Filler or facelift – when is which treatment the right one?

The desire for a youthful appearance is a timeless aspiration that has driven the development of numerous aesthetic procedures. Two treatments that have proven particularly successful are surgical facelifts and filler injections. But which option is used when? In this article, we take an expert look at the indications, characteristics and limitations of the two procedures.

Filler or facelift – which is better?

I hear this question again and again. The answer is: neither. There is no universal answer as to whether a surgical facelift or a filler injection is the better choice. Rather, it is a question of indication, age and the individual needs and goals of the patient.


When is a facelift the right choice?

Typical indications for a facelift are pronounced sagging skin and tissue in the cheek area, sagging skin in the chin area (double chin) as well as wrinkles and loss of elasticity in the neck.

Facelift indication


A facelift or neck lift provides relief by restoring previous facial proportions, improving the definition of the lower jawline and creating a harmonious overall appearance of the face and neck. SMAS lifting preserves the naturalness of your facial expressions and appearance.

However, the decision to have a facelift is also a question of age. Before the age of 40, tissue sagging is not usually so pronounced that surgery is necessary. Minimally invasive treatment methods such as laser, radiofrequency needling or injections offer a good alternative for younger patients.


The limits of the facelift:

Although a facelift reduces individual wrinkles by tightening them, it is not a wrinkle treatment but a surgical facelift. The facelift has no effect on skin quality. A facelift is therefore not the right measure for isolated wrinkle correction without pronounced tissue sagging. Injections or laser treatments are used to remove wrinkles. Phenol peeling for deep wrinkles.


Facelift facts


Operation duration:
2-4 hours

Local anesthesia with or without twilight sleep

Hospital stay:
1-2 nights

Follow-up treatment:
Cooling, lymphatic drainage

Socially acceptable:
After 8-14 days

Rare complications:
Post-operative bleeding (in the first few hours after the operation), visible, reddened scars, swelling or induration


Surgical result of a facelift:

Facelift result

This patient underwent a facelift and phenol peeling of the mouth region.


When is a filler injection indicated?

In contrast to a facelift, filler injections are a non-surgical procedure aimed at compensating for volume loss in the face and smoothing wrinkles. Typical indications for filler injections are loss of volume in the cheeks, nasolabial folds, marionette lines, fine lines around the mouth and eyes and transverse wrinkles on the neck.


Filler indication


The limits of filler injections

Although filler injections are an effective method for improving facial volume and smoothing wrinkles, they also have their limitations. Hyaluronic fillers cannot remove sagging or excess skin or tissue. They therefore do not lead to significant skin tightening and are virtually ineffective in lifting sagging areas of the face. In addition, fillers are temporary and require regular touch-ups to maintain the results.


Incorrect application of fillers can lead to puffy cheeks that lack natural definition, impaired facial expression due to tissue rigidity and unaesthetic, distorted facial proportions.


Hyaluron filler facts


Treatment duration:
Approx. 30 minutes

Shelf life:
Approx. 12 to 18 months

Socially acceptable:
Immediately or, in rare cases, if swelling or discoloration occurs, after about 12 hours

Rare complications:
Visible and noticeable irregularities that do not disappear on their own may require a limited correction. In very rare cases, pronounced swelling and discoloration may persist for about two weeks.


Can a facelift be combined with fillers?

Yes, by combining a facelift with filler injections, the benefits of both procedures can be utilized to achieve a comprehensive and natural-looking result.

While a facelift is used to lift sagging areas of the face, define the jawline and rejuvenate the neck, filler injections complement the rejuvenating effect with targeted wrinkle correction and, if necessary, volume enhancement.