Facelift or Fillers? (Photo)

I am in my early 40's and noticing more fine lines on my lower face, you can't see them unless someone is close up to me but I can tell they are starting to get more noticeable. I've heard about these injections called Sculptra that can fill in these areas but I don't know exactly how it works or for how long. I also don't know if a facelift would be better in the long run. Also, what is the cost for a facelift vs. Sculptra? These pictures show the lines I'm talking about. Thank you!

Doctor Answers 29

Facelift or fillers?

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You are candidate for either a face lift or full face laser resurfacing which will markedly improve the fine wrinkles and give a facelift-like effect.  Fillers will not resolve the fine wrinkles. You should consult with an America Board of Plastic Surgery certified plastic surgeon to discuss your concerns.

Tucson Plastic Surgeon

Facelift or fillers?

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Thank you for your question. You are a good candidate for a facelift if you have skin looseness, soft tissue laxity, and some deflation in the soft tissue in the cheek. Fillers can restore a youthful appearance to the skin by adding fullness to hollow areas and by filling in moderate to severe wrinkles. They commonly are used to fill in lines around the mouth and those that extend from the nose to the mouth.

1. Begin with a board certified plastic surgeon and visit several offices
2. Seek a surgeon who does at least 100 of these procedures per year
3. Internet discussions do not replace the advice of your physician

Henry Mentz, MD, FACS
Houston Plastic Surgeon
4.4 out of 5 stars 36 reviews

Facelift or Fillers?

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If fine lines and wrinkles are your main concern, the best modality for treatment would be laser resurfacing. Laser resurfacing will help to smooth fine lines, tighten the skin, and overall improve your skin texture.  If deeper lines are present, such as the nasolabial folds, then dermal fillers such as Juverderm or Restylane can be used for volume. Sculptra is more of a long term filler option, but it is used more commonly for cheek augmentation.  I do not suggest it to fill fine superficial wrinkles.  Good Luck!

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Facelift or fillers?

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Hi surromommy. Thanks for your question. Fillers and facelift surgery accomplish different things. Fillers are used to add volume, such as in the cheek or lower eyelid region. Sculptra is used when there is substantial volume loss in the entire face and the patient wants a semi-permanent result. However, sculptra will not improve fine lines & wrinkles.  Facelift surgery is used when there is loose skin and muscle that needs to be surgically lifted and tightened. Fine lines/wrinkles are best treated with either a good skin resurfacing procedure (such as lasers) or botox for dynamic wrinkles. The best treatment for you really depends on what bothers you. I suggest an in person consultation for a proper examination and a discussion. Good luck. Best, Dr H 

Sanaz Harirchian, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Facelift or Fillers?

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Thank you for your question.  Fillers can add volume to the mid face  which can have a very rejuvenating  effect.

However correction of the jawline and reduction of jowls  is in my opinion often best achieved with a facelift.

The removal of surface wrinkles as shown in the second photograph requires combined laser resurfacing.   Fillers can not remove these deep surface skin wrinkles.  However Botox can certainly help in the crows foot area and frown line area.

If you choose the surgical route a facelift followed 6 months later I combined laser resurfacing might be your best option.

For a more thorough review of nonsurgical options please read the following link:

Facelift or fillers?

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This is a question I get asked a lot in my office. It truly depends on where you are in the aging process. Generally 3 main things take place when we age: 1. Lose the elasticity of our skin and our muscle sags. 2. Lose the texture of our skin 3. decrease volume. So depending on how much of each you have will determine the procedure. In an early 40 yo generally noninvasive modalities such as RF/US to tighten the skin or a C02 laser to resurface the skin is enough. If you have a little loss of volume fat injections and fillers are a great fix. Hope this helps !

Ritu Chopra, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Facelift or filler

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you have to speak with a plastic surgeon. most lines can be filled out and make the skin look smoother with fillers. they help the collagen and give the face a fresher look. facelift is for a tighter look and refreshed look. see what your plastic surgeon says and what is the best way to go you may not need the facelift just yet

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.5 out of 5 stars 96 reviews

Facelift or fillers

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Dear SurroMommy,

Fillers will work best for resting lines on your face. It is injected just under your skin to give a lift and volume. It will soften the look. Facelift is really reserved for patients with sagging muscle and skin. One will not replace the other. For many patients, they need both surgery and fillers. Given your age, I would recommend you start with more non-invasive treatments. Sculptra works to enhance volume in your face and not meant for fine lines. Lastly, you might want to consider laser procedures to improve your fine lines.

Kyle S. Choe, MD
Virginia Beach Facial Plastic Surgeon
4.6 out of 5 stars 42 reviews

The three ways your face ages need to be treated differently

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There are 3 main ways that our face ages:

First, we have changes in the skin with thinning of the skin, damage from sun and loss of collagen.  This is manifest by the wrinkles and lines in the skin.  A good skin care regimen will help improve your skin texture.  If your skin damage is more severe, laser treatments or a medical grade chemical peel can give you more dramatic improvements in your skin.

Second, we have volume loss in the face.  This is a major contributor to the aging process and has been overlooked in the past.  Sculptra is a great way to treat pan-facial volume loss, but there are other products depending on the specifics of your face.  You can and will get some lifting from volume treatments, but there are limits to how much lifting you can get from fillers and volumizers while still keeping a natural look.

Finally, there is sagging and drooping of the deeper tissues of the face.  A facelift is the best way to address this sagging and drooping in the lower face and neck.  

At your age, without seeing some pictures of you, I can guess that you are most likely a great filler candidate. A lifting procedure like a Quicklift may be a good option for you if you have significant sagging present.  An in-person consultation will certainly be necessary to give you personalized recommendations.  Cost of these treatments varies dramatically based on your appearance, where you live, etc.

 Best wishes,

Michael Bowman, MD
Roanoke Facial Plastic Surgeon

Facelift versus fillers

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In our practice, fillers are used in the mid cheek area and nasolabial folds and marionette lines to temporarily fill in those areas. When patient's have excess facial skin, loose neck and facial muscles, jowls and fatty deposits in the neck, a face/neck lift is required. For many examples and more information, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 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.