The Liquid Face-Lift: “Filling” the Void between Surgical and Nonsurgical Alternatives

There are 4 major components of the facial structure change as one ages: skin, fat, muscle, and bone. Loss of elasticity in the skin and soft tissues, loss of volume, reabsorption of the bone, and gravity’s effects (sagging) are all signs of aging.

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Why are there so many alternatives to a facelift? It’s not because we’re against facelifts—that’s for sure. However, it’s time to shift our perspective from the face-lift as cure-all to the facelift as a complement to several other viable, safe, and healthy alternatives. It’s also time to stop thinking of the facelift as the gold standard of facial rejuvenation; it’s simply not.

For example, a facelift does not solve all of the problems of aging, such as age spots and/or surface texture changes, nor does it create a three-dimensional, fuller, firmer, youthful effect—unless it’s complemented by various alternative measures such as injectable dermal fillers, Botox and/or lasers.

Very few procedures have wide-ranging results; most are specialized treatments for a particular problem, such as volume loss or laxity. Fortunately, nowadays a variety of techniques is available to help with the aging process.

For instance, various degrees of wrinkles and folds on different areas of the face can be addressed with the use of injectables in a facelift procedure. Plumping up facial volume and filling furrows (deep wrinkles) can be addressed by using dermal fillers. Expression-related creases are caused by muscle contractions; however, with the use of muscle relaxing agents such as Botox, such creases can be made to appear flatter and youthful on the forehead and can be improved by fillers elsewhere.

Injectables, which are the main materials used in a liquid facelift, can address the following:

  • Lost fullness
  • Expression lines
  • Flattened or hollowed features

Watch Dr Azizzadeh speak about a cosmetic cocktailing, another name for a liquid facelift:

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Dr. Azizzadeh discusses the liquid facelift on British TV-show Lorraine.

Frequently Asked Questions

Q: How is a liquid facelift done?
A: After an examination, you and Dr Azizzadeh or Dr. Cabin will draw up a treatment plan that is designed specifically for the signs of aging and your personal goals. Temporary fillers such as hyaluronic acid-based (Restylane and Juvderm) or collagen-based, as well as longer-lasting injectables like Radiesse, and Sculptra are all candidates that we may use. Botox is often used in conjunction with fillers to relax facial muscles that contribute to wrinkles and furrows. Injecting fillers at varying depths to fill creases creates a more youthful contours and appearance. Depending on the number of injections sites and the injectables used treatment can take as little as 30 minutes. Restylane and Juvderm fill lips and creases, collagen fat grafting fill fine lines and thinner tissues, and Radiesse and Sculptra create new curves or fill deep crevices in facelift procedures
Q: What kinds of injectables are used in a liquid face-lift?

A: Generally longer lasting injectables like Radiesse and Sculptra are combined with Botox, hyaluronic acids and collagen fat grafting.

Injecting fillers at various depths to fill creases creates a more youthful contour and appearance. Treatment can take as little as thirty minutes, depending on the number of injections sites and the injectables that are used. Restylane and Juvéderm fill lips and tear-trough area under the eye while collagen products fill fine lines and thinner tissues. Radiesse and Sculptra create new curve, fill deep crevices and restore lost volume. Botox softens expression lines.

Q: Do you consider fat grafting in a liquid facelift?
A: We may also consider multi-level fat transfer, which is a longer-lasting option in facelift procedures versus injectable fillers, which are for the most part, temporary. Liposuction is used to harvest fat from the hips or thighs. The fat is put in small syringes and then strategically re-injected to replace lost volume or reshape the face. Today’s injection techniques allow doctors to place fat where significant amounts will survive. Fat is commonly injected in places such as: the hollows under the eyes, the midface, nasolabial folds, the lips, around the mouth, the jawline and beyond.
Q: What should I expect during a liquid facelift procedure?

A: Injectable face-lift results are usually visible instantly; however, if Sculptra is used, it can take up to three sessions to see improvement. Sessions are spaced about a month apart with improvement occurring gradually.

It is common to have multiple injection sites, and swelling and bruising may be experienced the first few days after treatment. To minimize swelling, patients leave the office with a pack of ice and are advised not to exercise for the first few hours in order to prevent an increase in heart rate or blood pressure. It is helpful (though not essential) for patients to avoid vitamin E, anti-inflammatories, fish oil, and any blood thining medications (aspirin and ibuprofen) that promote bruising.

Q: How long does a liquid facelift last?
A: The duration depends on which fillers were used in the liquid face-lift procedure. Collagen-based fillers last three to four months, hyaluronic acid–based fillers can last from six to twelve months, and semipermanent injectables (Radiesse, Sculptra) can last one to two years or more. Botox lasts from three to six months and may help temporary fillers to last longer by decreasing muscle action. In order to fine-tune the results, follow-up treatments may be necessary.
Q: What are the risks of a liquid facelift?
A: In order to fine-tune results additional follow-up treatments may be necessary. Additional injections are required in the event of asymmetry. Grandulomas (little bumps that can be felt and sometimes seen, under the skin) may develop when longer-lasting particle-based fillers like Radiesse or Artefill are used.
Q: What if I need more than just help with volume loss?
A: It is true that a liquid facelift using injectables applies just to early to moderate volume loss and laxity at the onset of aging. If your laxity and/or volume loss is moderate to severe, you will find greater relief in Ulthera’s non-surigcal skin tightening. Once you get past a certain point, you may require a surgical facial rejuvenation procedures such as blepharoplasty, endoscopic browlifts and/or customized facelift procedures.
The case for using popular, safe, and effective injectables to achieve a liquid face-lift is strong, but remember that it all depends on the initial analysis with our team of expert physicians. Be clear about your expectations and discuss all alternatives, openly and honestly, with Dr Azizzadeh and Dr. Cabin.

Liquid Facelift Before and After Pictures

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Learn more about Liquid Facelift:

textbooks - plastic surgery - dr. azizzadehRead Chapter 1: The Aging Face Consultation from Dr Azizzadeh’s best-selling medical textbook “Master Techniques in Facial Rejuvenation”.

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Contact Dr. Azizzadeh and Dr. Cabin today if you live in the Beverly Hills or Los Angeles, California area and would like to schedule an initial consultation. During your initial consultation Dr Azizzadeh will perform a throughout facial assessment and discuss treatment options to fit your unique needs.

Next, learn more about Ulthera’s laser non-surgical skin tightening procedure.