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KK
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What are the best options for a Facelift in Singapore?

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Aesthetic Medicine Plastic Surgery Skin, Hair & Nails

There are so many kinds of skin lifting and facelift treatments in the market (eg. HIFU, threadlift etc). What are the most recommended facelift methods to lift up sagging skin, in terms of effectiveness and how long the results last?

DOCTOR’S ANSWER (4)

Dear KK, 

There are many options and a myriad of procedures that can be done to improve and rejuvenate the face. The important thing is to be able to identify what the problem is so that the right procedure can be done. In the aging face, there are two problems - deflation of tissue (loss of fat) and descent of tissue (laxity). Hence you can see that the treatments either attempt to LIFT or FILL to correct the signs of aging. Once in a while, you may see or read of a patient that has a bloated look from too much fillers. This happens when too much filling is done and there is no attempt to address the laxity. The attempt to FILL your way to a LIFT can give you that problem.

In this age of advancing aesthetic medicine, there is an explosion of non-invasive and minimally invasive techniques which is good for the patients as they can seek such treatments for early facial aging changes. However, like some of the doctors mentioned, there are limitations of these non-invasive techniques as they require the skin to have a certain amount of elasticity and it certainly is unable to get rid of the excess skin laxity.

Non-invasive and minimally invasive techniques for facelift

Ultrasound based devices such as the HIFU or Ulthera are ideal for the younger patients as they cause skin tightening and provide a modest lift of the face. Personally, I have used both and I prefer the use of the Ulthera as it provides a more definite lift with a long lasting result. Some of the concerns are that it can be more painful so we provide the patient with ample anaesthetic to numb the skin before the procedure to reduce the discomfort. There are also some radio frequency based devices which I have used but with limited success.

Thread lifts have also become more popular as this is a minimally invasive procedure with rapid recovery and requires little time off work. The concept behind threadlift is the use barbed sutures that anchor the skin and the lift is obtained by securing these stitches to a stable point such as the temple. 

Injectables such as botolinum toxin (Botox) and fillers can be done alone or in conjunction with the above methods to reduce wrinkles and also to fill the deflated areas of the face brought about by aging. 

Fat grafts to face

Fat grafting is a technique that has been around for many years. In recent times, with a better understanding of the science and physiology behind fat grafting we are now able to reliably and reproducibly restore the lost volume to different areas of the face hence rejuvenating it and restoring a youthful look. Fat grafting is a highly operator and technique dependent procedure. This has to be done carefully so that one does not cause a hyperinflated face. I use the proprietary Tulip cannulas that are specially designed for fat graft harvest so that the correct sized fat particles are harvested. The fat is harvested from the tummy or thighs using liposuction techniques. Following that, the grafts are prepared with the use of a centrifuge using standard Coleman technique which is the current gold standard and proven to have the highest yield. The fat grafts are then injected into specific areas of the face using Tulip cannulas. 

Traditional Facelift vs. Composite Facelift

A traditional facelift is a skin only facelift which gives immediate and gratifying results. Patients will know this as the facelift that can be done under local anaesthesia and it only takes 1-2 hours. There are reasons for its simplicity because it only addresses the skin and not the underlying tissue. During the aging process of the face, it is not only the skin that is ages and becomes lax, the underlying muscle (called the SMAS) and the tissues also sag. The criticisms of this technique is that the results does not last as only the skin is tightened and the patient often has a wind-swept face with tell tale signs of a facelift due to the undue tension and pull on the skin. 

A composite facelift is a more refined and advanced technique where both the skin and SMAS is separated and lifted separately to address the problems of the aging face. The SMAS, which is the layer of the face that contains the muscles of facial expression is tightened directly hence reversing the aging changes, restoring contour to the cheek, jawline and neck and producing a more natural and longer lasting result. The composite facelift is a more complex procedure that is only performed by trained plastic surgeons as there is a risk of injuring the nerves that can affect facial expression. A composite facelift is able to address the nasolabial folds, the marionette lines, the jowls and can also be done with a neck lift to tighten the saggy skin around the neck. In certain patients, a brow or forehead lift is done in combination to elevate the upper 1/3 of the face and sometimes a lower eyelid and mid cheek lift also also performed concurrently if there is laxity around the periorbital region.

I hope this answers your question. Have a great week ahead and all the best!

