A liquid face lift which entail neuromodulators like Botox, Dysport, or Xeomin in combination with fillers to lift tissues. The neuromodulators work by blocking acetylcholine release thus causing temporary muscle paralysis.
What was noticed by patients and the early investigators like Jean Carruthers was that the wrinkles between the eyes disappeared because the muscles used to cause scowling were treated in addition to other muscles that caused spasms around the eyes. Hence, the birth of neuromodulators to erase wrinkles in the face.
How Does a Liquid Facelift work?
In the upper face, areas commonly treated are the glabella or area between the eyes to open up the eyes and erase frown lines. The frontalis or forehead is also commonly treated to smooth out the lines in the upper forehead.
Staying medial to the pupil will produce a lateral lift of the eyebrows by unopposed action of the frontalis laterally. In the mid-face the crows feet, bunny nose and a gummy smile can be treated.
In the lower face, the lip lines, puckering of the chin muscles and dropping lower lip are other conditions that are amendable to neuromodulators. The neck can also be treated to soften the platysmus muscles that can appear prominent and band like.
To produce a lift with neuromodulators one weakens certain muscles and opposing muscles will take over the exert unopposed action that will produced a lift in strategic locations. One area treated to produce a lift occurs by treating the depressor anguli oris which is the muscle that turns the corners of the mouth down. Treating this muscle will turn the lower lip up. The Nefertiti neck lift is another procedure is this gaining more popularity. This is done by treating the muscles under the jaw which are the platymus and sternocleidomastoid muscles. The muscles superior to the jaw will be unopposed and the result is a more defined jaw line.
I like to combine the neuromodulators in the neck with a Micro-needling treatment which has shown to increase collagen formation by 200%. The combination of both gives a tighter lifted neck.
One can use dermal fillers to replace volume but when more volume is needed, and for a more comprehensive correction; fat is my filler of choice. Having used fat for over a decade fat grafting is one of my favorite procedures to perform. One is able to sculpt the face and this becomes an artistic procedure. I can correct the deficiency globally by using between 40-60 cc of spun fat on the face. With so much research on stem cells published in the literature, fat has become the darling where stem cells are harvested from. To have a good retention rate of 70-80%, it needs to be placed in micro-aliqots in multiple planes with blunt cannulas. I usually deposit the fat is directly on top of bone or in muscle. Stem cells located in the fat graft will differentiate into viable fat cells which has a life span of about 7 years. This is what gives this procedure longevity.
In conclusion, the nonsurgical face lift involves correction of volume deficiency to lift the skin off of the boney skeleton along with neuromodulators to lessen get wrinkles and provide lifts in strategic locations like the eyebrows, neck and lower mouth. My procedure of choice to increase collagen formation and rejuvenate the skin along with producing channels into the dermis which allows for delivery of substances is the Micro-needlingRx microneedling device.