The term “liquid facelift” refers to the use of soft tissue fillers to create lifting and contouring of the face without surgery, explains Kathleen C. Suozzi, MD, the director of aesthetic dermatology at Yale Medicine and an assistant professor at Yale School of Medicine in New Haven, Connecticut. “It is not so much a defined procedure or technique as a concept,” she says.
When patients undergo a liquid facelift, they will receive numerous injections with various dermal fillers, injections, and lasers. “The type of product used and the location of injections will vary depending on patient needs and injector preferences,” Dr. Suozzi says. “In general, injections are targeted at the mid and upper face to pull tissue up and back.”
How Is a Liquid Facelift Different From a Surgical Facelift?
The major difference between a liquid and surgical facelift is invasiveness. “A liquid facelift is not surgery,” says Howard Sobel, MD, a clinical dermatologic surgeon at Lenox Hill Hospital and the founder of a private practice, Sobel Skin, in New York City.
As a result, the side effects and recovery are much milder, but so are the overall results.
“During a surgical facelift, the facial lining of the face is released and tightened. This cannot be achieved with fillers,” explains Suozzi. Experienced injectors can use a technique called subcision to release retaining ligaments during the liquid facelift procedure.
How It Works Exactly: What to Expect During a Liquid Facelift
A liquid facelift is a relatively quick outpatient procedure.
The attending physician will start by mapping out the specific areas for each patient for the best result possible, Sobel explains. “Those areas include the brow, chin, eyes, nose, cheeks, and lips to address facial contours, expression line and wrinkles, loss of volume in the cheeks, under-eye hollowness and sagging of the skin,” he says.
Before the injections, the patient will have a topical numbing cream applied to the skin for anesthesia. It’s left on for about 20 minutes or until the skin is numbed. Then the cream is cleaned off and the skin is prepped for the injections, Suozzi says.
“The injections are minimally uncomfortable and typically take around 30 minutes to perform,” Suozzi says.
What Types of Fillers and Injections Are Used?
Liquid facelifts involve a combination of fillers and injections.
- Hyaluronic acid is the most commonly used filler type, Suozzi says. It’s used to treat fine lines and wrinkles, facial folds, and to create structure, framework, and volume to the face and lips. “The lifting capacity of (hyaluronic acid) gels can be varied, making some fillers stiffer and better for lifting, while others are thinner and softer,” Suozzi says. Different hyaluronic acid fillers have different chemical compositions, which results in a different effects, such as making skin appear more hydrated or smoother, Dr. Shafer explains. An added safety feature of these types of fillers is that there is an enzyme that can “soften” or dissolve them, in cases when a patient isn’t happy with the results and doesn’t want to wait until they naturally dissolve over time.
- Calcium hydroxylapatite is a filler that has a composition similar to bone. As part of the aging process, skin, bones, fat, and muscles in the face become thin and shift, resulting in wrinkles, folds, laxity, and volume loss. The injectable calcium hydroxylapatite filler, Radiesse, is a biocompatible dermal filler that is approved by the U.S. Food and Drug Administration (FDA) to improve the appearance of moderate to severe facial wrinkles and folds, such as the nasolabial folds (the vertical creases running from the bottom of the nose to the corners of the mouth). “This makes it more structural and able to lift tissue,” Suozzi explains. “Care has to be taken with Radiesse because of the calcium content of the filler, which makes it not ideal for softer areas such as the lips and under the eyes,” says Shafer.
- Poly-L lactic acid is approved by the FDA for improving the appearance of nasolabial folds, contour changes, and other facial wrinkles. “It is typically used in conjunction with hyaluronic acid fillers to both lift the tissue and then to fill the face more diffusely to create a youthful appearance,” says Shafer. He adds that poly-L lactic acid fillers are more appropriate for globalized filling and not targeted structure or refinement. “It also requires several treatments but has the benefit that it is long lasting,” he says.
- Botulinum neurotoxin (Botox, Dysport) may also be used to relax fine lines and wrinkles, says Sobel. “Botox is a great adjuvant treatment to help reduce the dynamic lines of the upper face and give the skin a nice glow,” adds Shafer.
What to Expect After the Procedure
After a liquid facelift, the practitioner might suggest icing the areas of injection to minimize bruising and swelling, which may last up to two weeks. “Avoid blood thinners and NSAIDs, such as aspirin and ibuprofen, two weeks before the procedure to minimize bruising risk,” Suozzi says.
You may also want to avoid exercising and sun exposure the first few days following a liquid facelift procedure, says Sobel. “Avoid harsh exfoliants and peels for about a week and wash with a gentle cleansing cream or foaming cleanser,” he adds.
