Facelift vs. Injectables: What Do They Do?

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If any procedure has become synonymous with a person’s desire to look younger, it’s the facelift. Portland-based board certified plastic surgeons Dr. Kathleen Waldorf and Dr. Rachel Streu have watched over the years as the term has gone from describing just the rejuvenating surgery to being used in any situation where something is getting a fresh look. Buildings, cities, and even political campaigns seem to be getting facelifts these days.


That said, many people still have only a vague idea of what a facelift actually does, beyond making a patient appear younger.


It is important to understand that a facelift is primarily for changing facial contours that have shifted over time, generally to the lower portion of the face. While youthful skin is tight and smooth, the realities of aging cause lines and creases to form in the mouth and nose area. At the same time, fat that gives a face its youthful roundness can diminish (causing flat or hollow patches to form in the cheeks) and settle (causing a bottom-heavy, jowly look).


To that end, a facelift is ideal for focusing on the lower portion of the face and the neck, where these signs of aging appear. Wrinkles higher on the face, such as forehead lines, are not addressed by a facelift. Neither are sagging or drooping eyelids. Patients who want to smooth out or otherwise address these upper areas can choose a brow lift for the forehead or a blepharoplasty for the upper and/or lower eyelids.


Facelift results are significant, but can be subtle and natural looking when the surgery is performed by a skilled and experienced plastic surgeon. The changes are not temporary. Though a patient’s face will continue to age, the procedure essentially restores a more youthful look that will gradually show the effects of time once again.


Some women and men want to rejuvenate their appearance, but are wary of or are otherwise not prepared for committing to surgery. For these patients, injectables represent a viable solution.


Generally, injectables are effective, but do not provide the same results as surgery. The effects of dermal fillers and muscle relaxers to smooth wrinkles are temporary, lasting several months to a couple of years, depending on the product.


BOTOX® is likely the treatment people are most familiar with, given its tendency for making headlines and the fact that it is the most commonly administered cosmetic treatment around the world each year. Made from a purified form of the botulinum bacteria, this injectable prevents muscles from contracting—a definite benefit, since forehead muscles are responsible for pulling skin above the eyes and below the hairline into furrows and folds that are increasingly noticeable as the years go by. The same goes for muscles that come into play when squinting or smiling, as these create the fine lines known as crow’s feet.


Movement gradually returns to the injected muscles, and with it come the visible wrinkles again.


Dermal fillers are also injectables intended to smooth out wrinkles, but while BOTOX® targets what are known as “dynamic wrinkles” (given how repetitive motion leads to their formation), dermal fillers address “static wrinkles” that appear as the skin loses its youthful levels of collagen, hyaluronic acid, elastin, and more. One particular dermal filler, Voluma®, is specially designed to restore volume to the hollow areas that develop in the cheeks when facial fat diminishes there. This has the added benefit of creating structural support that lifts jaw-obscuring tissues lower on the face.


Like BOTOX®, fillers offer temporary results, with the injected gel ultimately being absorbed into the body.


One injectable, Kybella®, has a more permanent effect: rupturing the unwanted fat cells that make up a double chin. Once destroyed, these cells do not re-grow.


Patients are not limited to only one choice: surgical or nonsurgical. In fact, the two options can work together for an effect of overall rejuvenation, with surgical lifts addressing the creases and other facial contour issues, while injectables smooth out wrinkles and finer lines.


Learn more about nonsurgical treatments and facelift surgery at Portland’s The Waldorf Center for Plastic Surgery. Call (503) 646-0101 or 1-800-310-7901, or visit waldorfcenter.com.