At what age should I consider a facelift?

When to transition to surgical solutions.

This is a very common question. The short answer is, a facelift is appropriate at the age where you would benefit by it anatomically and are ready for it emotionally. Think about your group of friends and let’s say they are all around the same age. Are you all aging at the same rate? Not likely. We age at different rates depending upon genetics, environment, and lifestyle. I have done facelifts on women in their 40’s and advised others in their 60’s to wait, so there is no specific age at which the clock chimes and surgical intervention is imperative.

Difference between Surgical and Non-Surgical Treatments - The most misunderstood aspect of facial enhancement is the differences between surgical and non-surgical intervention—what they can and cannot accomplish. The advent of minimally invasive anti-aging technology has added a new dimension to facial rejuvenation. Skin tightening through radiofrequency or ultrasound, when used appropriately, can improve appearance and postpone surgery. Some are quite effective, and I recommend them depending upon the patient. However, ultimately these treatments cannot keep up with the pace of aging and become ineffective. Some patients are lured into a false sense of security with these innovations and are disappointed when their results diminish over time and that’s a problem. The limitations of current skin tightening technology is that is doesn’t affect underlying layers of skin, ligaments and muscle in as profound or permanent a way as surgery. In addition, the procedures that depend upon the body’s response to making collagen and elastin are inversely proportional to age, so the older you are, the weaker the response. In other words, those who need it most may realize the least improvement. Having said all that, there are new and improved methods on the horizon that look very promising, so stay tuned.      

The Role of Injectables - Another common misconception surrounds the role of injectables, or fillers. The term “liquid facelift” has been featured in many magazines leading people to believe it is an alternative to surgery. First, understand that as we age our skin sags. This is either because we are losing volume or because the skin and ligaments are loosening, or both. If the volume lost is mild to moderate, filler can “lift” the area to a certain extent, providing a more youthful contour and shape. But if the skin has loosened too much, filler will not be able to overcome the “sag.” In fact, overinflating will distort the appearance and contribute to the dreaded overdone and obvious look most people want to avoid. Fillers cannot counteract loose skin and when used inappropriately can actually stretch the skin you are trying to “lift.”       

When to transition to surgical solutions - Skin tightening treatments and fillers have revolutionized the world of cosmetic enhancement and certainly have earned their place “at the table.” But knowing when to transition from non-surgical procedures to surgery makes all the difference.  Postponing surgery beyond the capabilities of skin tightening procedures to improve underlying causes of aging can lead to lots of money spent toward diminishing gains. Fillers are a great tool for replacing volume but forcing fillers to counteract laxity and descent of tissue won’t improve appearance—it will accentuate the sag, calling negative attention to the very feature you intended to correct. Not everyone wants to have surgery and that is fine. But recognize the limitations of non-surgical treatments. They can be used to augment surgical facial rejuvenation, but none of them to date can take the place of surgery.   

While we can’t prevent aging by doing a facelift, I believe once you really need it and non-invasive treatments are getting less effective or appropriate, it is useful to consider surgery and I would say sooner rather than later. Your skin is more elastic, you will heal faster with shorter downtime and the whole result will last longer. Also, keep in mind that not all surgical alternatives are equally aggressive. Younger patients, or those with localized laxity in the jowl and neck area can greatly benefit from a “jowl lift” focusing exclusively on the neck and jawline.  A consultation is the best way to get educated on the latest in facial rejuvenation and a good start toward determining both timing and options for your specific needs.