Dermal fillers restore lost volume and soften folds with minimal downtime but are temporary, whereas a facelift repositions sagging tissue and removes excess skin for a longer-lasting change. Fillers suit early volume loss; a facelift suits established jowls and neck laxity. Using filler to try to lift heavy sagging often makes the face look larger rather than younger.
Two different problems
Facial ageing involves both deflation, where volume is lost from the cheeks, temples and around the eyes, and descent, where tissues slide down and gather along the jawline. Fillers address deflation by adding volume in specific places. A facelift addresses descent by lifting the tissues back up and removing loose skin. Working out which problem dominates in your face is the key to choosing well, and most people over forty have some of each, in varying proportions.
How dermal fillers work
Most fillers used in the face are made of hyaluronic acid, a gel that attracts water and is naturally broken down by the body over time. Injected by a trained practitioner, filler can restore cheek support, soften nasolabial folds, define the jawline and treat hollows. Treatment takes under an hour, with mild swelling and bruising for a few days. Hyaluronic acid filler can usually be dissolved if needed. Read more on dermal fillers.
How a facelift works
A facelift is performed under anaesthetic through incisions around the ear. The deeper layer of the face is lifted and secured, the jowls are raised back over the jawline, and excess skin is removed without tension. Often a neck lift is performed at the same time. Recovery involves around two to three weeks of visible swelling and bruising, with the final result emerging over several months.
Side-by-side comparison
- Best for: fillers: volume loss and early folds; facelift: jowls, loose neck skin and deeper folds from descent.
- Longevity: fillers: many months, depending on product and area; facelift: many years, while ageing continues.
- Downtime: fillers: a few days of possible swelling; facelift: around two to three weeks socially.
- Anaesthetic: fillers: usually topical or local; facelift: general or sedation.
- Reversibility: fillers: hyaluronic acid can usually be dissolved; facelift: not reversible.
- Risks: fillers: bruising, lumps and, rarely, blood vessel blockage; facelift: haematoma, infection, scarring, numbness and uncommon nerve injury.
- Cost over time: fillers: repeated treatments add up; facelift: a larger single cost.
The problem of overfilling
As sagging progresses, some people have more and more filler injected in an attempt to lift the face. Beyond a certain point, extra volume makes the cheeks look heavy and the face wider, and can blur natural contours, a look sometimes called ‘pillow face’. Filler can also migrate or persist longer than expected. If you notice you need more filler each time for less benefit, it may be time to consider whether descent, rather than volume loss, is the main issue.
Which is right for you?
Fillers are often a sensible choice in the thirties and forties for mild hollowing, early folds or subtle contouring, or for people who cannot or do not want to have surgery. A facelift tends to suit people with visible jowls, a softened jawline and loose neck skin, who want a longer-lasting result. Many patients benefit from both: a facelift to reposition the tissues and a small amount of filler or fat grafting afterwards to restore volume. Mr Nassab will examine your face and explain which approach addresses your concerns most naturally.
Cost
Filler treatment is quoted at consultation, as the volume and number of areas vary. A facelift costs from £14,500. A deep plane face and neck lift costs from £18,500 and a mini facelift from £8,000. The £150 consultation fee is separate. Treatments are only for adults aged 18 and over.
Frequently Asked Questions
Can fillers replace a facelift?
Fillers can delay the need for surgery in some people by restoring volume, but they cannot lift heavy jowls or remove loose skin.
Does existing filler need dissolving before a facelift?
Not always. It depends on how much filler is present and where. Mr Nassab will advise at consultation.
Can filler be used after a facelift?
Yes. Small amounts of filler or fat grafting are often used after a facelift to fine-tune volume once healing has settled.
Which lasts longer?
A facelift lasts many years, whereas filler usually needs repeating every several months to a year or so.
Is it possible to have too much filler?
Yes. Large or repeated volumes can make the face look heavy or wide and blur natural contours. A careful practitioner will advise when more filler is unlikely to help and whether a lift would be more appropriate.
