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When to Lift and When to Fill

newbeauty logoOriginal Article by Elise Minton. You may think that all fillers and injectables are interchangeable for one another and they all work the same exact way. But truth be told, you can’t inject anything just anywhere. Some have a specific purpose of lifting while others are used primarily to restore lost volume. And, then there are times when you need a little more than what comes in a syringe to really lift your skin back up to where it belongs.

“A number of changes happen to the face as we age. Skin loses its elasticity and begins to sag. The fat pads of the face atrophy or shrink, resulting in a loss of volume. And, the ligaments of the face loosen,” says New York plastic surgeon B. Aviva Preminger, MD. “The result of all of those changes is a loss of cheek fullness, deepening of the smile lines and the formation of jowls.” But how your doctor goes about fixing each one of these age-related issues really depends on the cause of the problem. “In many patients, there is a need for a combination of both lifting and filling,” says Dr. Preminger.

“Rarely will a patient have pure skin laxity as the only age-related problem,” says San Fransisco dermatologist Vic Narurkar, MD. “There are multimodal aspects to aging, which also include reduction in facial fat (temples, midface, marionette areas and upper cutaneous lip), in addition to laxity. Also, there are submental fat, hyperdynamic wrinkles and neck laxity. So often, injectables will complement lifting. We have shifted from ‘filling’ in the lines to rebalancing the facial compartments.”

One area of the face that almost always needs filling, according to New York facial plastic surgeon Dilip Madnani, MD, is the cheeks, which lose volume. Dr. Madnani says there are a fantastic area to fill because they act as a pillar, holding up the skin. “Once they start to lose volume, our skin starts to sag, producing the beginning of jowling. To address the area, I routinely combine facial fat transfer to volumize the midface and cheek area with a lower facelift or necklift to erase the years.” Other areas that often require filling include the tear troughs, temples, lips, nasolabial folds, marionette lines and superficial lines around the lips and mouth.

However, if there is significantly loose skin, anything that’s injected or used noninvasively may not do enough to give you the results you’re after.

“Patients who have severe jowling and laxity are better candidates for surgical lifting and then following with fillers or aurologous fat for rebalancing facial fat,” says Dr. Narurkar. “Those who are starting to show deflation but not a great deal of laxity are better for ‘lifting’ and rebalancing the face with fillers.”

It’s important to know that not all treatments will give the same longevity in terms of results. “Surgical facelifts last the longest,” says Dr. Madnani. “If surgery resets your appearance by 10 years, then you will always appear 10 years younger going forward, however you will continue to age from the point of reset. Most people come back for a touch up lift about 8–10 years after the first, and this can vary.”

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Male patient receiving an Emsculpt NEO treatment to the abdominal area.

Frequently Asked Questions

What can EMSCULPT NEO do for me?

EMSCULPT NEO is an amazing noninvasive body sculpting treatment. It’s perfect for patients who are looking to get summer body ready! With this state-of-the-art, two-in-one technology, you build muscle and burn fat at the same time! This treatment provides a 30% reduction in subcutaneous fat and 25% growth in muscle on the treated area after a recommended number of treatments.

How does EMSCULPT NEO work?

While you lie down and relax, EMSCULPT NEO sends high-intensity energies deep below your skin, making your muscles contract in a big way that is like doing thousands of crunches or squats in a few minutes. While your muscles are contracting, the energy from the applicator simultaneously sends warmth to your fat cells, heating them up to the point of destruction. So you build real muscle from the contractions while destroying fat cells that are later naturally eliminated by your body.

How many EMCULPT NEO treatments will I need?

The recommended treatment plan is 4-6 treatments, one week apart. Depending on the patient, you may see improvement in your muscle tone, core strength and posture within a few weeks. And you’ll see fat reduction continue for about 12 weeks after your last treatment.

Are there any patients for whom you do not recommend EMSCULPT NEO?

EMSCULPT NEO is great because it has been shown to be safe and approved for all body and skin types. Contraindications include hernia, recent surgery, and pregnancy, so if a patient has any of these conditions, they should wait until they don’t to get EMSCULPT NEO.

What is the difference between CoolSculpting and EMSCULPT NEO?

CoolSculpting is a well-known treatment that is excellent for reducing unwanted fat in targeted areas. EMSCULPT NEO also reduces fat, but it has the benefit of building muscle, which is what its predecessor EMSCULPT was made to do.

Which treatment you choose depends on what your body needs and your personal goals. If you have great muscle tone and only need to get rid of some extra fat in a specific area like your abdomen or below your chin, CoolSculpting is an excellent option. But if you have loss of muscle tone and need more of a lift or tightening to a certain area like your abs or butt, EMSCULPT NEO is your two-in-one solution.

What is your favorite thing about EMSCULPT NEO?

Not only is this treatment super convenient with one treatment lasting only 30 minutes, but there is also no downtime! Patients can go about their day as they normally would immediately after their visit.

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