liquid vs. surgical

The Face l i f t Gu ide

contents

T H E L I Q U I D

F A C E L I F T

06

T H E S U R G I C A L F A C E L I F T

11

T H E S K I N

16

Corrects: loose skin along the jawline ( jowls) , loose neck skin and fat, and sagging cheek skin and fat .

The Surgical Facelift

The Liquid Facelift

T H E B A S I C S

Restores volume to the cheeks, improves the appearance of some folds,

adds volume to hollow areas.

Is it too early for me to

consider this?

Will it really make a

difference?

What is the recovery

time?

How long will it last?

What will it cost?

BEFOREYOUGO

The only way to truly know if you are a goodcandidate for a facelift of any kind is bysetting up a consultation with a board certifiedplastic surgeon. But, it's still important to doyour own research; know what questions to askyour surgeon. This will help address anypersonal concerns you may have as you workwith him or her to develop a realistictreatment plan that will help you achieve theresults you want.

R E S E A R C H

" . . . t here were a couple procedures I asked about invo lv ing surgery and he to ld me that i t was too soon for me to be cons ider ing those and sugges ted some less expens ive a l ternat ives ! ! I have never had a p las t i c surgeon be so hones t and for thr igh t no t to ment ion he i s the BEST at exp la in ing procedures . . . the very bes t resu l t s I ’ ve had thus far! Raquel R. - Google Review of Dr. Donato Viggiano

E x p e r t T i p : G e t t o K n o w Y o u r S u r g e o n !

A youthful look depends on having the right amount of facial fat in the right

places. Redistribution, accumulation and atrophy of fat during the natural aging

process all lead to facial volume loss.

No longer supported by the sufficient deep fat volume inside, the skin and the attached

superficial fat start descending and hanging down and draping like an overly spacious

piece of clothing on a smaller frame.

The Aging Process

Instant results with little to no downtime

t he l i qu id face l i f t

A L L A B O U T   I N J E C T I O N SA liquid facelift is a much less invasive option than surgery. It is an incredibly quick and easy treatment using a combination of injections to smooth the skin, reduce the appearance of wrinkles, and add volume to areas of the face where

fat stores have decreased.

Neuromodulators are wrinkle-relaxing injections that

are used to treat wrinkles, frown lines and crow’s feet.

A minute amount of the neuromodulator is injected

directly into the underlying muscle, causing it to relax

and gradually smooth out the appearance of the

overlying skin. Botox and Dysport are examples of

neuromodulators.

NEUROMODULATORS

Dermal fillers differ in chemical makeup, longevity and

degrees of softness. Softer fillers are used in the lips, for

example, while sturdier fillers might be desired to enhance

cheekbones. Hyaluronic Acid (HA) is a natural substance

found in your body; high concentrations are found in soft

connective tissues and in the fluid surrounding your eyes.

It is extracted and reformulated and now has become one

of the most popular kinds of injectable fillers. Juvaderm

and Restylane are examples of HA fillers.

Polymethyl-methacrylate microspheres (PMMA) is

considered a semi-permanent filler and is most often

used to treat medium-to-deep wrinkles, folds and

furrows, particularly nasolabial folds. It can also be used

to fill out pitted scars and to augment thin lips. PMMA

has been used for many years in permanent surgical

implants.

DERMAL FILLERS

BELLAFILL (DERMAL FILLER)

Deep lines on the forehead

Wrinkles and fine lines around the eyes and mouth

Deep depressions under the eye (eye troughs)

Flattened cheeks

Lines from the corner of the mouth to the chin (marionette lines)

Lines that go from the nose to the corners of the mouth (nasolabial folds)

0203

When you desire a non-surgical way to correct volume loss in the face. A liquid facelift is a good option to consider when skin aging is not too pronounced and you want a combination of injections to correct various areas of the face.

