The reasons for sagging of the face are known collectively as volume loss includes the loss of skin tissue and thinning on the facial bone structure. This problem can be solved using a simple relatively less painful procedure.


When both doctors and patients think of solving the sagging facial skin problem the first solution that comes to find is to pull or tighten the skin to create a facial lift. This can be done through surgery or facial thread lift. But these solutions do not treat the actual cause of the problem. This is especially ineffective when using machines such as lasers, radio waves or ultrasound in treating the problem. These techniques can only impact the skin level and under shallow layer known as SMAS, which is considered too shallow. In addition, this SMAS layer of the skin is quite sticky thus it cannot be stimulated to become firm or create new tissue. However, it is an affective layer for surgery because it is quite strong and less elastic than the other layers of the skin. As a consequence the result of the surgery is quite long lasting. The use of facial thread lift with cogged or barbed textures are only skin deep. Over time the skin stretches and the results of the treatment fades away. The use of fine threads is more effective because they stimulate the growth of skin. Over time the skin is expected to become firmer. However, none of these solutions target the actual cause of the problem, volume loss. Surgery may seem like the longest lasting solution but the results are unnatural because it changes the facial proportions. In addition it fails to address the fundamental problem of the deepening of the face.

Demonstration of bone touching filler injection with blunt needle

The best solution is filler injection that targets the appropriate area of the face. This must be done after a facial analysis is completed on the mid face and lower face area. These areas are usually the first to show signs of aging because they have the most movement. Thus solving the problem must start by targeting these areas. 

The Butterfly Lift Technique

The Butterfly Lift Technique is an alternative solution for doctors and patients for facial lift and facial contouring. This alternative is simple and less painful therefore reducing the recovery time for patients.

Injection points on the malar bone, Zygomatic Arch, and canine fossa

1. Inject the filler right on the Malar Bone. This will result in a lift of the cheekbones and solve the deepening of the hollow under the eyes. 

2. Inject the filler right on the Zygomatic Arch in a butterfly wing pattern. This will help to lift the side of the cheeks. 
3. Inject the filler right on the Canine Fossa or the line along the side of the nose. This is not designed to solve the deepening lines on the face but to provide a support for injection point 1 allowing it to lift the cheek more effectively. 
4. Inject the filler along the side of the mouth and chin. These injections need not be deep because they are designed to uplift the mouth. 
5. Inject the filler in the chin as the anchoring point.

  • Use the filler to fill the areas of volume loss of the skin and bones
  • Use filler to create lift and a firmer skin
  • Use filler to support and anchor
  • Use filler for facial contouring

The Butterfly Lift Technique uses 3 – 4 syringes of filler. If done well the results of a firmer and more contoured face will be seen immediately. Older techniques yielded the opposite result even if the blunt tipped needles are used. The result is patients feel that their face is more bloated especially in the mid face area. 

Words of Warning and Side Effects

1. The Butterfly Lift technique can only be done using blunt tipped needles. This is because deep layers of the skin need to be targeted. This might result in the danger of hitting a blood vessel. In addition, the blunt tipped needle allows for better flow and better distribution of the filler resulting in a more even and smooth effect. 
2. The selection of the appropriate filler is also critical to success of the procedure. Some fillers absorb too much moisture and would result in a bloated appearance. It is important to choose the fillers that are safe. These are the Non-Animal Stabilized Hyaluronic Acid (NASHA) fillers. Also the fillers should be Large-particle homogeneous HA gel so that it would provide better support for a longer lasting effect. 
3. There are very few cases of bruising. Usually it is caused from the injection of anesthetics. The Butterfly Technique does not cause bruising thus the patient does not need recovery time. 

Butterfly lift injection diagram


The solution of sagging facial skin should start by targeting the fundamental problem of volume loss in skin and facial bones. The Butterfly Lift Technique is a simple, safe and effective technique to solve these fundamental problems. Any doctor, who is trained in the procedure, can use this technique. Long years of experience in using fillers are not necessary. Many doctors have been trained in this technique in the hope of bringing innovation to Thai beauty aesthetics medicine and for the benefit of patients. It is imperative that patients can trust and be confident that they are being treated in the hands of a well-trained medical professional. Patients no longer have to risk surgery or other techniques that do not work risking losing their money and getting unwanted side effects.