Filler or facelift? Deciding on facial rejuvenation
Is the change you see in the mirror volume loss or sagging? The right method depends on the answer. What I look at during the consultation.
The most common question from my patients in their forties and fifties is: “Is filler enough, or do I need surgery?” The answer depends not on your age but on what has changed in your face. Ageing shows in the face in three different ways, and each has a different solution.
Three different changes
- Volume loss: fullness decreases over the cheekbones, temples and under the eyes; the face looks hollow and tired.
- Sagging: cheek tissue descends, the jawline blurs and the neck loosens.
- Skin and expression lines: lines deepen on the forehead, between the brows and at the corners of the eyes.
Where filler works well
If volume loss is the main issue and sagging is mild, a measured hyaluronic acid filler can make the face look rested. For expression lines, botulinum toxin is often enough. These treatments are done at the practice, you return to daily life the same day and the effects are temporary.
Where filler is not enough
Trying to correct marked sagging with filler makes the face heavy. Volume is added, but tissue is not repositioned, and the result does not look natural. If the jawline has blurred and the neck has loosened, a face and neck lift may be a better option. A facelift repositions the tissue layer under the skin, not just the skin, which is why the result is more natural and longer lasting.
What do I look at in the consultation?
I examine you from the front, the side and slightly below, and we talk over your photographs. I look at skin quality, bone structure, the jawline and the neck. Sometimes the best plan combines both: correcting sagging surgically and balancing volume with a little fat transfer or filler.
Take your time to decide
Facial rejuvenation is a personal decision. At the consultation we go through the options, risks and recovery times side by side; you decide at home, without rushing. Results vary from person to person; this article does not replace a consultation.
