Which would you recommend; Fillers or Facelift ? (photos)

I have previously been recommended Juvederm fillers in my cheeks and naso labial lines. My main concern is how droopy my mid face is and the hollows under my eyes, I am only 34, don't smoke or drink. Would a facelift benefit me more than fillers ? I have Juvederm in my lips, and it is always lumpy no matter how much it is massaged. I don't mind this as it's not very noticeable. I have seen celebrities and friends with lumps presumably from filler.

Doctor Answers 38

Fillers or facelift

At age 34, you probably would benefit more from fillers than a facelift. Also because the lip is thin, fillers can feel more lumpy. In the face, the skin is thicker and the fillers are injected deeper and don't feel as lumpy.


Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 48 reviews

Recommendation

I agree that your lower face has a square shape from cheek fat descent.  Fillers will not address this.  Although you are young for this procedure, a mini lift can help recreate a more oval shape to your lower face.  A better option in your age group is Voluma or fat grafting to your malar eminence.  

Natural face lift techniques for minimally invasive lifts

Facelifting techniques, even the minimally invasive approaches with Minilifts are far too premature at this point for you.

It appears that you might be lacking a bit of bone support both below the eye area along the orbital rim as well as out in the zygomatic arch- at the cheek bone.

1.)  The first condition is know as a negative vector midface and predisposes to early aging changes relative to the bags under the eyes, or hollowing.  Essentially this is just a result of having less bone support to the under eye structures such as skin and fat.

2.)  The second area along the arch refers to a weaker malar prominence or cheek bone.  Remember that we all begin life with full lower eyelids and cheeks and these tend to shrink as we age.

I believe you would love virtually any filler that you might choose for both areas at the same time.  I would probably recommend Voluma but you could use anything really.  I know you can find an injector that can inject this successfully without lumps.

Best wishes.
Dr. Hobgood

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
4.9 out of 5 stars 46 reviews

Which would you recommend; Fillers or Facelift?

Given your photos and age, I think it is premature to consider a facelift.  If you would like to accentuate your cheeks, injectable fillers would be a reasonable approach at this stage in your life.  Deeper fillers such as Voluma should avoid lumpy results.  Seek out a boars certified plastic surgeon with extensive facial rejuvenation experience.Best wishes, Dr. Lepore.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.9 out of 5 stars 50 reviews

Fillers before facelift in younger patient

It is not likely that you would benefit from a facelift at age 34, but the addition of volume to the midface can often be helpful. this can be done with fat grafting, or with a deep filler such as Voluma. Because the filler is placed more deeply, it is much less likely to feel lumpy.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 47 reviews

Fillers or facelift?

Your face cannot be completely evaluated with just the frontal view photos that you provided, but there is nothing in the pictures that would demonstrate that you would be a good candidate for a facelift.  Fillers, when used in the appropriate patients, can help to address hollows under eyes and can provide some mild lifting.  Another potential treatment for patients that are not good surgical candidates would be Ultherapy.  This treatment can also provide some mild lifting in some patients.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Addressing cheeks vs facelift

Without a proper exam you cannot make decisions about exactly what you would need. Filling the cheek and under eye area can give you a much brighter appearance and shift the balance of your facial contours to a more aesthetically favorable configuration. This can also be addressed by placing permanent implants in the cheek area. Given your age it is unlikely that you are a candidate for a facelift procedure, but  Visiting with a facial plastic surgeon or plastic surgeon can help you to formulate a treatment plan suitable for your aesthetic goals. Best regards.

Sean R. Weiss, MD, FACS
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Facial Fillers will Improve the Mid-Face

A facelift is great for laxity of the lower face and neck. In a youthful face these areas will not be benefited by a facelift. Facial fillers such as Radiesse and Voluma, when properly placed will enhance the cheek and mid-face area of the face. In doing so, the hollows below the eyelids will be improved, as the fallen or absent cheek volume is lifted and contoured with these remarkable facial fillers.  Radiesse is a calcium based product and Voluma is hyaluronic product. Both are well tolerated by the surrounding tissues and will lift, contour and shape the cheeks.  Artistically placed, these facial fillers will rejuvenate the face, especially one that has either lost or has less mid-face volume. 

Here's Why I Recommend Fillers & Fat

At your age and from your photos, it is unlikely that you would benefit much from an invasive procedure such as a facelift. Volume loss in the cheeks can be addressed by thicker fillers such as VOLUMA or RADIESSE. Fat transfer can be done, as well, and is the best, longest-lasting option. If placed deeply, these should all not be lumpy. Under the eyes, I like to use BELOTERO. It is thin and smooth and usually can correct the tear trough depression without lumps and without the potential for turning blue as with other hyaluronic acid fillers. I also like it for the lips for the same reasons. Consult with a specialist in these options to learn what's best for you. Thanks!

Fillers & Fat Would Be Best

Thanks for your question. At age 34, you have minimal skin laxity, and so a traditional facelift would give you minimal benefit. I have on occasion done a midface lift in patients in their 30s with pleasing results. However, I would start with a filler underneath your eyes for the circles. I favor fat; it is the smoothest and most natural in appearance but requires more experience than filler injections for optimal results. For the cheeks, a long-acting filler such as JUVÉDERM VOLUMA XC or RADIESSE probably is the best option, although fat grafting can also be done to the cheeks. Good luck with your decision!

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.