Non Surgical Facelift – Reverse Facial Aging Without Surgery

non surgical facelift

Over time, we’ll all experience some degree of the effects of natural facial aging. As facial muscles weaken and our skin’s elasticity decreases, a variety of aging symptoms develop, including folds, wrinkles, sunken (hollowing) around the eyes, and sagging of the skin. While a facelift can reverse these aging symptoms, many patients we see are hesitant to undergo a costly surgical procedure that requires a long recovery period.

If surgery is not an option, patients can combine many of today’s best non-surgical treatments to achieve significant facial rejuvenation. The combination of non-surgical facial cosmetic procedures, sometimes referred to as a “non-surgical facelift”, can eradicate wrinkles, tighten loose skin, replenish lost volume, and renew the skin’s surface.

Non surgical facelifts can be particularly effective for patients with light to moderate facial aging who are seeking a more youthful appearance. Depending on the needs and goals of each individual patient, the following treatments can be performed in unison:

Neurotoxins

The category of Neurotoxins (including Botox, Dysport, and Xeomin) is the most common non-surgical cosmetic treatment in the United States, with over 7.3 million procedures performed in 2018 (source). Neurotoxins work by temporarily relaxing the underlying facial muscles that cause wrinkles and expression lines as they contract. After being injected into the target muscle, the neurotoxin blocks nerve signals in the muscles from reaching the brain, eradicating persistent lines and wrinkles.

Neurotoxin treatments are minimally invasive and can create dramatic results that can last up to 4 months. Common areas that can be improved include frown lines and forehead lines, low eyebrows (browlift), crow’s feet, jelly rolls (lines & bunching in the lower eyelid), bunny lines (lines on the nose) and downturn of the corners of the mouth.

Dermal Fillers

Hollowness, sagging cheeks or jowls, thinning lips, or the over-prominent appearance of facial bones are caused by facial volume loss, which is a natural part of aging. Dermal fillers can be used to add facial volume and create a plumper and more youthful facial appearance. The age-reversing results of fillers are so powerful that they are often called a “liquid facelift”.

Instead of relaxing facial muscles like neurotoxins, fillers are injected into targeted areas to add temporary volume to plump lips, fill wrinkles, plump and lift the skin, or restore cheek and jawline contour. There are many different types of fillers including:

  • Hyaluronic Acid Fillers (Juvederm, Voluma, Volbella, Restylane)
  • Poly-L-Lactic Acid Fillers (Sculptra)
  • Calcium Hydroxylapatite Fillers (Radiesse)

Fillers are commonly used in the middle and lower face, addressing the cheeks, mouth (nasolabial folds), chin (marionette lines) and lips. Fillers can also be used to improve lower eyelid bags or hollowing in the temples. Finally, fillers can at times be used to minimize the appearance of both scarring and cellulite along the skin.

Like neurotoxins, fillers are fast, have minimal discomfort, and require little downtime. Some bruising and swelling can be expected for one or two days. The results of fillers can be subtle or dramatic, depending upon each patient’s goals. Since fillers are temporary, most require regular maintenance treatments every 6-12 months in order to maintain the new, more youthful appearance.

Kybella

Kybella is the first and only non-surgical treatment approved by the FDA for contouring and improving the appearance of submental fullness (aka double chin). When injected into targeted fat pockets under the chin, Kybella causes the rapid destruction and absorption of fat cells while also preventing future fat accumulation. After treatment, the fat that is cleared from the area is processed by the body’s natural metabolic process. Kybella only targets fat cells; all other cells and tissue remain unaffected. Kybella causes significant swelling in the neck that can last for several weeks, but the results are predictable and reliable in the right patient.

CoolSculpting (Cryolipolysis)

CoolSculpting (cryolipolysis) is the elimination of fat beneath the skin by freezing the fat cells. The procedure is effective for the right candidate for fat anywhere in the body, including in the upper neck. Unlike Kybella, CoolSculpting only causes swelling for several days but each treatment is less effective than Kybella in the amount of fat dissolution that can be achieved.

Laser Treatments

Laser skin treatments have rapidly increased in both safety and efficacy over the past decade. Today’s laser treatments are able to instantly correct current facial aging symptoms while simultaneously stimulating long-term collagen growth for improved skin over time. Facial laser treatments can fall into two categories: laser skin tightening or laser skin resurfacing.

Laser Skin Tightening: Skin tightening lasers like Thermage, Fraxel or Ultherapy use radiofrequency, laser or ultrasound technologies to heat the collagen underneath the skin’s surface in order to tighten the skin and/or the muscular layer beneath the skin, with natural looking results. By heating the tissue to lift and tighten the underlying foundation, this strengthens the skin and stimulates the growth of new collagen. Fraxel lasering can also target pigment cells, reducing the amount of brown discoloration.

Laser Skin Resurfacing: Resurfacing lasers are dedicated to improving the appearance of the surface of the skin, addressing issues like sun damage, lines, wrinkles, acne scarring, and pigmentation issues like age spots. Laser resurfacing (sometimes called a laser peel) uses highly concentrated microscopic beams of laser energy to remove precise amounts of skin in a controlled, targeted fashion. The removal of old surface skin reveals newer and youthful appearing skin while also initiating new collagen and elastic growth to improve skin tone and texture. Usually these treatments are fractionated, meaning only a portion of the skin is treated at one sitting. This minimizes downtime and redness, but means that three to four treatments are needed to completely treat the face.

Chemical Peels

Chemical peels differ in strength and are classified according to how deeply they penetrate into the skin. Unlike fractionated lasers, the entire skin is treated at one time. Medium and deep peels penetrate beyond the upper layer of skin; the deeper the peel, the greater the effect on collagen tightening and skin smoothening. Surgical peels, like the Hetter peel (modified Baker-Gordon phenol peel), are among the most effective ways of smoothening and tightening the skin, but require at least two weeks of healing and patients have redness for over a month.

 


Minas Constantinides, MD, FACS

Dr. Minas Constantinides is a board-certified Facial Plastic Surgeon at Westlake Dermatology & Cosmetic Surgery in Austin, Texas. He is on the Executive Committee of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and is a Senior Advisor of the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS).


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