve the aesthetics of the area. Restylane can be used to improve the hollows under the eyes that lead to a tired look. In the midface, most individuals do not realize that the cheek tends to deflate; therefore, the goals are to improve the volume of the area by filling in the hollows. In the lower face, fillers can be used to improve the jawline and botox can be used in the neck to reduce the appearance of the neck bands. We typically use Radiesse and Sculptra for the midface and lower facial region.

Sculptra is different type of dermal filler, which in addition to filling in lines and creases, also provides a natural framework for the growth of soft tissue and collagen production, creating natural volume and contour. Because Sculptra stimulates one’s own body to grow its own
collagen, the results are very natural looking. Plus, Sculptra is injected beneath the skin in a simple office procedure and the results can last up to three years.

Multi-Level Fat Grafting also adds volume to provide a more youthful appearance, but does so by using your own fat. First the fat will be removed from the lower part of your body, and then injected back into the face in the desired areas. I have been modifying this technique and use it often with facelifts and eyelid surgery to enhance their respective outcome. The unique way of performing multi-level fat grafting has led to a very sophisticated, natural-looking results.

To enhance the results of liquid facelift, Fractional Laser Resurfacing can be utilized to improve the appearance of the overlying skin. This has been a revolutionary treatment that uses pinpoint laser beams to penetrate beneath the skin’s surface to eliminate old and damaged skin cells. At the same time it also stimulates the body’s own natural healing process to replace damaged skin with fresh, glowing and healthy skin. Fractional laser resurfacing can make an incredible improvement to wrinkles, scars, unwanted textural irregularities and crow’s feet.

Overall, there is an array of non-surgical options available and if used in an appropriate manner

Needle vs Knife
What has changed in the last decade with facial rejuvenation
can make a tremendous impact in one’s appearance. Liquid facelifts are ideal for individuals who do not want an extended downtime or are worried about undergoing extensive surgery. It is important to find a qualified dermatologist or facial plastic surgeon to perform each procedure as technique and experience are extremely important. If you would like more information, please visit