Should I do Fillers, Botox or have a Facelift?

By: Dr. Marcelo Antunes

With all the hype over the Internet and television, it’s easy to get overwhelmed and not know where to start in your journey to improve your appearance. According to recent statistics from the American Society for Plastic Surgery, there were over 15 million cosmetic surgeries performed in 2014 – up 3% from the previous year. Due to the increase in demand, the industry responds with what seems like an endless array of new products and procedures. However, it is very important to maintain a skeptical attitude and carefully evaluate new advances. What I have found is that when the patient is well educated in all the different available procedures and is involved in the decision process, they can be better prepared to discern the difference between fickle and reliable information.

As technology and surgical techniques evolve and improve, more people are asking for quicker procedures that involve a short recovery and still achieve long-lasting results. I am a big advocate and frequently perform non-invasive-minimal-downtime procedures such as soft tissue fillers, Botox injections, chemical peels and lasers. These are key components for a complete treatment and prevention of facial aging. So why would someone bother doing a facelift? Why go through the downtime? Should I just do fillers, Botox, lasers or a chemical peel? To answer these questions, we need to understand the aging process and the limitations of each treatment option.

As we go through the 40s and 50s, facial aging starts to take place. The skin loses its elasticity and wrinkles start to appear, the muscular layers and ligaments become laxed and the bony structures of the face show some signs of contraction. Despite the fact that everybody ages differently, the tissues of the face and neck start to sag in predictable ways, producing looseness in the neck skin, jowls, sunken cheeks and deep folds on the corners of the mouth. Dermal fillers can work fabulously camouflaging the contour irregularities and lessening the deep facial folds. Botox can prevent wrinkles. Lasers and chemical peels can invigorate the skin. These options are wonderful and avoid downtime, but they definitely cannot do what a facelift can. A good facelift should address the muscular layer of the face and restore its position to a more youthful one. These will correct the neck lines and folds, jowls, reestablishing cheek contour and soften the folds around the mouth. In addition, tightening the muscles leaves the skin without any tension and avoids the dreaded pulled look. A well done facelift remains the gold standard for facial rejuvenation and should not be feared.