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One day, when the face looking back at you in the mirror doesn't look entirely familiar, the thought may cross your mind: Wouldn't a facelift be nice? And then you banish the thought. Yeah, right—that's for movie stars. The rest of us just have to age with grace. But even in Hollywood, the surgical facelift is beginning to become yesterday's blockbuster, as a new generation of anti-aging treatments called facial fillers is taking over. And with fast recovery times, great, though temporary, results, and prices within reach, facial fillers might be something for us mere mortals to consider.

"If a person has facial aging, in the past we always did a facelift, but often that was not the correct procedure. Especially if there is aging around the mouth. The incisions were just too far away to improve that area," says Dr. Peter Pacik, of the Plastic Surgery Center in Manchester, New Hampshire. "Facial fillers are very effective at targeting specific areas and restoring them by replacing the volume that is lost as we age."

Facial fillers include a variety of injectable substances, including first-generation options, like fat and collagen, and newer, more rffective solutions, like hyaluronic acid-based products such as Restylane, Juvederm, and Perlane, which was approved in June by the FDA.

The filler is often used in conjunction with Botox, and is injected into targeted areas to restore volume in wrinkles, deep lines, scars, and sunken areas. A local anesthetic is used to minimize pain. The patient may experience some redness and swelling, but is generally ready to face the world in a couple of days. Prices depend on the product used and the area treated, but, Pacik says, $500-$800 gets a patient significant results.
Are facial fillers the right solution for you? If excess skin is present, your surgeon may recommend a lift instead. But if a few of the following are your goals, fillers could be a great solution: smoothing out creases or furrows, filling in sunken cheeks, filling in scars or plumping lips.

"I think we'll see a tremendous increase in demand for facial fillers as people become aware of them. I'm already doing half the facelifts I used to do, because this is a more effective tool for many people, and much more within reach. There are so few risks and complications if used correctly, and the fillers break down in the body and disappear over time, which adds to the safety," says Pacik.

It's not a permanent fix. Fillers last three months to a year or more, depending on the product. But many people are more comfortable with a cautious approach to cosmetic surgery. "Sometimes, even when a patient looks great, they have trouble adjusting to their new appearance," he said. "It's as if you had long hair and suddenly went short—you'd spend weeks not knowing who you were looking at in the mirror." Pacik prefers to do small improvements over time, rather than dramatic, full-face procedures, to make sure patients adjust as smoothly psychologically as they do physically.

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