Dr. Terence Goh

Plastic Surgeon


The information provided is purely for educational purposes and does not constitute medical advice or create any physician/patient relationship. Results may vary between individuals.

0 413 views 0 Doctors agree Fri Sep 21 2018 01:16:09 GMT+0000 (UTC)
Hi KK,

There are 2 main methods for non-surgical face lifting treatments.

Namely, Thread Lift and HIFU.

Both have its' Pros and Cons and will ultimately depend on how comfortable the patient is with each treatment.

1)  Threadlifts

The Threadlift procedure is probably one of the most effective lifting techniques when done properly.  It Lifts, Firms and stimulates collagen.  Results from a Threadlift is very dependent on the technique used as the design of the lifting vectors and depth of placement of the threads will affect the outcome.  Do note that only the thicker, longer threads with anchoring cogs and cones Lifts.  Thinner, shorter threads without anchors will not produce effective lifting results if any.

I personally also like to combine them with Fillers placed at specific lifting points in the face for enhanced and optimal results.

Results are usually immediate and lasts longer than HIFU.

The downside is that this procedure requires injection points so that the threads can be inserted into the deeper skin layer.

2)  HIFU

I usually reserve this treatment for my patients who require a lifting procedure with no downtime and/or are absolutely averse to needles.  Nonetheless, it is still a very strong device that Lifts and Firms as well but results are progressive over the months.  In terms of efficacy, results do not last as long as Threadlifts.  It is, however, a very comfortable procedure.

Hope this helps and do have a consult with a doctor you are comfortable with and who has ample experience with these treatments.

All the best!

0 655 views 0 Doctors agree Wed Aug 08 2018 03:26:57 GMT+0000 (UTC)

Dear KK,

The most effective treatment for severe sagging skin is surgery. 

Facelift surgery has the most dramatic results in a single treatment but has the longest recovery time. It has surgical and anaesthesia risks too. 


For mild to moderate saggy skin, you can consider non-surgical options like HIFU and Threadlifts.

Threadlifts

 - Effects: Threadlift gives immediate results by physically lifting the skin on the face and long term results by stimulating collagen production. Not requiring surgery, the threads are inserted after applying numbing cream or numbing injections.

- As the threads are inserted using needles, many patients might be concerned about the downtime from swelling, bruising and infection.

- Results last: 6 months to 18 months (depending on the number/type of threads use and doctor's expertise)

- Typical prices in Singapore: $1,000 to $4,000 (depending on the number/type of threads use and doctor's expertise)

As a doctor in Raffles Place, my patients are looking for an effective anti-aging treatment that fits into their busy lifestyle without the risk of downtime (No Bruising, No Swelling, No Needles).


HIFU (High Intensity Focused Ultrasound)

- There are several types of HIFU: Ultraformer, Ulthera, Sygmalift (list is non-exhaustive). 

- Effects: Gradual. 

- HIFU treatment restores the collagen in your skin that was lost over time using focused ultrasound waves.

- Results last: 6 months to 12 months (depending on the quality of HIFU and doctor's expertise).

- Typical prices in Singapore: for more details on HIFU treatment costs 


Hope that this helps!

Warmest regards,

Dr Justin Boey

0 643 views 0 Doctors agree Wed Aug 08 2018 08:48:30 GMT+0000 (UTC)

Hello KK,

Facelift treatment can be divided into surgical and non-surgical. In general, people with severe skin sagging will benefit more from surgical options while people with mild to moderate sagging can consider non-surgical options first. 

There are many non-surgical facelift treatments in the market right now: 

1. HIFU - best result in 1 to 2 months time and can last 9 to 12 months.

2. Threadlift - immediate result and can last anywhere from 9 to 18 months depending on the type of thread used. 

3. Filler - immediate result if injected in the right position. HA fillers can last 9 to 12 months on average while semi permanent fillers can last more than 1 year depending on the product used. 

4. Dermalift - best result in 1 to 2 weeks time and it will last 3 to 4 months. 

The best approach to non-surgical facelift will require a thorough assessment to see which procedure is more suitable for the patient. I usually prefer a combination approach to get the best out of the different treatment options available.

The different treatment options have their own pros and cons so speak to a trusted doctor to see which is the most suitable one for you. Hope this helps!

Regards,

Dr Jiwei Wu 

0 697 views 0 Doctors agree Tue Aug 07 2018 04:31:31 GMT+0000 (UTC)
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