Filler lifting is closer to a treatment that restores hollow areas and weakened support points so the facial line looks less saggy, rather than a treatment that physically pulls the skin upward.

 

In other words, filler does not pull the skin like a thread lift. However, when areas of volume loss and weakened facial support are corrected appropriately, the overall impression can look more refined, and the lower face may appear less heavy.

The most important point in filler lifting is “where to restore volume.”

 

If the face looks saggy, injecting filler only into the nasolabial folds or marionette lines can sometimes make the result look unnatural.

 

This is because nasolabial folds or sagging around the mouth are often not problems of that area alone. They can be affected by midface volume loss, reduced anterior cheek support, temple and cheek hollowing, jawline structure, and decreased skin elasticity.

 

Simply put, the face is connected like one piece of fabric.

 

If the corners of the mouth look droopy and we only fill the area around the mouth, the line may temporarily look softer, but the face can also appear heavier or the filler may look clumped.

 

On the other hand, if the midface and lateral support points are restored appropriately, the center of the face can look slightly lifted, even though the skin has not been physically pulled, and the area around the mouth may look less hollow.

 

That is why filler lifting should be understood not simply as a treatment that fills wrinkles, but as a treatment that evaluates both hollow areas and facial support points together.

 

Filler lifting is a volume treatment, but the key is structure

Filler is basically a treatment that restores volume.

 

However, in filler lifting, “structure” is more important than “volume.”

 

For example, if the anterior cheek and lateral cheek in the midface are hollow, the center of the face can look flat, and the nasolabial folds can appear deeper.

 

Also, when the support around the mouth becomes weaker, the marionette lines may become more noticeable, and the jawline may look less defined.

 

In this situation, what is needed is not simply adding a large amount of filler, but first identifying which part of the face has lost support.

 

The location and depth of filler injection, as well as the choice of product, should vary depending on whether the anterior cheek is lacking, the lateral cheek support is weak, the temple line is hollow, or the connection between the chin and jawline is insufficient.

 

In the attached photo, the main point of the change is not that the face suddenly became excessively plump.

 

Rather, the connection between the central face and lower face appears smoother, and the overall impression looks more refined.

 

To create this kind of result, it is important to design the treatment by looking at the balance of the entire face and placing filler only where it is needed, rather than simply filling along the hollow lines.

 

How has filler lifting been discussed in clinical research?

 

One study that can be referenced in relation to filler lifting is a 2022 paper by Di Gregorio and colleagues.

This study evaluated patients seeking midface treatment and applied a treatment algorithm using hyaluronic acid fillers by dividing treatment goals into volumizing, lifting, and contouring, while also considering the thickness of the skin and soft tissue.

 

The important point here is that filler treatment was not viewed simply as “filling a hollow area.”

 

The study considered that each patient may have a different goal.

 

Some patients may need volume restoration, some may need facial support and a lifting effect, and others may need more defined contouring.

 

In other words, filler lifting is not a treatment where the same product is injected into the same area in the same way. The product characteristics, injection location, and injection layer should differ depending on the patient’s facial condition and treatment goal.

 

This concept is very important in actual clinical practice.

 

If a filler that is too firm is injected superficially in someone with thin skin, the result may look uneven or unnatural.

 

On the other hand, if only a very soft filler is used in someone with thicker tissue and a need for structural support, the desired lifting effect may feel insufficient.

 

What kind of face may benefit from filler lifting?

 

There are several cases where filler lifting may be considered.

 

First, when the midface is hollow and the face looks long or tired.

When the volume of the anterior cheek or central cheek decreases, the center of the face can look sunken, and the nasolabial folds may become more noticeable.

 

Second, when the area around the mouth looks heavy.

 

If the marionette lines or the area below the mouth corners look hollow, the lower face may appear saggy. In this case, rather than filling only the mouth area, the surrounding support structure should also be assessed.

 

Third, when the jawline looks less defined.

 

The jawline is affected by fat, skin elasticity, bone structure, and volume loss. In some cases, filler alone may help, but in other cases, lifting devices, botulinum toxin, or treatments related to fat may need to be considered together.

 

Fourth, when the entire face looks flat and lacks dimension.

 

In this case, rather than filling only one area, the proportions of the temples, midface, chin, and jawline should be assessed together to create natural three-dimensionality.

 

Why can overfilling look unnatural?

 

The approach that should be avoided most in filler lifting is thinking, “The face looks saggy, so let’s inject a lot.”

 

Filler is a substance with volume, so if too much is injected, the face can naturally look larger.

 

Especially when too much filler is placed around the cheeks and mouth, the face may look heavy and round rather than lifted.

 

Also, if filler is injected too close to the surface, it may look like swelling or appear uneven from certain angles.

That is why filler lifting is not a treatment that fills strongly. It is a treatment that places the necessary amount only at the necessary points.

 

A simple analogy would be fixing a collapsed tent. You do not cover the entire fabric with thicker material. Instead, you find where the support poles have weakened and restore them.

 

Filler lifting works in a similar way.

 

Rather than filling the entire face, the goal is to find and restore hollow support points so the result looks natural.

 

How should we interpret the attached before-and-after photos?

Before / After: March 5, 2025

 

It would be too simple to look at this only as “the cheeks became fuller.”

 

In the after photo, the volume in the central face appears more balanced, the flow around the mouth looks less hollow than before, and the overall impression appears softer.

 

The balance of the lips and surrounding lines also looks more refined, so it is better to understand this as a change that considers the proportions of the entire face rather than a treatment limited to one isolated area.

 

In filler lifting, where not to inject is just as important as where to inject

 

Injection technique is important, but knowing where not to inject is also important.

 

For example, if someone already has enough cheek thickness and the central cheek is filled further, the face may look larger.

 

If there is a nasolabial fold and only the area directly under the fold is filled, the connection between the midface and mouth area may look unnatural.

 

If the jawline looks blurred and too much filler is placed along the entire jawline, the lower face may look wider instead.

 

That is why filler lifting is not a treatment that simply fills along a line. It is closer to finding the areas where facial support has weakened and restoring balance.

 

To summarize, filler lifting is not a pulling treatment. It is a design-based treatment

 

Filler lifting is not a treatment that pulls the skin upward like a thread.

 

It is closer to a treatment that is designed to restore hollow areas and weakened support points so the face looks less saggy and slightly more dimensional.

 

That is why the key is not “how many cc to inject.”

 

We first need to assess whether the midface is hollow, whether the mouth area looks heavy, whether the jawline has become blurred, and whether the connection between the temples and cheeks is lacking.

 

The firmness of the product, injection depth, injection location, and overall facial proportions should all be considered together to expect a natural-looking result.

 

As shown in the attached before-and-after photos, a good direction for filler lifting is not an overly plump appearance. It is a smoother and more refined facial flow.

 

In the end, filler lifting is not about simply choosing one good filler. The difference comes from accurately reading which areas of the face have become hollow or weakened, and restoring only what is needed :)

 

This was Director Won Dae-han.

 

Thank you for reading.

 

Source:
Di Gregorio C, et al. Individualized Treatment Algorithm Using Hyaluronic Acid Fillers for Lifting, Contouring and Volumizing the Midface.
Clinical, Cosmetic and Investigational Dermatology. 2022.