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Tips for a natural-looking ‘no downtime’ facelift

Posted: 10:54 a.m. Saturday, March 2, 2013

By Anita Mandal, M.D.
Question: A plastic surgeon injected the deep grooves at my mouth corners with Juvederm. While the grooves are gone, my lower face and chin look heavy and feel unnatural? How can I prevent this in the future?

Answer: This type of result can be prevented if overall facial balance is carefully assessed prior to treatment. As one ages, the facial soft tissues not only shift downward due to gravity’s pull but also migrate toward the center of the face due to loss of facial volume.

Aging of facial tissues gives a thinner outer face and fuller central face causing a disproportional appearance. For this reason, it is important not to fill each and every crease and wrinkle in the central face as filling can accentuate the aged appearance of the face.

In a face that is heavier centrally, I moderately fill, rather than fully correct, the nasolabial smile lines and mouth corner lines. Additionally, I use a 3-dimensional filler such as Sculptra to restore facial volume to the outer part of the face. Sculptra not only can restore youthful volume, but also cause a lifting effect in the facial tissues when placed in the cheek area and sides of the face.

Additionally, if greater lifting is needed along the jawline and neck, Ultherapy can tighten and lift the soft tissues with minimal to no downtime.

This approach — conservatively filling the central face combined with 3-dimensional filling in the outer face and cheeks along with Ulthera for further lifting — is very effective in creating a natural, more youthful appearance without surgery, anesthesia or downtime.


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