VF Lift vs fillers for sagging:
lift or add volume?

VF Lift vs fillers: lift or add volume?

The VF Lift vs fillers question is really a question about what has happened to the face. With age, facial fat compartments deflate and slide downward and inward, and the tissue that held them loosens (Rohrich 2007). Most faces show both descent and some deflation. The proportion decides the plan.

The VF Lift – Vertical Facelift is Dr Sin Yong's protocol on Volnewmer 6.78 MHz monopolar radiofrequency, planned zone by zone along vertical vectors. It works on what is already there. The Lift mode is directed at loose tissue along the jaw, the nasolabial folds and under the chin. The Sculpt mode flattens areas that pouch. The Restore mode is customised to hollow areas and used to stimulate the patient's own fat to regenerate, over the temples, forehead, under the eyes, lateral cheeks and prejowl sulcus.

Fillers add something that was not there. Dermal fillers fall into two groups. Hyaluronic acid gels occupy space and hold water. Collagen stimulators, such as CaHA, PCL and PLLA, give some immediate volume or none, then prompt the body to lay down collagen around the product. Placed on bone or in a deep fat compartment, filler restores support. What it does not do is return descended tissue to where it was.

The VF Lift and filler types side by side

The table compares the VF Lift modes with the main filler types used for sagging and hollowing. The last column links to the page for each.

“Filler adds to the face. The VF Lift works with what is already there. For sagging, I start with lifting.”

Dr Sin YongOn lifting versus adding volume

Why filler for sagging can make a face heavier

Filler placed to correct sagging tends to go where the shadow is: into the nasolabial fold, beside the marionette line, under the jowl. Those are the places where descended tissue collects. Adding volume there adds weight to tissue that is already moving down, so the face looks fuller but not lifted.

The second problem is accumulation. Hyaluronic acid filler often stays far longer than people expect; an MRI review of 33 patients found it in the mid-face of every one, including people treated many years before (Master 2024). When each top-up goes on top of filler that has not gone, the total grows. The pattern of a puffy, rounded face with blurred contours is described as facial overfilled syndrome, and filler placed to chase lines, in the wrong plane or in growing amounts is among its causes (Lim 2024).

Lifting avoids both problems for a simple reason: nothing is added. There is no product to build up, move from where it was placed, or form a lump. What happens when filler has already been overdone is covered on pillow face treatment.

What the VF Lift and fillers each cannot do

The VF Lift – Vertical Facelift cannot

• build bone, such as projecting a short chin or a flat nose bridge;
• add volume on the day; any Restore response builds gradually and varies with age;
• remove redundant skin, which is referred to a plastic surgery specialist;
• be used with a pacemaker or other implanted electronic device.

Fillers cannot

• return descended tissue to where it was;
• tighten lax skin;
• be dissolved if they are CaHA, PCL or PLLA, which have no dissolving enzyme;
• remove the risk of a blocked blood vessel, which is a recognised complication of any filler injection.

Neither relaxes a muscle; lines made by movement are a question for botulinum toxin.

Moving from filler to the VF Lift: what happens to existing filler

Many people asking about the VF Lift have had filler before and want to stop topping up. The VF Lift does not remove filler, and existing product is dealt with on its own terms first.

1. Map it. Dr Sin Yong takes the full injectable history and uses ultrasound to see what is still there and in which layer.
2. Hyaluronic acid causing puffiness is dissolved first, selectively and in stages, with hyaluronidase.
3. Collagen-stimulator overfill, from CaHA, PCL or PLLA, goes to the Sculpting mode of Time Freeze Laser LCLR® before any heat is added, because it cannot be dissolved.
4. Recent filler or threads in the treatment plane are timed around rather than heated over.
5. Then lift and restore. Once the face has settled, the VF Lift is planned zone by zone, with Restore used where support is needed instead of more product.

The Restore mode is often part of the plan for people recovering from a filler problem, once that problem has been assessed and treated. The wider approach to lifting without adding volume is set out in face lifting without fillers.

When filler is still the right tool

Dr Sin Yong prefers energy-based treatment for almost every concern that injectables are used for, but filler still answers a few things that energy cannot. Where the missing structure is bone, such as a short or receding chin or the nose profile, he places filler with a fine needle on the bone, usually CaHA or PCL. A hollow that is mainly bony is not reached by the Restore mode, and filler or a biostimulator is then discussed. Lips have no lifting equivalent. In each case the amount is conservative and recorded, so the next doctor knows what is there. How threads compare with filler for sagging is covered in thread lift vs fillers.