Facelift vs Fillers – Which Option is Right for You?

, facelift vs fillers, facelift, Inland Empire, facelift Inland Empire, Dr. Brian Machida, facial plastic surgeon, Inland Empire, California
Before and After facelift by Dr. Brian Machida

Working from home has moved many to improve their appearance.  And why not?  You can recover from procedures without missing much work.  And after seeing how bad webcams make most people look, many want to look better on Zoom.  As people consider their options to look younger and more attractive, they wonder which is better for them.  It’s a facelift vs fillers.  If you’re thinking about these alternatives, what factors should you consider?


Editor’s Note:Dr. Brian Machida is a double board certified facial plastic surgeon in Inland Empire, metro Los Angeles California.  He has an unusually high level of experience.  During his career he has performed over 4,000 facelifts.  His neck lifts and other facial plastic surgery procedures number in the thousands.  Dr. Machida taught for years at the University of Southern California’s Keck School of Medicine.  He now practices at STC Plastic Surgery in Ontario, CA.


Facelift vs Fillers? Try Fillers first – unless…

The general rule is:  If you’re young enough, try Botox and fillers first.  They can often correct signs of premature aging.  Of course, that rule mainly applies to people in their 30s and 40s.

If you’re in your 20s and are dissatisfied with your facial appearance, the problem is often structural.  We all have physical imperfections.  If you happen to be someone whose nose is crooked or too large or if your face isn’t symmetrical, surgery is by far the best way to correct it.  A skilled physician could use fillers to perform a non-surgical nose job.  But this is a temporary fix.  The cost of getting injections throughout your adult life will be substantially more than a surgical rhinoplasty, which should permanently correct the problem.

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Before and After Rhinoplasty by Dr. Brian Machida

Some in their 20s inherited excess fullness in their neck.  Or “tech neck” could have made your muscles sag prematurely.  Neck liposuction won’t be enough.  Your muscles need tightening.  Or you may have prominent marionette lines running from the corners of your mouth to your jawline.  In the past, some doctors tried to treat them with fillers.  This has not proved to be a good solution.  The only way to cure marionette lines is a surgical facelift.

Why people in their 30s may need fillers CONTACT Dr. Machida Inland Empire, CA 

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People in their 30s can have facial aging

Why might you need anti-aging treatments in your 30s?  It may be heredity.  Once you leave your 20s, vital skin proteins like collagen and elastin start to decline.  Skin can begin to sag.  Crow’s feet, circles under your eyes and deepening nasolabial folds start to appear.  That happens more quickly with some than with others.

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Smoking or vaping promotes facial aging

It could be due to lifestyle.  Tobacco decreases circulation to your skin.  Excessive alcohol accelerates the aging process.  A poor diet deprives your skin and muscles of nutrients they really need.  Too often, people in their 20s smoke, vape, or regularly have 3 or more drinks on any given day (2 or more for women).  If that was you in your 20s, by your 30s those lifestyle miscues may start showing up in your face and neck.

Finally, the environment may be to blame.  Too much sun accelerates facial aging by cutting your collagen and elastin production even more.  If you live in a hot, dry climate, spend lots of time in the sun, and don’t apply enough sunscreen, facial aging can start to appear in your 30s – or even sooner.

At one time, it was rare to see someone under 50 at a facelift consultation.  Now, younger people are choosing surgery.  Why?

When fillers really help – and when they don’t

Fillers provide outstanding treatment for hollows, sunken cheeks, moderate nasolabial folds, even for the first signs of bags under your eyes.  One filler, Bellafill, is FDA approved to treat even deeper nasolabial folds – for up to 5 years.  Young faces have natural fat pads under the skin that provide their features with a pleasing rounded look.  As you age, those fat pads become smaller every year.  Eventually, your facial volume loss becomes noticeable.  You may look older than your years – certainly older than you want to look.

Volume loss results in hollow cheeks.

Fillers can restore facial volume and your youthful look, as long as your facial muscles are still firm.  Juvéderm, Restylane, and other hyaluronic acid fillers last from 6 to 12 months.  Then you’ll need another round of injections to maintain your younger look.  Bellafill costs more per syringe but can last 5 years or even longer.

BeautiFill is a fat grafting procedure that transfers fat from body locations where you don’t want it to the facial fat pads where you need it.  With traditional fat transfer methods, 40-60% of fat cells die within the first year after your procedure.  With BeautiFill, up to 95% of fat cells transferred survive in their new locations.  As long as you don’t lose a lot of weight, BeautiFill fat grafting could restore facial volume for many years.

That’s important, because getting Juvéderm or Restylane injections for years can get expensive.  For instance, in metro Los Angeles where I practice, 10 syringes of Restylane cost as much as I charge for a facelift.  Consider:  Most patients require 3-4 injections per visit.  In 3 years or less, they’ll receive 9-12 injections, which cost as much or more than a facelift that will provide better results and last far longer. When it comes to economics, for most people the answer to the facelift vs fillers question is pretty obvious.

Facelift vs Fillers:  People 50+ usually need a surgical procedure

Once you reach your 50s, loose skin and facial volume loss come with another component:  sagging face and neck muscles.  The only way to correct sagging muscles is a surgical procedure:  a facelift and/or neck lift.

A facelift can firm up sagging muscles and smooth out wrinkles.  At my practice, we use a local anesthetic to numb the area and an oral sedative to put you to sleep.  Experts call this “the safest method available.” You’re not under anesthesia, but you won’t feel a thing.  I’ll make small, hard-to-detect incisions in front of and behind your ears and under your chin.  Using those openings, I’ll tighten your muscles, smooth nasolabial folds and marionette lines, and remove excess skin.  If you have volume loss, we can combine your lift with a long-term filler or BeautiFill fat transfer.

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Before and After facelift, laser and Sculptra filler by Dr. Brian Machida

Soon, you’ll really look terrific.  Recovery time is 7-10 days.  Afterwards, your workmates and friends will notice how much better you look.  Unless you tell them, most won’t know why.  And if you stay away from tobacco and excess alcohol and eat a skin-friendly diet, your great results can last for years.  For more information, please read Can Food Fight Wrinkles and Aging Skin?”

Regardless of your personal answer to the facelift vs fillers question, you’ll want to consult with a qualified, highly experienced physician.  For a surgical procedure or filler injections, choose a board-certified facial plastic surgeon or a plastic surgeon who specializes in facial rejuvenation. If fillers are the best answer for you, a board-certified cosmetic dermatologist is a good choice as well.  Filler injections done right usually result in a more attractive face.

Filler injections done wrong can result in tissue death and blindness.  Don’t go to an unqualified or less-experienced provider to try and save money on your face – it’s the only one you’ve got!

If you want to improve your appearance and want the opinion of an experienced, board-certified specialist on your personal facelift vs filler question, check the websites for professional organizations like:

  • American Academy of Facial Plastic and Reconstructive Surgeons (aafprs.org)
  • American Society of Plastic Surgeons (plasticsurgery.org)
  • American Academy of Dermatology (aad.org)

If you’re in Inland Empire, California, you can find me at STC Plastic Surgery in Ontario

CONTACT Dr. Machida Inland Empire, CA

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About Dr. Brian Machida, MD, FACS

Dr. Brian K. Machida, MD, FACS is a double board certified facial plastic surgeon. He has an exceptional level of experience, having performed ( read more )

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