This article has been medically reviewed for accuracy by New York board-certified facial plastic surgeon, Dr. Dilip Madnani on September 9, 2020.
If there’s one guarantee in life, it’s that we’re all getting older. Neurotoxins, fillers and lasers can stave off the signs of aging for years, but sometimes those line smoothers and volume boosters just don’t turn back the clock as far as we’d like them to. And unfortunately, no number of pricey lotions or extensive skincare routines will erase the most telling sign of aging: sagging skin.
As we grow older, the skin slackens as fat and muscle underneath it breaks down. The result? Drooping cheeks, a sagging jawline, and the dreaded turkey neck. For many who experience this kind of facial laxity, surgery—specifically, a facelift—becomes an appealing option, and about 121,531 people chose this face-firming alternative in the United States in 2018.
For those interested in becoming one of the thousands of people who have undergone a facelift, it’s always recommended to consult with a board-certified plastic surgeon in order to definitively know whether you’re ready for this kind of cosmetic surgery. However, there are a few indicators you can look for on your own in order to determine if you’re a potential candidate for a facelift. Here, we tap three top doctors for the five signs that you may be ready to go under the knife and the four signs that you’re not.
You’re a good candidate for a facelift …
If you have sagging jowls
No surprise here, but the most significant sign that a facelift may be ideal for you is when skin along the jawline droops. “You can tell somebody is a good candidate for a facelift when they have loose and sagging skin around their neck and on the sides of their face,” explains Dr. John Tutela, a plastic surgeon in Livingston, New Jersey. “Sometimes this will obscure their jawline, and [the area] where the corners of their mouth meets their jaw often [sags].” This loose, hanging skin along the bottom of the mouth and jawline is a major complaint for most pre-operative facelift patients, and it’s corrected during surgery.
If your “neck bands” become prominent
If the thick bands running up and down your neck—called the platysma muscle—appear loose, are clearly visible and hang down drastically, surgery may be recommended. According to Dr. Tutela, seeing platysma muscles as one or two discrete bands along your neck as well as a loss in the sharpness between your jaw and neck is a sign that a facelift (often in conjunction with a neck lift) could be beneficial.
If you can smooth your skin by pulling back on it
We’ve all watched our grandmothers or mothers tug back the loose skin on their face to imitate a tighter, more youthful look. And now, if sagging skin plagues you, you may be doing it yourself. It turns out, this is actually a helpful way to tell if you would benefit from a facelift. “A good rule of thumb is to gently pull up and back on one’s skin with fingers placed right in front of one’s ears,” says Beverly Hills, California, plastic surgeon Dr. Sarmela Sunder. “If improvement in the jawline can be achieved with that maneuver, then the individual may be a good candidate for a facelift.”
It’s valuable to note, however, that even if the skin is sagging significantly, it’s important that your complexion itself is in good condition before heading in for a facelift. After all, it could make a big difference in the outcome of your surgery. “Patients who have significant sun damage don’t typically have great results with a facelift alone and would do better with the combination of a facelift and some sort of resurfacing procedure to address the sun damage,” says Dr. Sunder. Since sun damage can manifest itself in the form of fine lines, wrinkles and pigmentation, many patients with subpar-quality skin cannot address all their complexion’s needs with just a facelift on its own.
If you frequently need filler to maintain your look
If other methods, like injectables, just aren’t cutting it when it comes to the kind of youthful appearance you’re going for, you probably need to take your anti-aging routine to the next level. NYC facial plastic surgeon Dr. Matthew White claims that “[if] you need multiple syringes of fillers every six months to maintain [the desired] effect—which can be costly—or if you have tried other noninvasive treatments and they were not effective,” scheduling a facelift consult is advised.
There is also a point where fillers stop giving desired results. If you feel that fillers are not working anymore, you may have hit a critical point in the natural aging process where minimally invasive or non invasive options are no longer producing adequate rejuvenation.
