In his 1997 book The Youth Corridor, plastic surgeon Dr. Gerald Imber advises readers to avoid the sun, exercise, judiciously treat the skin with lasers, and adhere to a nutritious diet. He also boldly proposes facelifts as a form of aging prevention for 30-year-olds wanting their looks to remain essentially unchanged for decades. Once deemed a controversial viewpoint, a quarter of a century later, it looks like Dr. Imber may have been onto something.
According to the American Society of Plastic Surgeons’ latest statistics report, patients ages 30–39 underwent a total of 2.1 million cosmetic procedures in 2020. Of these, 364,000 were surgical, with a small but growing number of millennials now opting to undergo facelifts instead of (or alongside) noninvasive treatments. Although the procedure was once believed to be most appropriate for people in their 50s and 60s, today the surgery is increasing in popularity with patients in their 40s and even 30s.
Why more millennials are seeking facelifts
As millennials begin to notice the first signs of aging, coupled with the rise of widespread social media use (arguably creating an intense preoccupation with appearance), it’s evident why Dr. Imber’s recommendation has found favor with this demographic. Although some have theorized that this trend has emerged due to the prevalence of WFH culture (giving people the ability to recover at home more discreetly), some plastic surgeons believe that this phenomenon will continue to gain momentum for the foreseeable future.
Board-certified New York City facial plastic surgeon Dr. Konstantin Vasyukevich has noticed the shift in his practice, with approximately a quarter of his facelift patients in their 30s. “Thirtysomethings are probably the most social media savvy and internet-educated group [of cosmetic surgery patients]. They base their decisions on objective criteria—they look at [all] the possible options for facial rejuvenation,” he says.
Despite the notion that the 30s may be too young for such an invasive procedure, Dr. Vasyukevich explains that a small but substantial part of this population could benefit from the surgery, because this is the decade when many people begin to notice early skin laxity. “It may not be [overtly] apparent yet, since that loose skin and soft tissue are still draped [on the bony structures of the face] pretty well,” he says. Still, even if the more classic signs of facial aging like jowl formation, deep nasolabial folds, and marionette lines aren’t evident, having at least one centimeter of pinchable lax skin in the lower face or neck technically makes someone a candidate for a facelift.
Perceptions about when and why to have a facelift have changed. This is yet another reason millennials seek out plastic surgery, including facelifts, as part of their self-care, explains Dr. Sarmela Sunder, a board-certified facial plastic surgeon in Beverly Hills, California. “In the past, people waited until they needed a facelift to lift up and remove a significant excess of skin,” she says. “Now people recognize that a conservative facelift or mini lift can be performed as a maintenance procedure at the first sign of noticing some laxity.” Rather than waiting for their skin to droop and wrinkles to deepen, many millennials are choosing to undergo facelifts as a preventive measure, to continue looking like themselves.
When nonsurgicals alone fail to deliver
These patients and their doctors are also beginning to recognize the shortcomings of noninvasive fixes, like devices, fillers, and threads, for the aging face. Certain doctors find noninvasive tightening procedures to be largely ineffective. What’s more, some of “these treatments can make future facelifting more difficult, because they can create scar tissue under the surface of the skin when done aggressively,” says Dr. Barry M. Weintraub, a board-certified plastic surgeon in New York City. “I caution patients to be very selective in seeking their providers and treatments and to remember that noninvasives fix wrinkles—only surgery can fix folds.”
Many younger clients are also put off by the telltale signs of too much filler, which can distort the features or inhibit normal facial expression. This appearance, nicknamed “pillow face,” gives a doughy, unnatural, and bloated appearance to the skin. These noninvasive procedures promise to lift the skin when, in actuality, they may volumize the face or give the illusion of a lift, with little to no actual lifting involved. Unlike older patients, most thirtysomethings do not need additional volume to rejuvenate the face. Instead, they would benefit from some lift.
Although noninvasive procedures may help patients stave off surgery for a time—until they’re perhaps more financially and emotionally prepared for it—Dr. Vasyukevich points out that these rejuvenation techniques have very limited longevity. The short-lived results of PDO threads, for instance, coupled with the high cost, may be driving patients to more permanent fixes. “Threads can provide a fantastic result, but the longevity of the thread lift is limited. It would not be uncommon to hear people say the results last no more than six months,” says Dr. Vasyukevich.
Still, he believes that there is a time and a place for these nonsurgical tweaks, to help people look refreshed. They’re also a good option for people satisfied with a subtle improvement and who wish to avoid surgery altogether.
Overall though, patients are embracing a more reasonable aesthetic for facial surgery. “A lot of people, especially those in their 30s, are trying to be proactive rather than reactive about their appearance. While five years ago, many women in their 30s were rushing to put a lot of fillers in their faces, [today] there is more of a trend toward natural enhancements,” says Dr. Sunder.
Marrying facelifts with noninvasive treatments
And sometimes the most authentic-looking effects are born of a combination approach—which is a truth more millennials have come to embrace. “While surgery is the definitive treatment and the results last much longer than a nonsurgical intervention,” says Dr. Sunder, it’s vital for patients to understand that a facelift should be part of a comprehensive treatment plan to prevent and combat signs of aging. “It is not filler versus surgery versus a laser,” adds Dr. Sunder. “These are complementary treatments, each addressing a different aspect of aging. Surgery treats laxity, fillers address volume loss, and lasers treat texture and pigmentation.”
“Once patients start developing those early aging signs [in their 30s to 40s], we want to [essentially] freeze the face for the next 10 to 15 years,” says Dr. Vasyukevich. While it’s difficult to predict how long a facelift result will last, a patient’s genetics, environment, lifestyle, and post-procedure maintenance will all affect the longevity of this surgery, explains Dr. Sunder. Even more influential is the type of lift one gets, with less invasive techniques tending to deliver less durable outcomes (think five years versus 15 years). Therefore, someone who gets a facelift at 30 may, at some point, need or desire a second.
The bottom line
“The facelift is not for everybody—there has to be some laxity for a facelift to work,” explains Dr. Vasyukevich. Moreover, “there is no specific age we say is a good age for a facelift…it all depends on multiple factors. The youngest patients I’ve performed this surgery on were 28 or 29. Typically, those people had some other reason beyond just facial aging, such as extensive weight loss or [previous] procedures that reduced facial volume, like buccal fat removal or shaving [down] the angles of the mandible,” he says.
Understanding what makes someone a good candidate for a facelift will help patients in their 30s and beyond assess the next steps in their plastic surgery journey. While not every thirtysomething should seek out this procedure, prospective patients must understand that they have surgical options that need not be viewed as unreasonable or inappropriate. “Getting a facelift is a matter of choice. Not everyone needs a facelift, and not everybody will benefit from one,” says Dr. Vasyukevich. “I’m really trying to educate people to make informed decisions about this procedure.”
