Liquid facelifts such as the Y Lift offer compelling alternatives to traditional lifts. Here we discuss the pros and cons of this new approach to facial rejuvenation.
A facelift is a surgical procedure that reduces wrinkles and sagging skin by tightening face muscles, removing excess skin and lifting the skin so that it sits higher on the face.
While today’s surgeons are skilled at achieving natural-looking results through such methods, facelift surgery still has two important drawbacks: first, the cost and, second, the amount of recovery time involved.
Consequently, there is much interest in finding less expensive, quicker procedures, with liquid facelifts -- especially the Y Lift -- becoming an increasingly popular alternative to traditional lifts.
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The Liquid Facelift Controversy
Many cosmetic physicians dislike the term “liquid facelift,” because the technique does not involve actual surgery. To them, calling a non-surgical procedure “a lift” is merely a marketing technique.
More serious is the concern that people going for liquid facelifts will be expecting the same results of a traditional lift but only receive the results of a facial filler. This is true, but only important if the patient wants the results of a surgical lift.
If a person can forget about the name and focus on the likely results, their decision to undergo a procedure will be based on realistic expectations. In fact, the absence of surgery is a strong plus in favor of the procedure for many patients.
Another objection is that the nonsurgical approach doesn’t last as long as a surgical facelift, in many cases only one year or less, whereas surgical facelifts typically last as long as 10 years.
Perhaps the most important question is how effective the procedure actually is. Liquid facelifts have grown more popular for the simple reason that many people are pleased with the results.
The skin is composed of three sub layers -- the epidermis, dermis and hypodermis -- under which roughly 20 facial muscles are stretched across the skull.
By the time most people reach 30, a few lines around the mouth and eyes have begun to appear, and by age 40 the skin often looks “tired,” having lost its natural resilience and started to sag. As a person’s bone structure begins to change, the jaw and chin lines lose definition, loosening the skin that was once supported.
The most common interventions at this point are Botox to relax the muscles that create facial wrinkles, and injectable fillers to augment areas that have lost volume. This type of treatment is what is sometimes referred to as a “liquid facelift.”
The FDA has approved several different types of injectable fillers for this purpose.
Part lubricant and part shock absorber, hyaluronic acids are natural chemicals made and absorbed by the body. They are popular dermal fillers because they bind collagen and elastin together to repair aging skin and restore their “spring-back” quality. The fillers often include a small amount of lidocaine to minimize discomfort during and immediately after injection.
The body absorbs hyaluronic acids over time. While this filler's relatively short life is convenient should the cosmetic results be disappointing, in most cases patients want “retouches” not long afterward. The entire procedure usually needs to be repeated within one year.
FDA approved brands:
- Captique: Lasts approximately 4 months.
- Hylaform, Hylaform Plus: Lasts 3 to 6 months.
- Juvederm, Juvederm Ultra, Juvederm Ultra Plus: The Ultra and Ultra Plus solutions contain lidocaine. Lasts 8 to 12 months.
- Juvederm Voluma XC: Contains lidocaine. Lasts 9 to 12 months.
- Perlane: Lasts 6 to 9 months.
- Prevelle Silk: Contains lidocaine. Lasts 6 months.
- Restylane, Restylane L: Lidocaine is mixed in with Restylane L. Cosmetic injections typically last 6 months or more.
- Restylane Lyft with Lidocaine: Injections last 6 to 12 months.
Calcium Hydroxyapatite (Radiesse)
Injected under the skin, Radiesse fillers offer the added benefit of stimulating the production of new collagen. Results normally last as long as 12 months.
Poly-L-Lactic Acid (Sculptra)
Sculptra is mainly used to correct smile lines. Like Radiesse, it helps gradually replace lost collagen — an underlying cause of facial aging. It takes a couple of months for the full results to be apparent, but in some patients they last for two or more years.
The Y Lift
The Y Lift is a trademarked treatment for people who want to restore facial contours without the expense and recovery time of a surgical facelift. The procedure is sometimes called the “15 minute facelift” because the it's done in less than an hour, under local anesthesia.
Physicians who perform Y Lifts note several critical distinctions between it and other liquid facelifts. The key innovation is the use of a special injection instrument that allows a deeper and more precise placing of the filler.
