I Have Minimal Face Drooping is the Silhouette Lift a Viable Option?

i have minimal face drooping is the silhouette lift a viable option?

Doctor Answers (8)

Ultherapy for the neck

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I would opt for an Ultherapy treatment to redefine and tighten the lower face and midface. Raffy Karamanoukian Los Angeles


Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

Correction of minimal facial droop

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There are so many manifestations of an aging face that your photos would help us.   Aging or droop can result from gravity, from fat loss, from sun and weather damage, from excess skin, and from sagging muscles.   So often a simple young woman's facelift solves all of these problem and if needed fat can be added at that time.   Dont be fooled by a cute name for some minimal procedure.  Go to a surgeon who does many face lifts and is certified by the American Board of Plastic Surgery and is a real trained surgeon that is a Fellow of the American College of Surgeons.   I am not a fan of costly procedures such as Ultherapy that do little and lasts even less.  I have just seen too many unhappy patients who feel they wasted their money.   There are so many non productive beauty machines out there that just do not hack it.  Beware and save your money for the real thing.     So get several consults from seasoned surgeons in your area that do many facelifts.   My Best,  Dr C

George Commons, MD
Palo Alto Plastic Surgeon
5.0 out of 5 stars 26 reviews

Nonsurgical tightening with Ulthera will be your best bet

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In my opinion patients with minimal facial laxity do best with nonsurgical tightening procedures.  The most effective and predictable results are being obtained with Ultherapy.  This is a treatment where an ultrasound transducer is used to look through the skin to the layers beneath it.  An ultrasonic pulse is then delivered to that layer to heat and tighten it.  This is done over the entire face or just in the area we want to tighten.  The results are some slight immediate tightening with continued improvement over the next 90 days.  The best part is there aren't scars or any significant downtime.  You can have the Ultherapy done in a couple of hours and go to dinner that night.  

Lee P. Laris, DO
Phoenix Dermatologist
5.0 out of 5 stars 11 reviews

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Mini facelift

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Dear ashleytt,

It would be best to go in for a consultation to see what your options are

Sometimes fillers can help achieve what you are looking for, other times, a mini-lift may help

You are so young that I think you should pass on surgery for now

Best regards,

Nima Shemirani
 

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

"The Nonsurgical 3D Vectoring Lift" Is An Excellent Technique For Nonsurgical Facelifting And Necklifting

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The Silhouette Lift is just a version of threadlifting that was fashionable when I began peforming them over ten years ago. Unfortunately, threadlifting proved to be expensive, have some downtime, and only temporary. For these reasons, they are rarely performed these days.

Fortunately, over the last decade our understanding of how our skin ages has undergone a revolution. Whereas once the visible signs of facial and neck aging were attributed exclusively to skin laxity or looseness, today, we know that the sagging, drooping, wrinkling, textural alterations, etc that characterize the passage of time are a result of a number of anatomical and physiological events. These include loss in the quality and quantity of collagen and elastic fibers, largely due to years of accumulated sun exposure and other environmental damage; an increase in facial expression muscle activity (hyperkinesis);  loss of facial volume (due to decreases in fat, bone, cartilage and muscle); weakening of the retaining ligaments that suspend and hold the skin and underlying tissues in place; and the fragmentation and downward displacement--due to the effects of gravity--of the fat compartments that are responsible for giving fullness, smoothness, and youthful contour to the face and neck. The result of this gravitational pull on compromised, devolumized facial tissue is that the face loses its youthful triangular shape and takes on a more boxy look as the jowls and neck sag.

To illustrate what happens to our skin as we age, just Imagine a fully expanded dining room table covered with a beautiful, smooth table cloth that hangs just so halfway down each of the sides of the table. Now consider what would happen if you were to remove both leaves from the middle of the table. Not surprisingly, the table cloth that draped so beautifully now droops down to the floor. To restore the table cloth to its proper position, you wouldn't conclude that it had gotten too loose and proceed to cutting it down all the way around the table to shorten it. You would simply reinsert the leaves of the table and voila. However, for decades, physicians perceived jowls and turkey necks and sagging cheeks to be simple laxity (skin hanging) and merely cut away the "excess" tissue" as part of surgical facelifts, necklifts and eyelifts--often creating artificial, cadaverous, skeleton-like, overly pulled tight faces--giving rise to the obvious and much dreaded,  "They've been done" look..

