Non-Surgical Face Lifts is a term that encompasses a combination of procedures toimprove wrinkles and lift the tissues of the face without surgery.Other common terms for these include a liquid face lift which entail neuromodulators like BotoxR., Dysport, or Xeomin in combination with fillers to lift tissues.
The neuromodulators work by blocking acetylcholine release thus causing temporary
muscle paralysis. What wasB noticed by patients and the early investigators like JeanCarruthers was that the wrinkles between the eyes disappeared because the musclesused to cause scowling were treated in addition to other muscles that caused spasmsB around the eyes. Hence, the birth of neuromodulators to erase wrinkles in the face.
We can now treat the whole face with neuromodulators.
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 Dermapen treatment which has
shown to increase collagen formation by 200%. The combination of both gives a tighter
Before. After Nefertiti neck lift and
Dermapen Rx. Note sharper jawline
and tighter neck.
The other component to non-surgical face lifts is replacement of volume to lift the skin
off of the bony skeleton. My mentor and colleague Dr. Mark Berman has coined the
Space Lift as a term to describe the above.
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.
Before. After fat grafting to cheeks, tear
troughs, temporals, lateral eye
brows, lips with Dermapen Rx.
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
DermapenR microneedling device.