Silhouette Soft. Am I better off with fillers?

Fillers and Silhouette Soft are totally different things. Fillers give you a volume restoration on areas where you need or have lost volume. Silhouette Soft on the other hand, lifts the sagging skin. However both can work complimentary to each other but one cannot replace the other. For the premature jowl sagging & marionette line, Silhouette soft is my treatment of choice because it has excellent results.

Thank you for your question.  Dermal fillers are a great way to help soften the early signs of aging.  The Silhouette Instalift procedure is another great way to lift some of the 'sagging' tissues associated with the aging process.  I will often use both approaches as they work synergistically together.    Which to start first?  It depends on patient assessment and aesthetic goals of the patient (a photo would be helpful).   If, for example, the marionette lines or jowls are mild, then either Instalift sutures or dermal fillers may be all you need.  For patients with a more pronounced presentation, then a combined approach may yield the best results.  I would visit with a board certified plastic surgeon with experience in non-surgical facial rejuvenation in your area to discuss your options in more detail

It's a shame that we do not have a picture of you. The first thing that happens as we age is volume loss and this can show itself as looking tired, a saggy jawline and shadows across the face. True sagging of the tissues appears much later. It makes sense to address the volume loss first; some fillers carefully placed in the cheek are and maybe the temples will lift the face. These are quicker, easier and cheaper than Silhouette and with less down time and discomfort. Silhouette is a great treatment to lift the face but ideally start with fillers.

Hi 
Silhouette Soft treatment is an ideal way to lift jowls, redefine the jaw line and reduce marrionette lines. Like every cosmetic procedure, if done by the right practitioner  using the right tools in the right patient excellent outcomes can be achieved. Comparing fillers to sutures is difficult, both give results however if combined you achieve better outcomes. In my experience a minimum of three threads per side are required to gain optimum results.

Dear LidaR,
Thank you for your question. 
The key to improving a saggy face lies in the FILL and LIFT approach. In the absence of pictures, here is the general rule.
Jowls are the downward migration of your medial cheek fat pads. 
Treatment is a 3 step process.
1. Fillers to restore areas of lost volume. In your case, the cheeks, marionette lines and the pre jowl sulcus.
2. Threads to lift your saggy jowls
3. Review in a month's time with a focus on global rejuvenation
What is the key to looking youthful?
The key to youth is to reposition, re-volumise and restore lost tissue. By firming, lifting and tightening skin, by adding volume where it has been lost, and by holding tissue together, we can achieve a DREAMLIFT. It all starts from the top, so we fill from top down. When we were younger, we had an inverted triangle face shape. As we age, our midface sags the most, resulting in the formation of jowls, and changing our face shape into a square. So the key here is to lift, while maintaining a natural, youthful you.
I hope this is helpful to you.

Thank you for your question.  It would be useful to provide some photos to see if you would benefit.  The threads are useful for the lower face for treatment of jowls and marionette lines in the right candidate.  Your surgeon should be able to identify if you would be a suitable candidate.

Silhouette Soft is the perfect treatment for skin laxity. Laxity occurs through natural ageing and is the result of deflation of fat compartments in the mid face leading to a gradual decent of the skin downwards and forwards. This results in an increase in naso-labial folds, marionette lines and jowls. To correct this a filler can be placed to restore the loss of volume and to lift the folds. The best treatment depends on the amount of laxity. As a 38 year-old the laxity should be mild and Silhouette Soft could be perfect. But fillers will give an improvement. Sometimes the ideal treatment is to do both!
The threads cannot be felt once in position in the subcutaneous tissues. The skin will feel tighter along the path of the threads at first and for about one weeks post treatment it is important not to overdo facial expressions but you can still open your mouth. Usually, one week after treatment everything will have settled completely. Finally it is important to add that there is an initial lift, but the results improve over the subsequent 2-34 months as collagen is stimulated.
I hope this is helpful. Best wishes

Hi there,
Photos would greatly assist, and naturally I can only give you my general opinion as I have not seen you for a thorough assessment.  In terms of the Silhouette Soft treatment guidelines, it is now considered best practice to place at least three threads per side.  We have had some evolution in the use of Silhouette over the past 4 or so years, with different schools of thought at different times.  It is now considered more reasonable to place more threads, and three are considered adequate to get a good result.  Naturally this is dependent on the patient also.  Silhouette are relatively effective for  repositioning lax tissue in patients in the 30-55 age group who have mild to moderate skin laxity and good skin condition.  Patient selection is key.  
Unfortunately when the correct situation is not chosen, the patient will get less than ideal results, with no result being the most commonly reported adverse event.  I consider Silhouette Soft to be a relatively weak anti-aging tool on its own.  However, I do use it in combination with fillers regularly.  Putting the volume back to the face with fillers can surely produce more dramatic results, but it you are looking for a very subtle, natural result then Silhouette could be an option for you.
Hope this helps!
Best,
MJ x

Dear LidaR:
This is a tough question without photos. An in-person consultation by a well-qualified, talented and Board Certified Plastic Surgeon is your best bet.

The Silhouette InstaLift (SIL) made of collagen stimulating dissolving suture with anchoring cones is inserted under the skin to mechanically lift, reposition and over many months stimulate tightening of the soft tissues of the face, neck, brow and now other areas of the body such as arms, thighs and breasts.
Fillers provide volume expansion or projection.
So, it depends on what your needs are.

My analogy is that with aging and skin / soft tissue laxity, the youthful smooth seas of the temple developed a “giant” wave at the cheek followed by a submalar hollow before hitting the shore along the mandible. Aging gives rise to 5 smaller waves and troughs at the lateral canthus, naso-jugal fold, nasolabial fold, lateral commissure/marionette fold and the neck fold.

The SIL acts in “harpooning” the soft tissues and reeling them back up toward the temple.
Fillers are used to fill the troughs or project the wave height.
Both can be used simultaneously. Adjunctive procedures include: Sculptra to create more collagen tightening under the skin and retinoids/chemical peels to tighten the skin from above.  Both SIL and fillers need some time for adjustment. When injected artfully a reversal of the skin waves occurs. For fillers 2 days to 2 weeks maybe needed to settle and feel normal. SIL will required time to properly anchor, settle and start the collagen building process; my patients need 5 days to 3 weeks before they feel fully back to normal including yawning, opening their mouth widely and turning your head so as not to “pop” the anchors and lose the lift. Many of my patients have undergone prior facial procedures or have heavier tissues and need many more than 1-2 sutures per facial side. I like the lift and stimulation achieved with 4-5 facial sutures, 2 brow sutures and 3-4 neck sutures per side.

This is a lot to understand. Please consult carefully so you understand what is best for you. All the best!

The best way to determine which treatment is right for you is through an in person evaluation.  Often times Silhouette InstaLift is used in conjunction with fillers for the most complete treatment.  If the threads are placed properly you should not be able to feel them.  Not everyone is a candidate for this treatment, but if your doctor feels you are a good candidate it is a procedure you should consider.