Face Lift or Fillers? Best Options For The Aging Face

A Family Savvy reader submitted the following question to Dr. Herzog regarding the best options for an aging face. As always, Dr. Herzog is happy to answer reader questions  submitted through the Family Savvy contact form. Photos are helpful in enabling Dr. Herzog to give targeted advice.

QUESTION:

Dear Dr. Jo,

I am in my early 70’s and am ready to do “a little work” on my face. I’m certainly not trying to look 40 again; I just want to look the best I can for my age. Where do I start? Will I have to have surgery, or are there other options for someone my age? Any advice would be greatly appreciated. (I love your posts and look forward to every one!)

Needing Some Work in Nashville

ANSWER:

Dear Needing Some Work,

A photograph would be very helpful so that I could write about you and not speak in generalities. Please send us a photograph so we can have a discussion specifically directed toward your needs. Meanwhile, let’s speak about the average 70-year-old and what she might like.

Most 70-year-old women are not trying to look 40, but they have certain things that really bother them when they look in the mirror. The things that patients typically notice first are the lines going down from the corners of their mouths to the chin (deep creases can be present in the 70’s), jowls, wrinkles above the lips, and the deep fold from the base of the nose down to the corners of the mouth. These things change the face from the heart shaped silhouette of youth to the upside down heart shape of the aged.

There are also things that nobody thinks of as making them look old but that others subconsciously  think of as signs of aging. These include very hollow, skeleton-like temples and deep folds across the chin (the witches chin). We can work on these problems with different fillers.

We get old looking because we lose volume. We lose fat as well as bone. Unlike a face lift, which will pull the skin tight on the face and eliminate many wrinkles, fillers will fill spaces and reestablish the shape of a younger face. Fillers put back the volume that was lost instead of pulling the skin tight across what is left. Some surgeons are now combining a lift and a fill to get a little of both things accomplished.

One option that a woman in her 70’s has is a surgical procedure. A face lift will tighten the skin on its frame. This is optimal for those with huge amounts of loose sagging skin, very large jowls, very loose neck, and very coarse deep wrinkles. This does not mean that these patients won’t need fillers in addition to surgery to achieve the best results. We use fillers on many patients after they have had a face lift. These patients also have changes in color and texture that come with aging that will not be corrected with a lift. Some patients prefer not to have surgery. Even those with a fairly large amount of laxity can have some improvement with non-surgical procedures; however, the results will not be as impressive if what they really need is surgery.

There are many patients in their 70’s  and even the 80’s that would do very well with a non-surgical approach. They have some jowls, a fair amount of wrinkling, and some laxity of their skin. They might also have changes in skin color and texture. All of these things can be addressed with fillers and often with laser resurfacing. These are all done in the office, require minimal down time, are relatively cost effective, and do not require general anesthesia. We are now seeing many women in their 70’s and making them very happy with their in-office results when injecting fillers and sometimes adding fractional CO2 resurfacing.

Next week, we will go over these options and talk about what you can do right in the office with topical anesthetic and look at least ten years younger without any surgery.

Hope you stayed tuned in and have a good week,

Dr. Jo