Most people don’t make the decision to get a facelift lightly. RealSelf members cite an average cost of around $15,000, with some doctors charging upwards of $100,000, so a facelift represents a substantial financial commitment. Therefore, it is typically a once-, perhaps twice-in-a-lifetime occurrence, making the longevity of its results essential. “Depending on the technique, in the hands of an experienced surgeon, a deep plane facelift should last 10 or 15 years,” says Dr. Amir M. Karam, a board-certified plastic surgeon in San Diego.
Although a facelift can give you a rejuvenated appearance, no aesthetic procedure can permanently stop the aging process or combat external factors such as gravity and UV damage. While most of us are familiar with general postsurgical routines, such as giving your body time to recuperate before getting back to the gym, work, or driving, several less obvious elements could undermine your facelift’s success long after the initial healing phase.
When you think of the ideal youthful face of a woman in her 20s and early 30s, two things contribute to that image, explains Dr. Karam. There’s the youthful skin, which is mainly uniform in color and texture and devoid of lines that often appear due to sun exposure and aging, as well as the facial shape without deep-tissue sagging in the jawline and neck. Dr. Karam explains that these factors are parallel and independent: “The position of the soft tissue is an anatomic reality [and] correlates directly with the changes in estrogen right around perimenopause and menopause,” he says. So while we may be able to keep the skin looking youthful, Dr. Karam explains, very little can be done by patients to stop deep-tissue sagging—aside from choosing the appropriate surgeon and facelift technique to fit their aesthetic goals.
With all of this in mind, here are some things to take note of if you want to maintain the results of your facelift for as long as possible.
Lifestyle factors
This will come as a surprise to absolutely no one, but doctors say your daily life choices are going to play a role in how long your facelift lasts. From the cigarettes you smoke to the cocktails you sip and the hours you bask under the sun, each lifestyle decision will, over time, wreak havoc on your facelift. While all three habits—smoking, drinking, and tanning—are bad for the skin, each one damages the skin and, by extension, your facelift differently, explains Dr. Konstantin Vasyukevich, a double board-certified facial plastic surgeon in New York City.
“Tobacco smoke affects small blood vessels. And once you limit the supply of oxygen and nutrients to the skin cells, they cannot regenerate, which ages the skin. Alcohol consumption can cause dehydration, so people who drink alcohol, they go through these periods where the body is dehydrated, then they rehydrate, and on the skin level, it causes expansion and contraction,” he says. Constant cycles of this will cause the skin to contract, while sun exposure and UV light, in particular, will damage collagen and reduce the skin’s elasticity overall, he notes.
Stress
Many of us grapple with unwanted stress on a regular basis, and recent scientific studies suggest that this stress can accelerate skin aging, potentially affecting the longevity of facelift results. A 2020 review published in the Journal of the European Academy of Dermatology and Venereology found that “chronic stress appears to be an important factor in determining an individual’s vulnerability to aging and age-related comorbidities via epigenetic modifications.” This indicates that chronic stress affects skin aging on a molecular level, which could have implications for the longevity of a facelift. “Of course, stress and a poor lifestyle will have an impact on every aspect of our internal structures. It probably also impacts facial shape as well,” Dr. Karam explains. Although he hasn’t monitored the specific impact of stress on facelifts, Dr. Vasyukevich agrees based on anecdotal evidence.
Lack of exercise or too much exercise
A sedentary lifestyle and insufficient exercise might quietly undermine your facelift’s results. While the benefits of exercise on both the body and mind are common knowledge, it turns out that moving your body is vital to maintaining and extending the results of a facelift. As Dr. Vasuyukevich puts it, “Cardio is fantastic because we want to achieve a nice healthy blood flow to the skin.” With enhanced circulation, essential nutrients and oxygen are delivered to the skin, promoting better healing and skin quality. On the other hand, while engaging in regular cardiovascular exercise can be an effective strategy for maintaining the results of a facelift, it’s important to strike a balance, as excessive exercise or heavy weight training may undo the results of a facelift sooner. “For weightlifters, we tell them to use Botox to prevent the overuse of facial muscles and to make sure to keep the face and neck relaxed,” says Dr. Vasuyukevich.
Upkeep neglect
Unfortunately, a facelift isn’t a one-and-done solution that lasts forever. According to Dr. Vasyukevich, in-office procedures are necessary, to enhance and maintain your facelift’s results. “People want to protect their investment, so it’s worthwhile to do certain things to make sure the facelift lasts longer. [For example,] using Botox in certain areas, such as in the platysma muscle in the neck, could be very helpful. And then, of course, restoring the volume of your face with fillers or fat grafting is critical in maintaining your results,” he says.
Although a facelift will correct the soft-tissue positioning and sagging of the face, the face continues to lose volume as we age, so including other cosmetic treatments in your routine is vital. “What’s happening to the skin as time goes on is, you’re losing collagen and the thickness of the dermis decreases,” explains Dr. Karam. Adding neuromodulators, to decrease the pulling of the skin; laser treatments, to thicken the dermis; and judicious amounts of filler, to volumize the face all complement one another to address signs of facial aging that may detract from the results of a facelift.
Poor technique
While lifestyle adjustments and environmental protections contribute to the longevity of a facelift, we can’t overlook what is probably the most important factor: good work. Dr. Karam emphasizes the critical role of surgical technique, stating, “it’s totally dependent on the techniques that are employed and the ability of the surgeon to employ those techniques properly.”
Dr. Vasyukevich also warns against getting procedures too frequently: “Not so long ago, [some] people would do a facelift maybe every four or five years, which causes the skin to appear unhealthy [because it starts] losing elasticity. The scar tissue in the deeper layers of the skin increases, and healthy fat tissue goes away with every subsequent procedure.” While this may seem like an extreme example, Dr. Vasyukevich’s insights apply broadly: each facelift can reduce the skin’s ability to bounce back. He goes on to emphasize the importance of a skilled surgeon during the initial procedure. In the hands of a masterful surgeon and combined with strategically planned follow-up treatments, your facelift can retain its youthful appearance over the long haul. Patients should do their research and ask to see the results of other patients before committing to any specific technique or surgeon, advises Dr. Karam.