If you pass the “ligament look-down” test
Ligaments, the connective tissues that build our face shape (as well as hold together our other body parts!), typically stretch and droop as we get older. To get an idea of how drastically your ligaments have stretched out, simply do the “ligament look-down” test. “[This] involves taking a photo of yourself looking down at your lap and comparing it to a picture taken from above,” says Dr. White. To do this at home, start by standing and bending at the waist. While in this position, take a selfie looking directly into your camera. Return upright and bend your head and neck backward, looking up to the sky, and take another photo of yourself. Compare the two photos: if they look the same, a facelift isn’t recommended. But if looking upward significantly changes your facial shape in comparison to when you’re looking down, then a facelift to tighten the appearance of the ligaments might be best.
You’re not a good candidate for a facelift…
If your main concern is aging around the eye area
The eye area is often one of the first places to show signs of aging, but a facelift is usually not the answer for correcting it. “Aging signs around the eyes are best [treated] with a blepharoplasty or laser around the eyes rather than a facelift,” says Dr. Sunder. A blepharoplasty tightens sagging skin around the upper or lower eyelid, usually by removing excess skin in the area. A facelift won’t have much of a dramatic effect on the eye area, since it’s typically more focused on the cheeks, jawline and neck. So make sure you pinpoint your aesthetic priorities—whether that’s fixing noticeable under-eye bags or slackened jowls—with your doctor during your consult.
If you’re not in good physical and emotional health
It can be easy to forget this as you scroll through endless before and after images of patients who have gotten successful facelifts, but a facelift is still an elective surgery—and a very invasive one at that. If you’re not in good health, you should not willingly put yourself at risk for a voluntary surgery such as this. Dr. White says that having a healthy diet, a regular exercise routine and no major medical issues is important for those looking to get a facelift, and Dr. Sunder agrees. “Patients who have other major medical conditions should generally not be considered for an elective procedure,” she says. “Patients with major bleeding disorders should not undergo a facelift surgery. I also generally do not operate on patients who are actively smoking or using nicotine products,” she adds. Smoking can contribute to poor wound healing, making post-surgery recovery harder than it should be. An unhealthy diet—one that excludes protein, vegetables and vitamins—can also inhibit wound healing and recovery.
Dr. White also asserts that an optimistic view on life and a good support network of friends and family is vital when undergoing a cosmetic procedure. Facelifts are considered major surgery, with around four weeks of recovery time needed before resuming normal activities. So make sure you’re healthy enough to undergo a medical procedure as invasive as this. Also remember to lock down an extensive recovery plan before you book your appointment. Having people—whether that’s friends or family—to help you recover, both physically and emotionally, is crucial for a successful healing process.
Realistic expectations are very important. Make sure you evaluate befores and afters of patient with similar face shapes and skin types in order to review what your expected results can be
Related: How a Tainted Wrinkle Cream Put One Woman Into a Coma
If the quality of your skin bothers you more than sagging skin
Unfortunately, facelifts are not intended to treat the tone or texture of the skin. “If your skin is already very tight and your issues are more fine lines and wrinkles, [your concerns] may be better addressed with aggressive skin care or laser resurfacing,” says Dr. Tutela. Facelifts address skin laxity only—they do not treat fine lines around the eyes or mouth, hyperpigmentation or hollow cheeks. So be very clear with your doctor about your skin concerns during your consult. After all, you may end up leaving with an entirely different anti-aging plan.
If you want a facelift for the wrong reasons
A facelift will fix sagging skin—and that’s it. Don’t look to surgery to be a “rescue” of sorts in your life. “[Surgery] won’t land you that job, win back a lost love or solve all your problems,” says Dr. White. Dr. Sunder agrees: “I do not operate on patients who do not have realistic expectations or [who] expect that their career prospects or romantic prospects will improve after surgery.” While a facelift can change you aesthetically, that’s pretty much all it can do. Patients shouldn’t expect it to change any other outside factors within their life.
