Nasolabial Folds – Facelift or Filler? Which Makes More Sense?

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Before and one week After Deep Plane Facelift by Dr. Brian Machida, MD, FACS. Dramatic improvement, including in nasolabial folds, is seen while patient is still healing.

If you are one of the millions who have deepening nasolabial folds, you no doubt wonder what’s the best way to look younger and more attractive.  After all, Zoom meetings are not going away.  Neither is people’s (especially employers’) tendency to judge you largely by your appearance.  So, you rightly want to enjoy the benefits of a younger, more attractive new look.  At the same time, inflation isn’t going away yet.  You want to get the best value for your investment.   You might wonder if for your nasolabial folds filler injections can help you look better with minimum discomfort and save you money.  Or if for your nasolabial folds facelift is the better option.

There are definite considerations – physical and economic – that you’ll want to take into account.  Discussing them can help you recognize which option – fillers or facelift – makes the most sense for you.

Nasolabial Folds filler or facelift?  Your age makes a difference

Nasolabial folds often start becoming noticeable in your 40s.  If you treat them before they get too deep, fillers can make a lot of sense.  At that point, you may only need three to four syringes to substantially improve your appearance.  Hyaluronic acid fillers like Juvéderm and Restylane typically cost around $700 to $800 per syringe in Southern California where I practice.  They may be a bit more or less depending on your location and the provider you choose.  That would give you a cost of $2,100 to $3,200 to substantially soften your nasolabial folds.

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Before and After Bellafill injections for deep nasolabial folds

However, it’s important to note that what seems like a lower-cost approach won’t give you long-lasting results.  Your body will reabsorb those fillers in about a year.  So, you’ll have to plan for another round of fillers in your annual budget or your deepening nasolabial folds will return.

If you want a solution to your nasolabial folds that will last longer, Bellafill is a better alternative.  This filler is FDA-approved to treat nasolabial folds for 5 years.  It’s more expensive than Juvéderm or Restylane – about $1,000 to $1,200 a vial where I practice.  So those 3-4 syringes will cost you $3,000 to $4,800 but can last five times as long.  This all makes good economic sense – if nasolabial folds are your only facial aging concern.

For nasolabial folds facelift makes more sense after 50

Once you’ve reached your 50s you generally have more facial aging to treat than just your nasolabial folds.  Marionette lines and even jowls may start to appear.  Other facial lines deepen.  While fillers can improve these, it will take many more vials.  The economics often don’t make sense anymore.

Filling lines, wrinkles, and nasolabial folds in your 50s can often take 6-10 vials of filler.  To get five years of improvement with Bellafill, you’ll pay from $6,000 to $12,000 in Southern California.  For that much money, you should get a younger look that lasts a lot longer than five years.

Which facelift makes the most sense for you?

While there are several different types of facelifts out there, the most common today are the SMAS facelift and the Deep Plane facelift.  The SMAS facelift will give you natural-looking results at a lower cost.  It’s good for people with moderate aging primarily in the lower third of the face.  This procedure can do a good job of eliminating moderate jowls and marionette lines, as well as facial lines and wrinkles.  But the SMAS facelift will not improve your nasolabial folds.

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Patient, 73, Before and After SMAS facelift and neck lift by Dr. Brian Machida. Despite substantial improvement, nasolabial folds remain.

A Deep Plane facelift can provide far more than the SMAS facelift’s 1/3 of an inch lift.  The Deep Plane procedure can help you look years younger, providing dramatic results not possible with any other treatment.  You can find details in “A Better, Safer Facelift Smooths Nasolabial Folds and Marionette Lines that Others Can’t.”

As you can see from the patient photo at the top of the article, a Deep Plane facelift will substantially improve your lower nasolabial folds.  It’s more expensive than a SMAS facelift, but if your lower nasolabial folds are a major concern, this is the facelift for you.

A SMAS facelift typically costs $9,000 to $15,000 depending on where you get it.  A Deep Plane facelift can cost as little as $15,000 to as much as $27,000 or more in Beverly Hills and New York City.  I’m able to charge less because of the techniques explained in “How to Make a $27,000 Beverly Hills-Quality Facelift Cost Much Less.”

Nasolabial Folds Filler or Facelift?  Do the Math

As long as you follow your surgeon’s common-sense recommendations, facelift results often last 10 years or more.  A Deep Plane facelift can make you look dramatically younger and more attractive.  Depending on the surgeon and where you get your procedure, Deep Plane facelifts can cost as little as $15,000 to as much as $27,000 or more.  Doing your homework can make a real difference in what you pay for a truly high-quality facelift.  Is a Deep Plane facelift a good deal?

First, let’s take a look at what fillers will cost you.  To get the greatest degree of facial rejuvenation possible with fillers, the most economical filler over a 10-year period is Bellafill.  Let’s assume you can get Bellafill injections for the lower amount in my area, $1,000 per vial.  If you have enough facial aging that you’re even considering a facelift, you’ll need 8-10 vials of Bellafill.  Remember, Bellafill lasts 5 years, so over a 10-year period you’ll need two rounds of shots – 16-20 in all.  Here’s how that adds up:

16 Bellafill vials at $1,000/vial = $16,000 – Yearly cost: $1,600

20 Bellafill vials at $1,000/vial = $20,000 – Yearly cost: $2,000

If this seems like a lot, compare the cost with hyaluronic acid (HA) fillers like Juvéderm and Restylane.  They cost less – $700 to $800 per vial – but only last a year.  Note what the same substantial level of facial rejuvenation – 8 to 10 vials, costs per year with hyaluronic acid fillers:

8 Hyaluronic Acid filler vials at $700/vial – Yearly cost $5,600

10 Hyaluronic Acid filler vials at $700/vial – Yearly cost $7,000   CONTACT Dr. Machida Inland Empire, CA

Deep Plane Facelift – $15,000 to $27,000 – Yearly cost $1,500 to $2,700

As you can see, a Deep Plane facelift costs thousands less per year over 10 years than hyaluronic acid fillers like Juvéderm and Restylane.  Depending on how many vials of Bellafill you need and who performs your Deep Plane procedure, that facelift can cost $500 less per year.  If you’re in Inland Empire, California, you could save even more.  My Deep Plane facelift cost is on the lower end of the price range.

And a Deep Plane facelift gives you far more than filler injections.  No filler can get rid of a turkey neck, neck banding or a double chin.  A Deep Plane facelift can handle all three (the double chin requires adding neck liposuction).  A Deep Plane facelift will substantially soften your lower nasolabial folds, lift your cheeks and improve your midface while eliminating jowls.

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Before and After Deep Plane Facelift by Dr. Brian Machida.  Her neck is substantially improved without neck lift.

Fillers make good sense if you’re relatively young and just need to improve your nasolabial folds a bit or fill some facial hollows.  If you have jowls, marionette lines, other facial lines and wrinkles, a SMAS facelift can improve those.  But if your facial aging is more extensive, your cheeks are sagging, you have deepening nasolabial folds, or your neck is also aging, a Deep Plane facelift is definitely the way to go.  The formula is:

  • Age 45 or less, minor nasolabial folds = Filler
  • Age 50 or more, facial aging + minimal nasolabial folds = Facelift
  • Age 50 or more, facial aging + neck aging + deepening lower nasolabial folds = Deep Plane Facelift

What would work best for you?  A board-certified facial plastic surgeon or plastic surgeon who specializes in the face and neck can say for sure.  If you’re in Inland Empire California, come see me for a free consultation at STC Plastic Surgery in Ontario.

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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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