A "really good" facelift should last . . .

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Any surgeon who tells you a specific number of years for how long a facelift "lasts" is lying to you at worst, or taking a blind guess at an answer at best. The age and genetics of the patient have as much to do with the "real answer" as the skill and experience of the surgeon. Both are equally important. Several examples may help understanding here.

Any facelift (assuming it is properly done on an appropriate candidate) will create improvement that will make the recipient look [younger, refreshed, less tired, more energetic, insert positive adjective of your choice] better. That lucky patient will still continue to age, but with the presence of a layer of invisible scar tissue beneath the skin (and hopefully, skillfully-placed, well-hidden, and precisely-sutured facelift incision scars) that will slow and reduce the inevitable continued loss of elasticity and collagen content in the skin as she ages. In other words, this patient will age less rapidly than her imaginary clone or identical twin sister who did not undergo a facelift!

So let's do a facelift on a youthful-appearing, genetically-blessed woman in her late 40's who is just beginning to show signs of aging. A skillfully-performed facelift will rejuvenate her appearance, but the results will not be as dramatic as a facelift on a same-age woman who, for example, gained weight, lost weight, had unfortunate genetics, experienced too much sun or tobacco exposure, and as a result of all of this, looks pretty haggard with loose and sagging jowls, wrinkles, rough and damaged skin, etc. The latter patient will have a more remarkable improvement, BUT will likely continue to "age" more rapidly than our first example, and will need revision or touch-up or "another" facelift sooner. And, of course, the degree of fastidiousness of the patient and the degree to which their appearance "bothers them" is a huge factor on just how much laxity, wrinkling, and sagging is "enough" to warrant the first or subsequent trip to the plastic surgeon!

Another example might be similar to a personal one: I had the opportunity to perform a facelift, forehead lift, upper and lower eyelid lifts, and necklift on my mother-in-law 17 years ago when she was 74. This delightful, dear lady recently passed away at age 91, and she looked younger than her actual age all through those 17 years. But her dramatic improvements at age 74 would have been less, yet much better if she had undergone the procedure in her 50s (I was in college then). She only underwent that one operation, and never asked to have her appearance "frozen in time" by more and more surgery (though she could have!) as some Hollywood actresses have been known to do.

"Stopping the clock" requires repeat operations on tissues that are progressively more aged, and the degree of improvement diminishes with time and age as well. This is what gave rise to the "urban legend" that "Once you have your first facelift, then you have to keep having them over and over to look good!" That is true only if you are trying (usually unsuccessfully) to "stop the aging clock" and "always look" a certain age.

I have patients for whom I have performed facelift surgery 15 years ago that still look fabulous and bring in their friends. Unfortunately, some of the friends don't have the genetics of my "great result" patients, and after their facelifts they merely look good, and will continue to age less "well" than their genetically-blessed friends who have had the same exact operations! I have other patients for whom I have performed every bit as good an operation, but who have poor genetics, smoking history, too much sun exposure for too many years, and their facelifts "last only a few years" before they would benefit from more surgery. They still look better than if they had never had surgery, but they just don't do as well as those who have better genetics, better habits, less sun and tobacco exposure, or earlier surgery.

You are "ready" for a facelift when your appearance bothers you enough to spend the time, money, and recovery to have the degree of improvement an honest plastic surgeon tells you is possible--NOT what you want to hear, but what is realistic and honest. A well-performed SMAS facelift with properly-placed incisions will give you better results than any kind of "mini-lift", thread lift, "Lifestyle lift" or anything that sounds as if it was named by a marketer or advertising MAD man.

Get advice from several ABPS-certified plastic surgeons who have years of facelift experience, and beware "bogus-boarded" cosmetic surgeons who may be board-certified in specialties that have little or no training in plastic surgery. Best wishes! Dr. Tholen
Article by
Minneapolis Plastic Surgeon