There's a question I hear almost every day in my office: "Doctor, what is the best treatment to rejuvenate the face?"And the truth is that The answer isn't a single treatment — it's the right combination..
Modern dermatology understands that facial aging occurs in several layers simultaneously: skin, collagen, deep support structures, and muscle expression. And each layer requires a different approach. Therefore, the Combined protocol of Liftera, biostimulator and Botox. It is the gold standard for non-surgical facial rejuvenation today.
I'll explain how these three treatments complement each other, in what order to do them, and why this is the strategy that delivers the most natural and lasting results.
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Table of Contents
Why combine Liftera, biostimulator, and Botox?
Because each one addresses a different layer of facial aging. O Liftera 2 It acts on the deeper layers of the skin and the SMAS, delivering structural lifting and firmness. biostimulator (Sculptra, Radiesse) replenishes lost collagen and restores density. botox It softens the dynamic lines of expression. Together, they form the most complete combined protocol in aesthetic dermatology: Deep firmness + structural reshaping + softening of expression linesThe result is natural, progressive, long-lasting, and respects the individual anatomy of the patient.
Why is a single treatment not enough?
Facial aging is a process multifactorialIt's not just the skin that changes — all the layers of the face transform over time.
- The skin It loses collagen, becomes thinner and less elastic.
- Facial fat It moves from the upper compartments to the lower ones.
- The ligaments that support the face loosen
- The bones They undergo subtle reabsorption, reducing structural support.
- The muscles of expression They accumulate dynamic brands over the years.
Hence, Treating only one layer is not enough.It would be like painting a wall without fixing the underlying structure. The result is partial and rarely delivers what the patient is truly seeking. a firm, rested and natural face.
The Liftera + biostimulator + botox combination treats multiple layers at once — which is why it works so well.
What does each treatment do to the face?
Let's understand everyone's role within the agreed protocol.
Liftera 2: deep support and lifting
O Liftera 2 It is a Korean microfocused ultrasound device for exclusive medical use. It acts on the deeper layers of the skin, including the... high school — the same layer that a plastic surgeon manipulates in a surgical facelift.
What he delivers:
- A real facelift, without surgery.
- Structural soundness from the inside out
- Facial contouring (jaw, jowls)
- Brow lift effect (Raises eyebrows, opens the eyes)
- Intense collagen stimulation progressive
With the new protocol Dash-Dot-DashThe technology has become even more precise, and results are visible from the very first sessions.
- Microfocused Ultrasound: Natural Lifting | See the Before and After! How Does it Work? | Click here!
Biostimulator: structural replacement of collagen.
Os injectable biostimulators (Sculptra, Radiesse, HarmonyCa) operate in collagen replacement which was naturally lost over time.
What they deliver:
- Increased skin density
- Structural volume replacement where the face emptied
- Firmness and skin quality progressively
- Lasting result (12 to 25 months, depending on the product)
- Absolute naturalness — it's your own collagen being produced
Biostimulators are the structural reinforcement which Liftera alone does not deliver.
Botox: smoothing expression lines
A Botulinum toxin treats dynamic wrinkles — those that appear with movement (forehead, glabella, crow's feet) — relaxing the responsible muscles.
What she delivers:
- Smoothing of dynamic wrinkles
- Prevention of deepening of static brands
- More relaxed expressionwithout a tired or angry face
- Subtle brow lift effect when applied correctly
- Natural resultmaintaining the patient's expression
Botox is the elegant finish of the combined protocol.
How do the three treatments complement each other?
Here's the beauty of the combination: Each one does what the other cannot do alone..
| Treatment | What are you doing | What can't he do alone? |
|---|---|---|
| Liftera 2 | Deep support + lifting | It does not treat dynamic wrinkles, nor does it replenish injectable collagen. |
| biostimulator | Collagen replacement + density | It does not act on the SMAS, it does not treat dynamic wrinkles. |
| Botox | Softening of expression | It does not treat sagging skin, nor does it restore structure. |
Together, they cover all the major layers of facial agingThe result is integrated, natural, and long-lasting rejuvenation—exactly what the patient truly wants.
In what order should the treatments be done?
The correct sequence is an essential part of the result. In my practice, I usually follow this order:
1. Detailed assessment first
Before any application, I do a thorough clinical evaluation To understand:
- What is the patient's main complaint?
- The degree of sagging and the quality of the skin.
- The individual anatomy of the face
- Objectives and expectations
- The budget available for the protocol.
Based on this assessment, I will determine which sequence makes the most sense for your case.
- Radiesse: what it is, benefits, before and after photos, and price | Click here!
- Sculptra: what it is, price, before and after photos, and alternatives | Click here!
2. Liftera 2 + Biostimulators comes first
I usually start with the Liftera 2 because he works structural basis of rejuvenation. Next, I'll move on to the biostimulator to replenish collagen and restore density.
Combining these two procedures in a single day can stimulate collagen production up to 7 times more..
- Microfocused Ultrasound: Natural Lifting | See the Before and After! How Does it Work? | Click here!
4. Botox as a finishing touch
Finally, the botox It is used to soften dynamic lines and provide a final touch of naturalness to the treatment. In some cases, Botox can be applied close to the Liftera treatment—always respecting safe intervals.
Important: the order is flexible.
This is a sequence ClassicalHowever, each case has its own particularities. In some patients, I may start with Botox for quick wrinkle relief, or prioritize biostimulators when there is significant volume loss. The correct order is the one that makes sense for your individual assessment.
When should the combined protocol begin?
There is no exact age, but in general:
- Starting from 30 years — Ideal phase to start, focusing on prevention (Liftera, baby botox, Profhilo). Biostimulators are added as needed.
