2 syringes Restylane Lyft or 1 syringe Juvederm Ultra Plus XC with PRP Lift and PRP Facial for volume loss/faint lines? (photos)

Question

36 years old. Noticed volume loss the last 2 years (texture/tone of skin is also not the best). Undereyes seem more hollow & nasio labial areas seem more pronounced (from sagging cheeks) with the beginnings of faint smiles lines, & faint marionette lines. Corners of mouth seem to droop from beginnings of sagging cheeks. I have been given 2 opinion: 2 syringes of Restylane Lyft in cheeks OR 1 syringe of Juvederm Ultra Plus XC along w/a PRP Lift & PRP Facial, w/SkinPen Microneedling.

Nelson Castillo, MD · Answer

If interested in your cheek and volumizing I would strongly recommend the two syringes of Lyft.  There is little to support use of PRP and your results would be subpar for your goals.  I would also recommend starting with treatments of Sculptra for the hollows of your cheeks as well as along the jawline to help support your natural contour. Hope this helps.

Harold J. Kaplan, MD · Answer

Hi Flora.  It seems that you have a lot of concerns that you want to address.  In these situations, we try to get our patients to prioritize the area that is concerning them most so that we can develop a treatment plan that fits that concern.  If the cheek area is more concerning than the under eye and nasolabial folds then 2 syringes of Restylane Lyft is a good starting point. The cheek is a large area so depending on what kind of contour changes you want, you may need more at follow up treatments.  We do not recommend PRP and for volume depletion like the cheeks or under eyes it is not meant to help.   PRP has no FDA approval and very few studies that indicate any benefit for healing in the face.  It is an injection for orthopedic surgery that cosmetic physicians have coopted with proof that it works for anything.  Your investment is better made in fillers.

Jason Emer, MD · Answer

Hi Flora. Yes, facial volume can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. Implants or fat are alternatives. For the under eye hollows, a combination approach will give the most improvement. Non-invasive, less-downtime options include fillers, lasers, microneedling/PRP, Cosmelan peels and stem cells.For nasolabial folds, you need fillers for the folds themselves and Sculptra to provide anatomical support through collagen building. Lasers and microneedling/PRP will improve texture and tone while Ultherapy/radiofrequency treatments will provide skin tightening and lift.Technique is important here, and combination approaches are key to long-term results. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Wilfred Aguila, MD · Answer

HI, you might benefit from a little Botox® to your chin and to the DAO's which are the muscles that cause the angles of your mouth to droop. This will decrease the dimpling on the skin over the chin and raise up the corners of your mouth. Possibly follow this with small amount of filler to the chin so that it fills a deficit there and evens out your lower face. For the cheeks,  you would only need a small amount of filler (Voluma, Restylane) anteriorly to fill in the deficit and soften the nasolabial folds. Be careful not to use too much filler since you have good structure of the cheeks laterally and over filling these could lead to a "chipmunk" effect. Choose an experienced injector with a good eye for aesthetics. Best, Dr.A.

Karol A. Gutowski, MD, FACS · Answer

Don't waste your time mixing PRP and fillers. Whoever is offering this does not understand the difference between fillers (Juverderm and Restylane are different and have different physical properties). In your case Lyft would be much better but there are even better options for you like Radiesse and Bellafill. The use of PRP is not fully supported by good studies so it may not help you. See link below for examples.

Davin Lim, MBBS, FACD - Account Suspended · Answer

If you have been given only 2 options, take the Restylane Lyft- PRP and one syringe of Juvederm will not yield good results. Aim for bespoke placement of the HA filler- namely a scatter around the troughs and mid cheeks. IMO 2 ml is the starting point. You can easily take 4-8 ml depending on your budget and concerns. If you think about the actual volume 2ml is only half a tea spoon. I prefer fillers over PRP as a stand alone treatment due to the predictably. A good injector will take into account your facial features and volume loss in certain areas. Bespoke injectors will always combine different filler types including Sculptra, Bolletero, Radiesse, Restylane, Juvederm and many others- start slowly. Filler jobs are NEVER a sprint, they are marathons for life. Davin S. Lim

2 syringes Restylane Lyft or 1 syringe Juvederm Ultra Plus XC with PRP Lift and PRP Facial for volume loss/faint lines? (photos)

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