Published January 4, 2012 By Dr. Adam Lowenstein

Today I saw another patient who was interested in soft tissue fillers because her dermatologist had done this to her face in the past. What she needs is a face lift. She had deep “marionette lines”, where the sagging tissue of the cheek folds over the depressions below the corners of the mouth. She wanted me to fix this by filling up these lines with Restylane, when instead a face lift is the proper way to proceed. I explained to her that these lines are caused by falling of the facial tissue lateral to the mouth, and not a loss of tissue in the areas of the marionette lines. Why would we treat an area that never had volume with an increase in volume using fillers? This only creates un-natural lumps and ridges. I pointed out to my patient that she already had these un-natural contours from the previous fillers that had been placed by her dermatologist.

What my patient needs is a face lift. By performing a face lift in her case, the sagging tissue lateral to the marionette lines is lifted to a more youthful position. Because the tissue no longer sags over the corners of the mouth, the marionette lines are vastly improved, and often go away. The face lift replaces the tissue to it’s proper position, and un-natural fillers are not needed. I have a lot of information on my website about face lifts, and I encourage you to become well educated about the best ways to achieve your goals. Sometimes soft tissue fillers are a great idea… but sometimes, the Santa Barbara Face Lift is the right thing.

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