The Science of Beauty: When to Lift and When to Fill
Like an exquisite artwork, knowing where to highlight with colour and where to shade is key to creating a masterpiece, according to aesthetic doctors who have been in the industry for decades.
“You may think that all fillers and injectables are interchangeable for one another and they all work the same exact way. But the truth is, you can’t inject anything just anywhere” says Dr Kenneth Lee, medical director of SW1 Clinic. According to him, some have a specific purpose of lifting while others are used primarily to restore lost volume. And, then there are times when you need a little more than what comes in a syringe to really lift your skin back up to where it belongs.
A number of changes happen to the face as we age. Skin loses its elasticity and begins to sag. The fat pads of the face atrophy or shrink, resulting in a loss of volume. And, the ligaments of the face loosen. “The result of all of those changes is a loss of cheek fullness, deepening of the smile lines and the formation of jowls” explains Dr Lee. But how your doctor goes about fixing each one of these age-related issues really depends on the cause of the problem. “In many patients, there is a need for a combination of both lifting and filling,” he says.
“Rarely will a patient have pure skin laxity as the only age-related problem,” says Dr Low Chai Ling who usually treats her patients with a combination of anti-aging therapies. “Finding the perfect combination is the holy grail of anti-aging” she says. There are multimodal aspects to aging, which also include reduction in facial fat (temples, midface, marionette areas and upper cutaneous lip), in addition to laxity. Also, there are submental fat, hyperdynamic wrinkles and neck laxity. “So often, injectables will complement lifting. We have shifted from ‘filling’ in the lines to rebalancing the facial compartments” she explains.
One area of the face that almost always needs filling, according to Dr Lee, is the cheeks, which lose volume. He says there are a fantastic area to fill because they act as a pillar, holding up the skin. “Once they start to lose volume, our skin starts to sag, producing the beginning of jowling. Dr Tan Ying Chien, consultant plastic surgeon who practices at the same practice agrees. he adds “To address the area, I routinely combine facial fat transfer to volumize the midface and cheek area with a lower facelift or necklift to erase the years.” Other areas that often require filling include the tear troughs, temples, lips, nasolabial folds, marionette lines and superficial lines around the lips and mouth.
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However, if there is significantly loose skin, anything that’s injected or used noninvasively may not do enough to give you the results you’re after. In fact, patients who rely solely on filling up the face when they should be lifting their skin may end up with ‘pillow-faces’, warns Dr Low.
“Patients who have severe jowling and laxity are better candidates for facial lifting (either surgical face lift or non-surgical facial threadlifts) and then following with fillers or fat transfer,” says Dr. Low. “Those who are starting to show deflation but not a great deal of laxity are better for ‘lifting’ and rebalancing the face with fillers.”
When it comes to lifting, there is a myriad of options for patients to choose from. So there is no excuse for one to put this off until it’s too late, says Dr Kenneth Lee. Women who are not willing to undergo surgery for its prolonged downtime can choose non-surgical options such as the Infinity V-lift, a facial threadlift procedure using 100% bio-absorbable collagen threads. Other FDA approved options for skin tightening include Thermage and Deep tissue tightening Ultherapy. Those who want a lifting facial can also opt for 24K Uplift, a HIFU based facial that has proven popular with many young women looking to delay the effects of age.
It’s important to know that not all treatments will give the same longevity in terms of results. “Surgical facelifts last the longest,” says Dr. Lee. “If surgery resets your appearance by 10 years, then you will always appear 10 years younger going forward, however you will continue to age from the point of reset. While all treatments can lift the skin to some extent, it is not possible to compare the effect of a surgical facelift with a facial.”
Choosing your weapon of choice judiciously seems to be the best option to ward away the effects of age. It seems that too much of one thing is no longer the “in” thing. Rather, seek out a combination of proven treatments that will give you a holistic improvement of your face.