Today, we can address many aging skin changes nonsurgically in a matter of minutes with little or no downtime. For muscle overactivity, we have neuromodulators, such as Botox, Dysport and Xeomin. For roughness, textural changes, skin dullness and mottled pigmentation, we have topical prescription medications, chemical peels, medical microneedling, etc. For fine wrinkles, we have fillers and for deeper furrows and volume loss, we have developed volumizing injectable fillers. And now, for sagging skin and apparent laxity, we have the Nonsurgical 3D Vectoring Lift.

A vector describes a magnitude and direction of force. Aging skin is characterized by a negative downward and inward vector of sagging. To counter this, surgeons traditionally pulled skin upward and outward--i.e. using a positive vector. The key difference between the outcomes of traditional surgical correction and nonsurgical 3D vectoring, both of which lift upwards and outwards, is the Nonsurgical 3D Vectoring Lift's additional corrective dimension of ‘forward projection’. This 3D effect is the result of volumizing with the use of injectable agents designed for this purpose, such as Radiesse, Voluma, Restylane SQ, and Stylage XXL.

The Nonsurgical 3D Vectoring Lift is predicated upon the fact that the face and portions of the neck differ in their degree of mobility. The region directly in front and behind the ears is a fixed, denser, relatively immobile area, in contrast to the mid-cheek region (hence the greater tendency of this region to sag with the passage of time). These anatomical differences are exploited in the Nonsurgical 3D Vectoring Lift by making the fixed areas serve as anchoring points for the mobile tissues. 

In determining the positive vectors for the mid to lower face, the tissues that require lifting are identified by pulling the skin directly in front of the ears in a direction perpendicular to the area that requires correction. If the pulling results in lifting of the desired tissue, then the vector has been correctly identified and is then marked in accordance with 3D vectoring protocol. A similar approach is used in the region of the bone in back of the ear when dealing with neck laxity. One the proper vectors are marked, the volumizing agents are injected in a series of radiating bands that serve as support struts to the skin and that impart the necessary 3D outward projection--the lift--that distinguishes and defines this nonsurgical approach. The high viscosity and elasticity of the volumizing fillers serves to hold and re-support the overlying tissue and restore more youthful contours.

Although volumizing fillers are reabsorbed over time, they do promote new, native collagen synthesis, which may continue to provide structure, firmness and improved skin quality while continuing to lift tissues. A typical Nonsurgical 3D Vectoring Lift of the face takes about fifteen minutes to perform. Bruising and swelling tend to be minimal, and most people can return to work or social activities immediately following treatment.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Silhouette Lift

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The silhouette lift is a thread or suture lift.

These were popular about 10 years ago.

I tried them for my patients at no charge - results did not last.

Patients paid thousands for these lift - typically with disappointing results

Today face lifts and fillers will give you more predictable results.

Research shows that a mini-lift before age 50 gives the best results.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.5 out of 5 stars 21 reviews

Silhouette threads -Mini-face lift

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Thank you for your question.

Silhouette threads are used fo minimal sagging of mid face, lower 1/3 face, upper neck, eyebrow lift and nasal tip lift procedure. It is inserted via small incisions ( not withan endoscope  as the previous doctor suggested). The threads have small cones along its length to ensure the lifting effect. The threads are ancored into sagging tissue and pulled into a desired position and fixed to a special mesh pad sawn to fascia. Excess skin can be trimmed after pulling before the wound is stitched. These threads if used correctly can be very effective and can be tightened in the future by re-opening old scars.

I often combine these threads with Vaser liposuction of the jaw contour and double chin areas.

 

Alexandra Chambers, MD
London Dermatologist
5.0 out of 5 stars 14 reviews

Silhouette lift was better suited to midface

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Ashleytt: The Silhouette lift (endoscopically assisted barbed sutures) was useful in the era before fillers, especially for improvement of the midface (cheeks below the eyes) and nasolabial folds.  It did little to reverse mandibular jowls and neck.  In order to avoid failure of the barbed sutures, the patients were advised to avoid chewing, laughing, yawning for a minimum 4 weeks.  Despite this, I had a number of patients who had suture exposure/extrusion both in the cheek as well as the scalp.  Assess your face well and choose a technique which will provide you maximum benefit, with minimal cost, including down time.  Good luck.

Lavinia Chong, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 37 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.