Facelift, Fillers, or Both? The Barefaced Truth

We understand. Believe us, we do. You’d like to have some “facial rejuvenation.” You’d like to look natural, but better. And, you’d like to avoid surgery.  Possible?


Well, two things.  And, both are true.

1.   “What you want to hear”

Modern injectable fillers, Botox-type injections, and facial implants, can often give you the improvement you want.

2.   “What you’d rather not hear”

The barefaced truth. Sometimes, only surgical intervention can lift faces, eyes, foreheads, and necks to the level of improvement you’d like to have.


With some injections, you actually can achieve this, with careful attention to the term “Lift.”   You should also note; most injectables are effective for periods of months, and most patients do return for regular touch-ups. Here’s a rundown of some popular choices:

  • VOLUMA – This is the newest and longest-lasting hyaluronic acid filler. It’s FDA-approved for injection into the cheek area. Injections can help fill a sunken, drawn-looking cheek, and may last up to 2 years.
  • RADIESSE – Similar purpose, including filling deep creases. The substance is a bit thicker than Voluma. The duration of its effectiveness- estimated between 9 and 12 months.
  • JUVEDERM, RESTYLANE, PERLANE – Again, these are hyaluronic acid fillers, injected into the nasolabial folds (the deeper creases between your nose and mouth), and other areas, to fill hollows. The results may last from 6 to 9 months.
  • BOTOX & XEOMIN – These injections don’t fill, they ‘smooth’ wrinkles and fine lines in different areas by temporarily “disabling” the underlying muscles; most often used between the eyebrows, and in the crows’ feet areas. These treatments usually last from 3 to 4 months.
  • FAT TRANSFER – This is listed last, because it does involve some surgery.  The fat that’s injected, first has to come from somewhere else in your body, and fat is ‘harvested’ with Liposuction.  If you decide to go this route, fat injections are used in many facial areas to smooth and plump. But take this into account with Fat Transfer to the face – Fat cells will behave as fat cells, even after they’ve been “re-located.”  So, if you gain a bit of weight following your fat transfer, those cells may expand. If they’re in your face, the added plumpness could be noticeable. The best advice on this is; don’t ask for more than your surgeon recommends.


The total cost is going to depend largely on how much of the products you’ll need to make a change. Pricing of fillers and Botox, is usually listed by the syringe, or “CCs” of material used.

You may need a number of syringes to fill a cheek hollow. You may want Botox in multiple areas.  In our office in San Jose, Injectable Specials are frequently available for our patients’ benefit.

A broad answer to the question: you may see cosmetic improvements for several hundred dollars. And, you may also spend several thousand dollars for your “Liquid Facelift.”

** And here is an important advisory which you should consider above all.  Choose an expert and experienced injector. We recommend seeking a Board Certified Plastic Surgeon.


  •  FACELIFT:  If you have sagging, drooping skin, lax skin in the jowl area and/or cheeks, a surgical facelift may be your best option. As effective as fillers are, they still won’t take care of many of the most noticeable facial changes that come with aging.

My San Jose and Palo Alto Facelift patients all know that just as their features are unique, their surgery will be customized accordingly, and will be unique to them. You’re probably reading a lot about different types of approaches and incisions. The length of the incisions around the hairline, ears, or chin, is determined by the patient’s particular needs. Once the incision is made, skin, muscle, and fat are tightened, tailored, or repositioned. The objective is to achieve a natural, rejuvenated appearance.

  •  NECKLIFT:  Loose, excess skin and fat are removed. The jawline and chin are re-defined.
  • BROW LIFT:  Can reduce forehead wrinkles, frown lines, and lift sagging brows.
  • EYELID LIFT (BLEPHAROPLASTY): Remove loose skin and excess fat in upper and lower lids, tailor lids, and reposition fat pads. (Eyelid Lift, does not lift the brow.)

Sometimes, patients are confused by advertising, or ‘stories.’ And sometimes, what you see can lead you to expect something that is not possible.

With that in mind, please pay attention to the following (no matter how good the ads look)

** Note to remember** A Facelift is one surgery that addresses a number of issues. Don’t expect a facelift to correct a “turkey” neck appearance, or lift droopy eyelids. These are addressed in separate surgeries, mentioned above. They can be, and often are performed together.


Here’s a good way to think about your facial surgery results.

You will always have the improvement you gained through these surgeries. Your cheeks, jowls, neck, and/or eyelids, will have been changed permanently.

Does that mean they will never change again?

No. Time, and the natural aging process continue. If you feel, in some time, perhaps years later- that you would like another surgical “lift,” it is possible to repeat these procedures.


This is actually what most patients are doing. If you choose surgery, you may certainly have injections of Botox, or fillers from time to time. You may also choose various skin resurfacing treatments, including peels and lasers, for further refreshment.

The options for restoring your facial appearance are many. We know that a lot of what you see and hear, can be confusing. Our experienced staff will be happy to answer your questions, or schedule your consultation.

[Dr. Vincent Lepore is a Stanford-trained, Board Certified Plastic Surgeon. He’s been providing Cosmetic and Reconstructive Surgery to patients in the San Jose and Palo Alto areas, for more than two decades. Dr. Lepore, Dr. Maser, and Dr. Bates all have extensive experience in Face, Body, and Breast procedures. To schedule a complimentary consultation, please call us at (408) 356-4241.]

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