While both facelifts and “liquid facelifts” sound very similar, they are in fact two very different procedures. One involves making surgical incisions and literally lifting, while the other is a skilled art form involving a variety of injectables—mainly neurotoxin and filler—designed to restore volume and reduce wrinkles. So how do you know which one to choose? These facial experts say it all comes down to whether you need to restore volume, reduce skin sagging, or both.
What’s the Difference?
“Typically, a ‘liquid facelift’ is for patients on the younger side, with less skin laxity and more an issue of volume loss and redistribution,” explains Palo Alto, CA facial plastic surgeon Sam P. Most, MD. “Despite what you may think, fillers to do not lift much, but can disguise hollowing/volume discrepancies that are signs of aging.”
A “Liquid Facelift” Is Not a Facelift
According to Palo Alto, CA facial plastic surgeon Sachin S. Parikh, MD, calling it a “liquid facelift” to begin with is a bit misleading. “In my opinion, it’s hard to get a naturally-occurring hyaluronic acid gel filler to actually lift tissue,” he says. “It’s just like a gel, it’s not going to actually lift anything to a capacity where you see an appreciable difference, but it can volumize and add structure and balance in areas that you lack volume because as we age, we lose volume in the superficial middle layer and deep layers of fat.” With fillers, Dr. Most explains, you can add that volume back and stimulate more collagen to create a more youthful look. “Now, we call it a ‘liquid facelift’ because we’re using liquid to create it, but it’s not a facelift.”
Who Is a “Liquid Facelift” Best For?
If the signs of facial aging are early, then most facial experts say to take the injectable approach. “The aging would primarily be in the form of volume loss and hollow appearance of the face and would not have a significant sagging component,” says New York facial plastic surgeon Konstantin Vasyukevich, MD. “The ‘liquid facelift’ would result in improvement of the facial contour with higher and fuller cheeks and more defined jawline.”
“A good candidate candidate is someone who is not interested in having surgery and is looking for noninvasive options,” adds Westborough, MA facial plastic surgeon Min S. Ahn, MD. “If there’s not too much extra skin and there’s still good skin tone, a little bit of filler will have more of a noticeable lifting effect than if they have a lot of extra skin.”
Who Is a Better Surgical Candidate?
When skin sagging and laxity is moderate to severe— think jowling in the lower face, deep lines and wrinkles—Wayne, NJ facial plastic surgeon Jeffrey B. Wise, MD recommends opting for surgery: “A liquid lift simply can’t tighten the skin quite as effectively, nor can a liquid lift do as much for the neck as surgery. Moreover, facelift surgery can be combined with other procedures such as fat transfer, laser skin resurfacing, brow lift, liposuction under the chin and eye procedures for an overall rejuvenating surgery that improves one’s appearance for many years to come.”
The Mirror Test
Dr. Vasyukevich says a good measure of who could use a surgical versus an injectable facial treatment is the mirror test. “To do the test, stand in front of the mirror, place your fingers on the sides of the face and lift the skin up,” he advises. “If significant improvement is achieved, then a conventional facelift would be the best procedure. If no or little improvement is achieved with lifting the skin, then a liquid facelift might be a better option.”
Gradual Improvements
While one is not a substitute for the other, New York facial plastic surgeon Lee Ann M. Klausner, MD says when used properly, dermal fillers can help prolong the need for a surgical fix down the line as they tend to help delay the onset of aging. “Dermal fillers, when placed well and in the right places, can restore lost volume to the face and this can have the secondary gain or reducing the appearance of lax skin,” she notes. “Long-term, they can be therapeutic in that they can support the skin and perhaps slow down sagging.”
