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Is your face sagging or hollowing?

Posted:12:02 p.m. Friday, June 13, 2014

By Anita Mandal, M.D.

Question: I’m in my late 50s. My face is sagging and my cheeks are hollow. A plastic surgeon advised that a facelift will correct the sagging and the will fill in hollow areas. Is this true?

Answer: Our face age on multiple levels. We all experience some degree of sagging due to loss of collagen and elastin, and the effects of gravity. Additionally, everyone’s face hollows from loss of fat and bone, especially in the cheeks, temple and under the eyes. This volume loss causes a loss of tissue support, especially in the upper half of the face, resulting further tissue sag.
Facelift surgery allows the surgeon to reposition and lift loose tissues, particularly along the jaw and neckline. A facelift focuses on treating tissue sag. Typically, a facelift will not improve hollowing to a significant degree. Ultherapy, a non-invasive ultrasound treatment, can also give a non-surgical micro-facelift to improve sagging.
A most effective treatment of facial hollowing is injectable fillers. Since hollowing is a three-dimensional issue that requires volume restoration, much more filler is needed for the cheeks as opposed to facial lines. Because of the higher filler volumes needed, a long lasting or “permanent” filler such as Bellafill® may be more suitable than temporary fillers like Radiesse™, Sculptra™ or Voluma™.
Too many people falsely assume that a facelift or full facelift will take care of all or most of their facial rejuvenation needs. It is important to recognize that while related, primary sagging and facial hollowing are two separate problems with different treatments.
Careful consultation with a Facial Plastic Surgeon who has performed both a high volume of facelifts, yet is also a skilled injector, is the first step in determining whether you require lifting, filling or both.

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