November 20, 2015

Liquid Facelift for the Age 37 Plus Patient

Angie Buonassisi
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Thirty seven? That seems kind of specific. Why did we decide to make this post for patients over thirty seven? There is a good reason: research shows that we all start to lose volume in our faces at around that age. When this happens, the changes are subtle and often hard to describe. Our patients often say... "I don't look dramatically different, just not as good as before", "I need to put more effort into makeup and hair to look "alive" and "I am happy, but I don't look happy".I first started to notice my face didn't look quite the same when I was 37 and had just lost weight from my second baby. At first I thought the weight loss was the culprit, but I realize now that my face was bound to change, simply because of my age. Drat! Thank goodness facial volume loss can be so effectively treated with dermal fillers.

Why Do I Look Less "Pretty". I'm Not Old But I'm Starting to Look It. What Is Going On Here, Face!?

The changes were subtle at first. Mostly I found I could not get a decent picture of myself no matter how hard I tried. Selfie or not, I didn't look as "pretty" anymore. No manner of attempt at facial gymnastics improved the situation...pursing my lips slightly made me look like a fish, and lifting my cheeks made me look surprised. Upon looking in the mirror, things were no better. Don't get me wrong, nothing had changed dramatically, but I just looked like a less appealing and youthful version of myself. Less plump, less pretty.I've had lip injections for years and love the results, but I started to wonder if I might need a little help elsewhere. I decided I needed to get the opinion of a specialist and explore some other options.A review of my photos and concerns with Nurse Injector Jillian of Fiore Skin Clinic in Vancouver helped reveal the changes in my face that were bothering me:

Upper Face Assessment

  • my cheeks are noticeably flatter and less full than they were in my 20's: Jillian explains to me that this is one of the first areas of the face to lose volume
  • my naso labial folds were once non existent...but now I notice them as shadows: I have a slightly deepening line from nose corner to mouth corner - Jillian shows me how a dropping and flattening cheek puts pressure on the naso labial folds, making them look deeper than before
  • I have these little shadows in the corners of my nose: it seems that as the tether point between the nose and cheek, when the naso labial fold deepens, so do the depressions here which look like triangular shadows at the nose corners

Lower Face Assessment

  • my mouth shape has changed - my lips looked smaller and less plump: the standard lip augmentation I've been having for years isn't doing the trick anymore and I need volume in other mouth areas than just the pink of my lips
  • my lip margin is just...blah...where did that lip line definition go: lip liner doesn't even help anymore and just makes my lips look old
  • I have a depression on either side of my mouth, just below the mid to outside area of my lower lip, that is actually failing to support my lips like that area once did - my mouth has actually shrunk back closer to my teeth
  • my mouth looks like it is slightly turned down in the corners

In addition, I have some dynamic wrinkles around my eyes when I smile (crow's feet) and in between my eyebrows when I squint (glabellar or 11s). I've had these areas treated with Botox many times before so this part will be a walk in the park. As she has done this for me before, she begins with the Botox injections which take less than a minute.

The Plan for My Liquid Lift

I have to be honest, seeing the photos of myself with obvious shadows and folds was a little depressing. The good news, however, is that dermal fillers are quick, easy and just what I need. I like the idea of a non surgical treatment that has a short recovery time. Jillian warns me of the possibility of some bruising and reviews her recommendations. She explains that adding volume to one area always changes the way areas nearby look, so we will go step-by-step and assess as we go.

Cheek Augmentation & Naso Labial Folds

  • The plan: She will replace volume in my cheeks which will elevate them slightly and take pressure off of my naso labial folds. If I still need help with the naso labial folds themselves, she will inject right into them. She explains that a natural looking liquid facelift returns the face to the natural shape it had before - an upside down triangle (with the point at the chin). If she leaves the cheeks alone and injects right into my folds, she will be making my face look strange as it will be wider and thicker in the folds area - which we want to be thinner relative to the upper part of the face.
  • The treatment: She does my cheeks and I LOVE the result immediately. My mid face looks lifted somehow and the product has given my cheeks definition they've never had. I am thrilled already. I look so...pretty! My naso labial shadows look better already and we decide not to put any product into them. I've learned since then that whenever I start to notice my folds, it is time to get my cheeks done.


  • The plan: She wants to add volume to my entire mouth area so that it will support my lips better, in addition to plumping and defining my lips themselves.
  • The treatment: Jillian starts with my lip margin. She doesn't want to overdo it, so she places a small amount of product along the edge. This looks good immediately and I can't wait to see the results of the rest of the treatment. She then plumps and augments the fleshy part of my lip. So beautiful! Now she focuses on my mouth corners which have become a little droopy. She puts a little depression in each corner which immediately gives the impression that I am pleased - I look like I am happy rather than grumpy. I love it! She then fills the depressions below my lips against my chin and this really puts the final touches on my treatment.

The Final Results of My Liquid Facelift

I am so happy with my slightly lifted and contoured face. I look happier, perkier, friendlier and more like I used to. My cheeks look just beautiful and seem to create a pedestal for my eyes. I snap a couple of selfies of myself (which I do not post to facebook ha ha) and I definitely look better. The shadows are gone and I am photogenic once again.This treatment was completed in less than 30 minutes including the consultation. My friends know I do injections so I will proceed with social life as usual (my face will be tender and a little swollen for about 3 days) but I will avoid planning any important work meetings just in case I bruise.For this treatment we used 3 syringes of Galderma products (a combination of Emervel Deep and Emervel Lips) which for me will last about 6 months. Jillian used 40 units of Botox. The total cost is about $2500 and worth every penny.I leave the Fiore Skin Clinic office with a smile on my face and a skip in my step and feel like I can conquer the world with my new cheeks and lips. It seems crazy, I know, but that is how I feel after my treatment. I will be back.

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