If you have been searching for a facelift, a mini facelift, a neck lift or eyelid surgery, you are probably trying to answer a simpler question first: is surgery really the only way to get what I want? Sometimes it is. A lot of the time, it is not. I want to walk you through what non-surgical treatment can actually do for an aging face, where it stops, and how we figure out which side of that line you are on.
I will be honest up front, because this is a touchy area in aesthetics. People hear "non-surgical facelift" and think we can do miracles. We cannot, but there is a lot we can do.
Why your face changes in the first place
The treatment depends on the cause, so it helps to know what is happening.
By the age of 30 we start to lose collagen, and collagen is what gives your skin that snap, that ability to bounce back. Collagen and elastin both decline as we age.
The bones in your face get reabsorbed and get smaller. Your eye sockets actually become bigger as you age. Believe it or not, you lose bone around your nose and your cheeks, and along your jaw.
Then there are the fat pads. Some of the fat pads in your face shrink and get smaller. Others start to sag and get displaced, and they do not fit into their compartments anymore, so to speak. That is where jowls come from.
So facial aging is really three things happening at once: loss of collagen, fat pads that shrink or descend, and bone loss. Everybody loses it in a different order. Some people hollow out around the eyes first, some people see the jowls first.
Morpheus8: tightening without surgery
If what bothers you is sagging or loose skin, Morpheus8 is where I usually start the conversation.
Morpheus8 is radiofrequency microneedling. It uses 24 needles, and the radiofrequency gets shot through those needles into the deeper layers of the skin where the fat lies. The needles create a controlled injury, which stimulates your body to heal itself and produce collagen, the good old collagen production that everybody is obsessed with right now, and the radiofrequency tightens.
On the face, we usually do the whole face, and you may notice a lift overall. It is really popular under the chin and on the neck, the turkey neck. We can also treat just around the eyes with a smaller tip to help tighten. They call that the non-surgical blepharoplasty. It is not eyelid surgery, and it will not remove skin the way surgery does. Whether it is right for your eyes is something we look at together.
The protocol is three treatments, four to six weeks apart, then one a year to maintain. You numb for a whole hour, and the appointment takes an hour and a half to two hours total. It is best done in the cooler months when you are not in the sun, and if you have a risk of hyperpigmentation we have to be really careful with it.
Filler: putting back what you have lost
If what you are seeing is really volume loss, hollows, flattened cheeks, deeper folds, that is filler, not tightening
Dermal filler is hyaluronic acid, which is something your body already makes on its own. I use the RHA Collection by Revance, which ranges from something very light and stretchy all the way to something sturdy enough for a cheekbone or a jawline. It provides almost a substitute for the bone you have lost, and it integrates beautifully into the skin.
I want to be careful with the word "lift" here. Cheek filler is not actually lifting the rest of your face. It gives the appearance of lifting. By restoring volume in the cheek, it can make the nasolabial folds everybody hates, and the marionette lines, look less dramatic. It can take some years off your face. But it is volume, not a facelift.
Fillers can last anywhere from 12 months to two years. Believe it or not, lips tend to go the fastest, because you are talking and moving your mouth all the time.
Looking at the whole face, not one spot
This is the part I love. People come in and say, "I hate my nasolabial folds." Well, the reason you have nasolabial folds is often that you are losing cheek volume. So instead of filling the fold, we look at the whole face and treat the deficit that is causing it. That is what facial balancing really is: using filler, tox, lasers and good skincare together, based on your face and your goals.
Resurfacing and tox: the surface lines
Some of what makes a face look older is not sagging at all. It is lines, texture and tone on the surface.
For those, CO2 laser resurfacing is great. It takes off that whole top layer of skin and gives you that glass skin appearance. It is wonderful for the lipstick lines around the mouth, around the eyes, uneven tone and pigment. CO2 is resurfacing, though. If tightening is your main goal, that is Morpheus.
Microneedling with SkinPen and IPL (Intense Pulsed Light) also help produce collagen, and good medical-grade skincare and sun protection are part of every plan.
Neurotoxins like Botox, Dysport, Jeuveau and Daxxify relax the muscles that create lines when you move: the forehead, the 11s, crow's feet, bunny lines. A lot of people also like it in the neck, on the platysmal bands along the jawline. Tox is short-acting, about three to six months.
When I will send you to a surgeon
Here is the honest part. Non-surgical treatments do not take away the amount of skin you have. Only surgery will do that. If there is a lot of loose skin, or a lot of sagging, some things really are just a facelift.
And if you would need an enormous amount of filler to get where you want to be, fat grafting with a surgeon may be the better route.
The consult is how we sort that out. If I think you are not a candidate for what we do here, I will tell you, and I will send you to a surgeon. We have surgeons in the area we like and trust.
What realistic results look like
It really depends on the degree of loss or sagginess. That is why I cannot tell you from an article what you will see, and why I would rather set realistic expectations in the consult than promise you something in print.
Results also do not last forever, because your face keeps aging. Filler lasts one to two years, laser results about a year, tox three to six months. I always tell people it is a long-term relationship. It is years of taking care of your skin. You can be in here as much or as little as you want,.
I believe in baby steps. We start with a little at a time and build, so you still look like yourself.
Common questions
Is there such a thing as a non-surgical facelift? Not in the sense of removing skin. What non-surgical treatment does is tighten, restore volume and improve the skin's surface. For many people, that combination is what they were really after.
What is the best non-surgical treatment for a sagging jawline or neck? It depends on the cause. For loose skin under the chin and on the neck, Morpheus8 is where I start. Tox can help with the neck bands. Where bone and volume have been lost along the jaw, filler supports it. A consult tells us which.
Is there downtime? With Morpheus8, no gym or sweating for 24 hours, and you have to stay out of the sun. With CO2, you could be down three days to two weeks depending on the depth, and you need to stay out of direct sunlight for at least two weeks. With filler, you can have swelling and bruising.
Start with a consultation
We do not do anything this involved without a consult first. We will look at your whole face, talk about your goals, and put together a plan that fits, whether that is here or with a surgeon.
Toribella Skin Clinic is in Cherry Hill, New Jersey, a short drive from Haddonfield, Moorestown and Marlton.
Book a free consultation online or call or text 856-474-3636
