Is your face more like a grape or a raisin?

How to add volume to restore a youthful appearance.

Most think that a “facelift” is the answer to make one look more youthful, but is it? When there is significant skin laxity (when you can pinch more than a couple inches on each side of the face and neck, then yes, a facelift is needed. But for most, it is the loss of volume that causes the face to droop. The face becomes narrower at the top and fuller near the jawline. Jowls appear and the cheeks sag.

Volume loss is approached very differently than sagging skin. There are several options to restore volume back, lift the face, enhance the cheek bones, fill the hollows in the temples, and fill the volume loss that appears in front of the ears.

  1. Hyaluronic acid fillers (i.e. Restylane and Juvederm). These are great options, results are instant, but depending upon how much volume one needs, this can get quite costly. Results last 6-12 months for most, although some may see even longer lasting results. When one only needs 1-2 syringes or one wants to look great for a specific event, this might be a great option.
  2. Sculptra is not really a filler, but a bio-stimulant. A what? I heard you. This product does not add volume by itself, but stimulates the body to make its own collagen, which adds volume. Results take 4-8 weeks to fully appreciate, but often last 1-2 years. This is a great option for those who need moderate to significant volume or those who do not want to come back frequently for touch-ups. The price can get costly, but if you factor that you will need less frequent treatments, it can be cost effective.
  3. Autologous fat transfer has been around for a long time and, can be quite effective and is long-lasting. This procedure takes fat from one area of the body, usually the hip, outer thigh, or abdomen and it is injected into areas that need volume. Up to 50% fat survival is seen and is permanent. This is a great option to treat the cheeks.
  4. Radiesse is another filler that works well. At 6 months, patients will often need a touch-up, but results do often last 1 year.

Adding volume to a face is like painting. Every work is different. Every surgeon’s work will look different. Getting fillers is not like buying a pair of shoes–it doesn’t matter where you buy them, it will be the same shoe. You may like one person’s work and hate another’s. In short, choose your provider carefully!

Robert S. Bader, M.D., Dermatologist