Question: I am investigating non-surgical alternatives to a facelift. Does this usually mean injectable fillers, or would a fat transfer work? Are these considered permanent solutions?
Answer: Well, injectable fillers and fat transfer can certainly give the illusion of rejuvenation by filling in depressions and giving volume to the areas of the face where it is needed. Injectable fillers, for the most part, are temporary solutions, though they are quite simple, have extremely low risk, and overall are a relatively good value. Fat transfer, on the other hand, can be permanent and because in most patients fat is a nearly inexhaustible material that can be harvested and used in the face, we can use much larger volumes of fat than a patient would desire with the injectable fillers, simply due to the significant cost that multiple syringes would generate. The down side of fat injections are that the majority of the fat, over the first year, will resorb, and we therefore need to overfill the area if we want to end up with the expected outcome that we desire. With that said, I don’t tend to try to aggressively overfill the area, as I feel that when aggressive overfilling occurs, you are simply wasting fat, due to the fact that you are going to increase the percentage that is not viable and will not survive long term. I, therefore, try to choose a happy medium where we are placing more fat in the area than we desire, and ultimately we may end up with slightly less than we desire, but the patient never has to go through a time period where they look overinflated.
Another alternative to a facelift that is non-invasive would be the Ultherapy device, which uses ultrasound to heat the deeper layers of the face. This causes new collagen deposition which tightens and lifts the facial structures. It is the only FDA-approved non-invasive device that has ever been given a browlift indication by the FDA. We also use it in the cheek and jowl area, as well as the area under the chin. The exciting part about the Ultherapy device is that it is extremely consistent in the way that it delivers the energy to the deeper tissue, and therefore maximizes our patient’s outcomes.