How It's Done
The focus of the Y Lift is to rejuvenate the facial structure rather than restore plumpness to the skin. This begins with a study of the face to determine what needs correcting, and how much filler will be required. Typical changes involve cheek augmentation, softening of the nose to mouth lines, and lifting the mouth to improve the jawline. Note that the amount of filler used can have a significant impact on the total cost of the procedure.
Once the doctor has marked off the areas of the face that are to be treated, the next step is to inject a facial filler, usually Juvederm. The injections are made with a special instrument that makes a very small hole in the skin, allowing the physician to reach below the muscle and better position the injection. The depth of the injection also enables the physician to use much more filler than when it’s placed in, or just under, the skin.
There lies the distinguishing difference between standard filler use and the Y Lift injection -- traditional injections place the filler just below the skin, while filler for a Y lift is placed at a much deeper level, between muscle and bone. At this depth cheek augmentation and jaw line definition are more pronounced.
Once the filler is injected the physician massages the area to shape it, sculpting the restored cheek and jaw lines. This technique allows the physician to mold the shape in accordance with the individualities of each face. Antibiotics are used at the point of injections, but there is no need for any stitching of the skin.
The Y Lift is sometimes advertised as “the lunchtime lift,” because the patient can return to work immediately after leaving the doctor’s office; however, the procedure does produce some swelling and bruising around the cheeks and chin. Don’t expect to return to work that afternoon and not have people ask what happened to you.
Other Liquid Facelifts
The Y Lift is only one type of liquid facelift. Different products and techniques can be used to address various aesthetic concerns.
Most commonly, liquid facelifts begin with a Botox treatment for wrinkles around the mouth and eyes. Botox injections relax the muscles that, when taut, cause wrinkles. The injections wear off after three to six months.
The latest generation of dermal fillers allow doctors to sharpen facial contours such as cheek, jaw and chin lines. Some surgeons still favor using cheek implants, but liquid facelifts are gradually replacing them.
Unlike the Y Lift, other liquid facelifts inject the filler into the dermis or hypodermis layers of the skin. There are three main areas where the injections are made:
- The upper cheek region just below the eyes and stretching toward the ears (the malar area)
- The hollowed out region below the cheekbone (the submalar area)
- The chin and jaw area
The roundness of the face owes much of its appeal to the fat and collagen of the upper cheek, an area covering the bone that supports the muscles which move the jaw bone. Over time the fat and collagen decline. The upper cheek loses its healthy glow, jowls can appear, the area around the eye hollows and the mouth can sag. These all result from diminished support for the skin.
The idea behind injecting fills in this area (in the hypodermis or directly below it) is to restore volume and support, lifting the skin without surgery. Patients should give serious thought to how they want to look after the procedure. Do they want dramatic changes, aiming for the apple cheeks of Snow White, or do they prefer more subtle lines? Part of the answer depends on the patient’s face. Discuss this in detail with your doctor.
The fills used for this area are usually one of the hyaluronic acids.
If you ever wondered why Abraham Lincoln is never ranked among the more handsome of our presidents, take a look at his cheeks. They are hollowed out and give an already tall, thin man a gaunt look. In those days before plastic surgery, Lincoln turned to a beard to subtly fill his cheeks and put some life into his face. Then he straightened out the lines a bit more by wearing a stovepipe hat.
Today, a physician would inject filler to add volume and support beneath the cheek. The fills used are commonly Sculptra or one of the hyaluronic acids. These give the impression of a lift without the surgery.
The so-called weak chin results from a loss of bone. In the past chin augmentation surgery was recommended but the popularity of the procedure appears to be declining, at least in part because of liquid chin contouring.
The contouring of the cheeks should be able to improve definition and pull jowls away from the chin, but fills can also be applied directly on the chin region itself.
What a Liquid Facelift Lift Costs
Cosmetic surgery is rarely covered by insurance and the patient must bear all the expenses. The price depends on how much filler is used; final costs are based on the number of syringes required, and typically run from $600 to $1,000 per syringe. Botox prices range from $300 to $600.
