Last year Americans spent $2.7 billion on injectables for cosmetic purposes, according to the American Society for Aesthetic Plastic Surgeons, including wrinkle relaxers and volumizers. Increasingly, many of these patients are requesting “liquid facelifts”, an in-office treatment once considered novel but now seen as a less invasive option to a surgical facelift.

As we age, skin begins to lose collagen and elastin that contribute to sagging skin and facial features. Pioneered by celebrity dermatologists such as Patricia Wexler, MD, a liquid facelift combines different injection techniques to gently lift facial features, reduce wrinkles and creases, eliminate folds, soften contours or achieve a more rested, energetic look. But with more than 12 brands on the market including Botox®, Dysport®, Xeomin®, Juvederm®, Perlane®, Voluma®, Restylane®, Sculptura®, Elevess®, Hylaform®, Prevelle®, Radiesse® among others, how can you make sense of it all?

Let’s break down the different categories of injectables:

Botulinum toxin (Botox, Dysport, Xeomin)

The “original” injectable, Botox® was ushered into the market with national buzz that has stood the test of time. Botox injections can strategically combat frown lines, forehead furrows, crow’s feet and other wrinkles. The injection is administered directly into the tissue or muscle with a tiny needle. Results last for approximately 3 to 4 months. The procedure may result in side effects like redness, swelling, and burning sensations for the first 24 hours, but they are considered temporary.

Hyaluronic Acid (Juvederm, Perlane, Voluma, Restylane, Elevess, Hylaform, Prevelle)

Hyloronic acid is a naturally occurring element in the skin, serving as a building block of connective tissue throughout the body. It acts as a network that transfers the central nutrients from the bloodstream to the skin cells. Effects last up to 6 months. The outcome is visible right away and you can resume daily tasks. Temporary bruising, itching, redness tenderness can occur for the first 24 hours.

 Calcium hydroxylapatite (Radiesse)

Radiesse is an injectable skin filler that contains microspheres comprised mainly of calcium and phosphate ions. Calcium hydroxylapatite is identical in composition to the mineral portion of teeth and bone. After Radiesse is injected, thin tissue forms around the microspheres, filling wrinkles and creating a semi-permanent support structure for the skin. Results may last up to two years or more.

 Poly-L-lactic acid (Sculptura)

Marketed under the brand Sculptra®, Poly-L-lactic acid is an injectable filler used to replace lost facial fat. Poly-L-lactic acid is safe — absorbed naturally by the body — and has been used for years in dissolvable stitches.  This product stimulates the body’s own collagen for better skin texture and a more long lasting result. A full treatment of Sculptra consists of an average of three injection sessions over a few months and can last for more than 2 years. The most common side effects with Sculptra include tenderness, redness, bruising and swelling at the injection site. These side effects typically subside within a few days.

If you’re considering a liquid facelift, your doctor will explain the different injectable types and, depending on the result you’re looking for, she or he will customize an approach leveraging one or more of them to address your specific challenges.

Product Note:

Lidum4 from BioScriptives is a topical analgesic that numbs the skin. Lidum4 is a clinical product to use before, during and post treatment to sooth skin and ease discomfort – however temporary – of these non-surgical procedures.