- Between 35 and 45 years — phase in which the combined protocol delivers the most transformative result
- Starting from 45+ — phase in which all layers require robust treatment, with biostimulators in more consistent doses.
Patients who start the protocol early reach their 50s and 60s with significantly firmer and better preserved faces — is the concept of prejuvenation, preventive rejuvenation.
How long does it take to see the result?
Each treatment has its own timeline:
- BotoxIt starts working in 3 to 5 days, peaking in 10 to 15 days.
- Liftera 2Visible improvement starting after 30 days, with a peak between 3 and 6 months.
- biostimulatorProgressive results, peaking between 3 and 6 months.
In the combined protocol, the patient usually notices Subtle differences right from the first few weeks. (botox) and the full result consolidates over the first 6 months. From then on, it is maintained with annual maintenance or semi-annually, as the case may be.
How long does the result last?
The combined durability of the protocol is one of its greatest advantages:
- Liftera 2: 12 months or more
- biostimulator12 to 25 months, depending on the product.
- Botox: 4 to 6 months
Therefore, the protocol is usually... renewed in annual cycles...with occasional Botox touch-ups throughout the year. Patients who consistently follow the protocol usually observe a... significantly greater preservation of skin and contours than the average age.
Can I add other treatments to the protocol?
Yes, and in many cases this further enhances the result. Complementary treatments that are part of the personalized protocol:
- CoolPhase (Korean radiofrequency) — for surface firmness and skin density.
- Profhilo / skinboosters — for deep hydration and skin quality
- Fractional lasers — for texture, blemishes and surface rejuvenation
- Microneedling with active ingredients — for skin quality
- Strategic filling with hyaluronic acid — for specific, targeted areas
- Prescribed skincare — daily basis to support all results
Each combination is determined through individual assessment, within a personalized protocol.
Dr. Renata Ralha: specialist in combined protocols in Rio de Janeiro
Just like dermatologist, full member of the Brazilian Society of Dermatology (SBD), I attend at Renata Ralha Clinic (Rio de Janeiro) with:
- Medical care only, with detailed evaluation before each protocol
- Over 700 5-star reviews verified on Google
- More advanced technologies (Liftera 2 with new Dash-Dot-Dash protocol, CoolFase, premium biostimulators)
- Only original products. from recognized international brands (Galderma, Merz, Allergan, IBSA, Classys, Asterasys)
- Customized protocols — no pre-packaged deals, each plan is individually designed to respect your face shape, your goals, and your investment.
- Clear ethical stanceAligned with the guidelines of the Brazilian Society of Dermatology (SBD), the Brazilian Society of Plastic Surgery (SBCP), and the Federal Council of Medicine (CFM).
- Free aesthetic evaluation to build your combined protocol
Each patient leaves the office with a clear, realistic and personalized plan — focused on delivering the best facial rejuvenation results with absolute naturalness.
Conclusion
The combined protocol of Liftera, biostimulator and botox This represents the most comprehensive non-surgical facial rejuvenation available today. Each treatment is effective on its own—but together, they deliver a level of results that neither could achieve individually.
The key lies in the intelligent combination, the individual assessment, and the execution by experienced medical hands. It is this equation that delivers the results my patients seek: firmness, naturalness, a rested expression, and a face preserved for much longer.
Dr. Renata Ralha She is a clinical, aesthetic, and hair dermatologist. full member of the Brazilian Society of Dermatology (SBD), with complete training in Dermatology and Dermatological Surgery. Practices in Rio de Janeiro as A benchmark in combined facial rejuvenation protocols, Liftera 2 with Dash-Dot-Dash protocol, CoolFase and premium biostimulators.With personalized service and over 700 verified 5-star reviews on Google. CRM 52-84102-1 RJ | RQE 28115.
Dr. Renata Ralha, Clinical, Aesthetic and Hair Dermatologist, CRM: 52-84102-1 RJ, RQE No.: 28115
Dr. Renata Ralha She is a clinical, aesthetic, and hair dermatologist. full member of the Brazilian Society of Dermatology (SBD), with complete training in Dermatology and Dermatological Surgery. Practices in Rio de Janeiro as A benchmark in combined facial rejuvenation protocols, Liftera 2 with Dash-Dot-Dash protocol, CoolFase and premium biostimulators.With personalized service and over 700 verified 5-star reviews on Google. CRM 52-84102-1 RJ | RQE 28115.
Dr. Renata Ralha, Clinical, Aesthetic and Hair Dermatologist, CRM: 52-84102-1 RJ, RQE No.: 28115
It depends on the case. In some situations, yes — with proper medical planning. In others, I prefer to space them out to maximize the response to each treatment. The definition is always individual.
We usually allow a few weeks between the two treatments, depending on the skin's response and the personalized protocol. This interval optimizes the results of both treatments.
Yes, when done by experienced dermatologistUsing original products and administered in a doctor's office. Each treatment individually has a well-established safety profile, and the combination respects appropriate intervals and dosages.
Yes. Some patients prefer or have contraindications to Botox. In that case, Liftera + biostimulator They are already delivering significant results in terms of structural firmness and replacement.
Women and men from the age of 30 onwards who complain of sagging skin, loss of volume, expression lines, and a desire for natural rejuvenation. Each case is evaluated individually.
The result is supported by 12 to 18 months...with occasional maintenance throughout the year. Patients who consistently follow the protocol maintain firmness and contour for decades.
Na Renata Ralha ClinicProcedure performed personally by Dr. Renata Ralha, a board-certified dermatologist with the Brazilian Society of Dermatology (SBD), using premium technologies and products.
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