01

Liquid facelifts work for people who want a natural look with little to no down time. Most people return to work and their normal activities right away. However, with any injection there may be mild swelling and redness at the injection site. Occasionally, bruising may occur, which usually clears in a week. So, here’s when to get it:

When you are between the ages of 30 and 50 with mild skin aging. A liquid facelift is NOT GOOD for hiding damage like very deep smile lines, jowls, and loose, sagging skin. When skin aging is too pronounced, fillers cannot conceal the damage.

When you want to correct a combination of the following:

When you want to see temporary results. Many people like the idea of a liquid facelift because the results are temporary. If they don't like the results, they aren't committed. However, because the results are temporary, you have to keep getting the injections to keep the look you love, and the cost can add up. Having said that, Bellafill is permanent. Once you have achieved the correction you desire with Bellafill, touch-ups are only needed as you experience the natural changes due to facial aging.

When to Get It 

ADVANTAGEthe liquid

Initially less expensive than a surgical facelift. RealSelf.com lists the average price as $2375.00 (but, often it is much less, depending on what you need.) Less invasive than surgery. General anesthesia or IV sedation is not required because, again, it's not surgery.Very little recovery time. Sometimes referred to as the “Lunchtime Facelift,” a liquid facelift typically has no real downtime. Apply a little concealer after the treatment, and you're good to go.Looks natural (when done by an expert injector) Can treat all areas of the face (when an expert injector is doing the injecting)

Is considered very safe with few side effects (when done by an expert injector) You don’t have to have all of the injections at once. While some patients choose to use multiple fillers in one visit, many patients decide to stage their treatments for a less noticeable, gradual improvement. Others want to see immediate results with a full liquid facelift and spread out their maintenance appointments. The results are temporary. If you don't like the effects, you aren't committed. If, however, you do like the results, you can consider using Bellafill at your next injection session for life-time results.

RealSelf.com

Results for the most commonly used products are temporary. Although Bellafill is stated by the company and the FDA to last up to five years, it is probably permanent (after all, the permanent part of Bellafill is composed of the same material used for replacement lenses in cataract surgery, and these lenses never “go away”). However Bellafill may not be used on all parts of the face. Alternate fillers, such as Restylane, may be used to obtain maximum results but will need to be maintained as directed by your doctor. The same goes for neuromodulators, such as Dysport or Botox.

It doesn't correct any signs of aging of your neck

If you like the look, it can be expensive to maintain. If you used any product other than Bellafill, a significant amount of money could be spent yearly to maintain the correction with the more commonly used temporary fillers. This cost is dependent on the types of fillers used and how quickly your body metabolizes them. This means that, over time, your liquid facelift could cost more than a surgical facelift.

DISADVANTAGEthe liquid

Reliable, long-lasting results

the surgical facel i f t

It is important to understand a facelift without a brow lift or eyelid surgery only addresses the lower two-thirds of the face – the cheeks, jawline, and neck. It is common for patients to choose to have an eyelid lift or brow lift at the same time as a facelift, but in these cases, a plastic surgeon will actually be performing two or more different procedures in a single operation.

and loose skin on the neck. A mini-facelift may be used when the signs of aging are mild, while a standard facelift is typically the best option for advanced signs of aging.

A surgical facelift involves skin being repositioned into a more youthful framework by lifting and firming sagging facial tissue to restore a more pleasing look. After the initial incisions, the skin is separated from the underlying tissue, which allows the plastic surgeon to reposition the deeper facial tissues, ultimately creating a firmer foundation for the skin. Excess skin is trimmed away, and the remaining skin is gently laid back over the newly rejuvenated facial tissues, resulting in a smoother, more youthful contour by eliminating jowls on the lower face

t h e s u r g i c a l f a c e l i f t

Y o u r f a c e a n d n e c k h a v e j u s t b e g u n t o s a g . Y o u r s k i n s t i l l h a s s o m e e l a s t i c i t y . Y o u r b o n e s t r u c t u r e i s s t r o n g a n d w e l l d e f i n e d . Y o u d o n ’ t s m o k e . Y o u ’ r e i n g o o d p h y s i c a l a n d e m o t i o n a l h e a l t h . Y o u h a v e r e a s o n a b l e e x p e c t a t i o n s f o r y o u r s u r g e r y .