A Y Lift can cost as little as $4,000, or twice that much. Retouches every 6 to 9 months can add another $1,000 - $2,000 to that price.
According to the Liquid Facelift Association, non-Y liquid facelifts generally start at $2,000 depending on the amount of filler used, and the Botox adds another $200 to $600.
Frequently Asked Questions
How did the Y Lift get its name?
The procedure is said to revitalize the face into a Y shape, with augmented cheeks (the top points of the Y) and a younger nose-mouth look (the stem of the Y).
What is the liquid in a liquid facelift? How is it injected?
The liquid is dermal filler, injected by syringe in liquid form.
Is there any real lifting in these non-surgical techniques?
It depends on how you think of lifting. If you imagine a person doing the work, then a surgeon cutting and physically lifting is the only true lift. If you can imagine a natural lift, however, as when a tide lifts a boat, then these procedures result in true lifts. The injected fill changes the volume and structure supporting the skin, lifting and tugging it into a new position.
That said, it seems likely that these procedures would not be called lifts if they didn’t have the surgical facelift as a reference.
Are there support organizations for these procedures?
The Liquid Facelift Association of Oklahoma City is dedicated to informing the public about the risks and benefits of treatments.
The Y Lift is a trademarked name and can only be offered by surgeons trained and certified in the technique. Information about the procedure can be found at www.ylift.com.
How long should I expect a liquid facelift to last?
The Y Lift claims to last as long as 2 years, but that’s including touch-ups (probably 2 of them). The hyaluronic fillers used in these procedures are naturally broken down by the body, making the procedure safe but not permanent.
Liquid facelifts using fillers like Radiesse and Sculptra generate their own collagen and can last approximately 2 years.
Aging, of course, doesn’t suddenly stop after you’ve had a procedure. This is why you can’t continue enjoying results for years afterward with only touchups. Eventually, you will need to consider getting another full liquid facelift.
Which filler is best?
It depends upon what you’re filling. The Y Lift generally uses Juvederm of one type or another. The effects are visible immediately and provide good volume. Other liquid facelifts use different fills depending on the desired results and area being filled.
The malar region is directly supported by bone and can be thickened with hyaluronic acids. The submalar region has less physical support, so many physicians prefer to use Sculptra here. It takes longer to work its magic but provides good support and results last for a long time.
What age is best for a liquid facelift?
It depends on your genes and health history, but for most people it’s their late 30s and early 40s when the effects of time begin to show some wear and tear. Because the procedures are so much quicker and simple, patients often seek them at a younger age than they might a traditional, surgical facelift.
What are the risks of these treatments?
The risks of a liquid facelift are few and far between, especially when treated by a board-certified plastic surgeon or provider. However, expect there to be some swelling and bruising immediately after treatment.
Most of any swelling and/or bruising disappears in a few days. Brief headaches sometimes follow injection. Botox is used for many purposes beyond cosmetic ones and its side effects may be more notable in other treatments, especially those for children.
The dosage for cosmetic procedures is small and the most serious side effects are not known to trouble cosmetic patients. 1 patient in 20 experiences an eyebrow droop; in which case your physician can add a small amount of Botox to a counteracting muscle and lessen said droop. While rare, some patients have experienced a brief period where an eyelid remains shut. Occasionally the botox spreads beyond the injection point, producing facial-muscle weakness.
Dermal Filler risks
Dermal fillers can create bruising and swelling for a few days following treatment. The easiest way to avoid risks is to hire a board-certified physician who has a long history with the particular filler being injected.
Can I do anything to reduce the risk of bruising?
Some bruising is likely, but you can reduce the amount by:
- Stop taking inflammatory painkillers (e.g., aspirin, Motrin, Advil, Aleve) a week before the procedure. Use Tylenol or similar product if you need a painkiller.
- Abstaining from alcohol for 24 hours before the procedure.
- Foregoing strenuous exercise on the day of the procedure.
Can I slow down aging with retail hyaluronic acids?
Hyaluronic acids are a natural body substance and can be bought in vitamin and supplement shops in tablet, lotion, or gel form. There is no evidence suggesting that using them orally or as rub-ons will slow down the aging process, nor any reason to expect they would.