Question: I have deep nasolabial smile lines and sagging at my mouth corners. I’ve been advised to get fillers but when I pull back the sides of my face with my hands, it all goes away and I look more refreshed. Wouldn’t it be better to get it over with in one shot by having a facelift instead of spending on fillers that don’t last forever anyways?

Answer: A facelift is indicated for sagging of the lower face along the jawline, loose skin of the neck, and platysmal muscle banding under the chin. Unlike surgery, injectable fillers treat lines and volume loss. Bellafill – the 5-year filler – is most popular in my office for deep lines, grooves, and facial hollows.

Surgery is not a substitute for fillers and, conversely, injectables do not replace the need for surgery. Fillers and surgery usually address different aging concerns. Deep nasolabial lines are due to volume loss of the nasolabial folds and are usually treated with Bellafill in my office. Sometimes, deep smile lines are the result of volume loss in the cheek area above the folds, causing the cheek fat pad to push down and deepen the folds. In these patients, Bellafill can restore volume to the cheeks and even soften the nasolabial fold. A facelift is not as effective in restoring cheek volume or eliminating nasolabial folds.

Sagging at the mouth corners is most effectively treated with fillers like Bellafill which lasts 5 years. While a facelift can lift sagging of the jawline and improve jowls, the downturn of the corners of the mouth is often due to repetitive downward pull of a muscle known as the depressor anguli oris. While Bellafill can effectively lift the mouth corners, a facelift won’t work on this depressor muscle.

While it’s easy to pull your face up with your hands, one has to keep in mind that the facial tissues are made of layers of skin, fat, muscle and bone with numerous blood vessels and nerves running through. Regardless of whether you are having surgery or fillers, your doctor must pay careful attention to the various tissue layers in order to avoid complications and give you a good aesthetic result. These treatments are much more involved than a simple “pull of the hands”.

A detailed consultation with a Board-certified Facial Plastic Surgeon who specializes in the face and neck and is experienced in facelift surgery as well as injectable fillers such Bellafill – the 5 year filler – is the first step in optimizing your facial rejuvenation treatment.