Does the Silhouette Lift result in "puffy" face?

Question

I'm considering the Silhouette Lift to improve the moderate sagging I've started to notice in my lower jowl/upper neck area. I'm 49 with overall good skin quality - people commonly mistake me to be in my mid to late 30's. My question is the following: I've read that Sculptra (which is found in the Silhouette material) can cause the face to swell in appearance. I have high cheek bones so worry about having a puffy or fake appearing face. Thanks.

Jeffrey J. Roth, MD, FACS · Answer

Thank you for your question.  The Silhouette Lift consists of small entry points made in your skin by a needle.  There is no scalpel used.  No incision scars.  This is all good news if someday you might need or want a formal facelift/necklift.  You can also receive another Silhouette Lift a couple years after the first if you are still not ready/not a candidate for a facelift.  The material is the same that we use with Sculptra injectable.  Sculptra is usually done without patients looking puffy.  Often Sculptra patients will come back every few years for a touch up.  Volume can also work well with other modalities, (Juvederm, Volluma, etc.).  The choice between modalities depends on how much these issues bother you, how aggressive you want to be, and your anatomy.   Again, one should do a proper history and physical exam to see if you are a candidate.  Best to see a Board Certified Plastic Surgeon or Otolaryngologist, (ENT).  They will be able to let you know what might work best in your case, (Silhouette Lift vs. Fillers vs. Surgery), as they do all of the above.  Please call with any questions.Jeffrey J. Roth, M.D. F.A.C.S.Board Certified Plastic SurgeonLas Vegas Plastic Surgery

Jeffrey S. Rosenthal, MD · Answer

The Silhouette Instalift, indeed, is composed of two materials with one being Sculptra.  The threads are woven under the skin, and in these areas the patient will see volume replacement.  Unlike, Voluma or Radiesse, the volume replacement is much more subtle.  Whereas, Voluma and Radiesse are great for sculpting and contouring the mid-face, cheeks and temples the Silhouette Instalift is excellent for improving the nasolabial folds, marionette lines, jowls and upper neck.  Properly place, the Silhouette Instalift improves hollows by lifting the sunken or fallen tissues and then stimulates your native collagen for about 6 months. The combination restores volume loss in the areas where the threads are positioned. Thus, it is ideal for those who require a moderate lift of the lower face and upper neck and for those who do not have a large amount of subcutaneous fat or very lax neck muscles which would afford less than optimal results. The Silhouette Instalift is perfect for those who require rejuvenation of the face on an outpatient basis with minimal downtime and for those who are demonstrating early loss of facial tone but are not ready for a surgical facelift.

Young R. Cho, MD, PhD · Answer

Thank you for your question.  The Instalift sutures do encompass  the same material as Sculptra which results in collagen stimulation.  There may be some initial swelling associated with the procedure but this subsides after a few days.  The Instalift procedure can be used to create a very natural appearance.  The results, however, really depends on your surgeon's ability to assess your face and design your custom plan to ensure that you receive a natural result.  Just like any aesthetic procedure involves such as injectables, your results will depend on the skills and experience of your surgeon.  I would recommend visiting with a board certified plastic surgeon with a great deal of experience with the Instalift procedure.

Gregory A. Buford, MD, FACS · Answer

Like any procedure, if performed correctly the results should appear natural.  The same is true with the SIL procedure.  Since the suture material is composed of the same material (PLLA) as Sculptra, as it breaks down it stimulates your body to produce collagen and effectively leaves behind a given amount of mid face volume.  So unless you have an inordinate amount of sutures placed (which is unlikely) and they are placed in the wrong directions or vectors, results should appear very natural.
I hope this information helps!

Chris Lowery, DO · Answer

In the first week to 2 weeks after getting the InstaLift procedure, some swelling is normal and can give the treated area a slightly puffy look. However, this should be minor and diminish relatively quickly. The InstaLift offers extremely minimal side effects or downtime compared to traditional facelift surgery, and should not leave you looking "done."

Dean P. Kane, MD, FACS · Answer

Dear jshu:
Any puffiness from the Silhouette InstaLift (SIL) as it is FDA approved should resolve in 24 hours. The placement of these “Sculptra-dissolving” sutures requires injection of a local anesthetic. The anesthetic liquid will absorb within 24 hours and if no additional bruising occurs, my patients have been exceptionally pleased the following day.
  
The SIL is a new foundation for the minimally invasive facelift. It is the concept that the Silhouette sutures combine an immediate mechanical lift with a progressive collagen building and tightening that inspires the upward re-positioning of the soft tissues. With additional procedures,  added:
  
collagen building and skin firming / tightening with skin undermining and / or Sculptra injectable,
  volume filling with hyaluronic acid fillers such as Restylane and Juvederm
  and skin tightening using the Obagi ZO Skin Health Systems and Peels can be performed at one procedural session. 
  This combination will create “puffiness” as you describe which may last 2 to 3 weeks. 
  
Please consult with a well-qualified and talented, Board Certified Plastic Surgeon who performs non-invasive, minimally invasive and surgical options to offer what is best for you. I hope this is helpful. All the best!

Camille Cash, MD · Answer

The swelling that is associated with the Silhouette InstaLift is generally minor and will resolve over the first week.  Bruising may occur as well, but is temporary.  I encourage you to meet with a board certified plastic surgeon in your area to learn about this exciting treatment.

Bruce E. Katz, MD · Answer

Thank you for your question. Silhouette InstaLift™ is a minimally invasive procedure that is able to target the deeper layers of skin on a patient’s face and neck. This new target area makes the procedure stand out from existing procedures that only treat the surface or outer layers of the skin. After a Silhouette InstaLift you might experience some swelling but typically most patients find that the swelling goes away after a week or two at most. InstaLift has absorbable lift sutures that tighten the skin and stimulate collagen as they dissolve over time. Results will continue to improve for up to several months after surgery. I recommend getting a in person consultation with a board-certified dermatologist.

Nissan Pilest, MD · Answer

Unlike other fillers on the market, Sculptra is an injectable that volumizes not by the product itself, but by stimulating the body’s own collagen response. Because collagen stimulation is gradual and takes time, you would either need to inject quite a high number of vials, or place Sculptra improperly to create an undesired “puffy” look.
With that being said, yes, the Silhouette sutures are made up of the same collagen stimulating material as Sculptra, however with the amount of material being placed in the tissue, the chances of creating “too much” volume is slim. Bear in mind that Silhouette is not meant to mimic the dramatic results of a facelift, rather with proper candidate vetting and suture placement, is meant to achieve a subtle and natural-looking result.
  
If you are concerned with creating an unnatural appearance, you can certainly start with a smaller number of sutures. If after allowing some time for collagen stimulation, typically at least three months, you may find you are comfortable adding more sutures. Be sure to consult with a board certified Dermatologist who has performed a number of Silhouette InstaLift procedures. Best of luck.

Davin Lim, MBBS, FACD - Account Suspended · Answer

I tell all my patients to EXPECT swelling and bruising for at least 3 days, possibly up to one week. This is because we have to track through tissue to get the best result. Ice for 10 min after the Silhouette Thread lift procedure every hour for the rest of the day can reduce swelling. This can be repeated the next day. Dr Davin S.  Lim. Brisbane. Australia.

Does the Silhouette Lift result in "puffy" face?

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