S t e p 1 : A n e s t h e s i a A d m i n i s t e r e d S t e p 2 : S u r g i c a l I n c i s i o n s M a d e S t e p 3 : M u s c l e a n d C o n n e c t i v e T i s s u e R e p o s i t i o n e d a n d T i g h t e n e d S t e p 4 : E x c e s s S k i n T r i m m e d A w a y S t e p 5 : I n c i s i o n s C l o s e d S t e p 6 : D r e s s i n g s A p p l i e d S t e p 7 : A f t e r C a r e I n s t r u c t i o n s G i v e n

I n g enera l , the p ro cedure i s a s f o l l ows :

when to get it.. .

. . .and what to expect

Surg i ca l f a c e l i f t s o f f e r the mos t r e l i ab l e and l onge s t - l a s t i ng r e su l t s o f a l l f a c i a l r e j uvena t i on t e chn ique s t o r e d e f i n e t h e j a w l i n e , c h e e k s , a n d n e c k . The r e su l t s o f a f a c e l i f t l a s t 10 year s o r more . A g i n g c o n t i n u e s , b u t a p e r s o n w i l l t y p i c a l l y a l w a y s h a v e a m o r e y o u t h f u l a p p e a r a n c e t h a n i f t h e y h a d n e v e r h a d t h e f a c e l i f t . I n t h i s s e n s e , a s u r g i c a l f a c e l i f t l a s t s y o u l i f e t i m e .

A surg i ca l f a c e l i f t c an s cu lp t and r e juvena te a rea s o f the f a c e and ne ck tha t l i qu id f i l l e r s canno t addre s s .

R e a l s e l f . c o m

the surgicalADVANTAGE

Anesthesia/IV sedation is required Although add on procedures can be done at the same time, they are considered separate procedures and will add to the cost of your facelift.Surgical facelifts cost more up front than a single liquid facelift. A surgical facelift can cause swelling and minimal pain, and will require 2-3 weeks of recovery time. Facelift scars are permanent, but are hidden in the natural contours of your face and hairline. However, depending on your body’s healing ability and the skill level or your surgeon, there is the possibility of noticeable scarring. Some people will want a second procedure, called a revision, later.

DISADVANTAGEthe surgical

While the structure of your face will be improved through either a liquid or surgical facelift, it is important to note that the actual quality of your skin itself will not improve with any type of facelift on its own. Your surgeon will generally recommend reliable skincare products, including retinoic acid, sunscreen, vitamin C, and/or skin rejuvenation procedures such as micro-needling or chemical peels to further enhance your youthful new look by improving your skin.

MicroNeedling MicroNeedling, also called Collagen Induction Therapy (CIT) is an aesthetic medical procedure that involves using a multi-needle head to pierce the skin (after a topical numbing agent is applied) with tiny, sterile needles in order to cause injury to the tissue which leads to increased collagen production during the healing process. This means that the deeper parts of the skin are treated without removing the top layer of skin. It is designed to treat various skin conditions such as fine lines and wrinkles, light scarring from acne and photo damage, and to improve skin color and other skin texture changes.

Chemical Peel A chemical peel involves the application of a solution containing either alphahydroxy acids (AHAs), trichloroacetic acid (TCA) or phenol to remove the top layers of skin. The AHA peel is the mildest, removing the fewest layers of skin; phenol solutions achieve the deepest peel. The formulas for each type of peel can be adjusted for individual cases. A chemical peel may be performed in conjunction with a facelift, but it is not a substitute since it does not achieve the same effects.

Dermesse Skin Care The signs of aging are a result of cellular damage and a reduction in normal cellular activity resulting from sun damage and environmental factors or the natural aging process. In order to combat the signs of aging, an effective skin care program must produce results at the cellular level. The Dermesse products do just that.

final considerationsTHE SKIN