40, female - Timeline for facelift? (Photos)

Question

F/40/125lbs/Active Questions on when to consider a facelift? I am starting to notice changes in my overall skin tightness (laxity of neck, mild jowling) and haven’t really progressed aesthetically past botox-looking to see when a facelift is warranted or what would help best for these concerns.

Raffy Karamanoukian, MD, FACS · Answer

Unlike other tightening treatments, Ultherapy only requires a single treatment every one to two years and has long-term effects in skin stimulation and collagen production. Ultherapy is ideal for men and women who are experiencing mild to moderate skin laxity and desire a noticeable and long-term skin tightening treatment without the complications and risks of more invasive surgical procedures. Ultherapy can be combined with dermal fillers, Botox treatments, chemical peels, skin tightening lasers, and skin facials. Our plastic surgery and cosmetic center in Santa Monica offers Ultherapy as a complement to other skin treatments and cosmetic rejuvenation procedures.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Natalia Vidal Laureano, MD, FACS · Answer

Thank you for your question—this is a very common one.

At this stage, you appear to be a great candidate for non-surgical treatments like radiofrequency, Morpheus, or Sculptra. These can help tighten the skin and restore some volume with subtle, natural-looking results. Because you currently have only minimal sagging or jowling, a facelift would likely not provide a dramatic enough improvement to justify surgery and scars just yet. In a few years, when those changes become more noticeable, a facelift may be more worthwhile and impactful.

I hope this helps as you consider your options!

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

There is no precise timeline for considering a facelift intervention. It is primarily a matter of the degree of problems that you feel are visible and the degree of change that the surgery would be able to offer.

For a relatively good evaluation of the potential impact of a facelift, I would advise you to examine your appearance when you lie down completely flat and look in the mirror. This correlates relatively well with the impact of a facelift intervention.

If you feel that you would like to achieve these facial characteristics now, a facelift procedure is generally able to come very close, or sometimes even better than the appearance when you lie down. If you feel that there is a difference, but it is not sufficient to validate a facelift intervention at this point, it is preferable to continue with skin care and non-surgical treatments for the time being.

Pasha Mostofi, MD, DMD · Answer

Hi there. You’re asking a really good, and very common, question for someone in your early 40s. From what you’re describing and what I can see, you’re in that “in-between” phase: you have early looseness along the jawline and some neck laxity, but not heavy sagging. That’s exactly the stage where it’s worth being thoughtful about timing rather than rushing into surgery too soon.
A facelift is typically best when there is enough skin laxity and descent to meaningfully improve, think more defined jowls, loss of jawline, and visible neck banding. Right now, your changes look mild to early moderate. If you did a full facelift today, you’d likely get a nice result, but it might feel like a big step for a relatively subtle issue, and you’d be “starting the clock” earlier than necessary.
At your stage, many patients do very well with less invasive options to bridge the gap. Thoughtfully placed neurotoxin can soften downward pull, and treatments like skin tightening (RF or ultrasound-based) can help with early laxity. These won’t replace a facelift, but they can buy you several years while keeping things natural.
That said, if what’s bothering you is the early jowling and neck definition, and you want a more definitive, longer-lasting improvement, a mini-lift or early lower facelift is a very reasonable option in someone like you. Patients who choose surgery at this stage often love it because the results are subtle, refreshed, and age-appropriate rather than dramatic.
In practical terms, most patients with your degree of change start seriously considering a facelift somewhere between mid-40s to early 50s, but that varies based on anatomy and personal preference. There’s no “right age”, it’s more about when the changes bother you enough that smaller treatments aren’t cutting it.
A consult with a facial cosmetic surgeon can hopefully provide you with a conservative non-surgical plan for now versus an early, natural-looking lift. The right answer really comes down to how much improvement you’re hoping to see and how long you want it to last. Hope this helps!

Warren Schutte, MD · Answer

You are too early for a facelift. It is great that you are already getting botox. Incorporating collagen stimulating laser work into your routine should be your next priority.

Gary Motykie, MD · Answer

At 40, early signs like subtle neck laxity and the beginning of jowling are something I see with some regularity. What’s changed in recent years is that patients aren’t waiting for things to become severe — they’re coming in earlier, which I often describe as “setting the stage.”

Facial rejuvenation isn’t really about age, it’s about timing and anatomy. Non-surgical treatments can help maintain and camouflage early changes, but they don’t address the underlying structure. When someone is starting to notice these shifts and wants a more lasting, natural improvement, that’s when we start having the conversation about a conservative surgical approach.

When done at the right time, a facelift doesn’t look like a “facelift” — it just looks like a more refreshed version of you, and it tends to age more gracefully over time. The decision ultimately comes down to when non-surgical options stop giving you the level of improvement you’re looking for, which is why a proper in-person evaluation is key.

Gary M. Horndeski, MD · Answer

You are young for a facelift. I recommend an eccentric lip lift, not a bullhorn lip lift. This does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This takes 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Phuc Dinh, MD · Answer

At age 40, what you’re describing, early neck laxity and mild jowling, is very common, and this is often the stage where patients begin considering longer-term solutions beyond injectables.A facelift is not strictly about age, but about anatomy and progression of tissue laxity. In early stages like yours, less invasive treatments (such as skin tightening, energy devices, or fillers) can provide temporary improvement, but they do not reposition deeper tissues.If your goal is a natural, soft, and longer-lasting result, a conservative deep plane can be appropriate even at this stage. When performed early, results are often more subtle, very natural, and age gracefully over time.The key is not to wait until changes become advanced. Instead, the decision should be based on when non-surgical options no longer give you the result you want.A proper in-person assessment is essential to determine whether you would benefit more from continued non-surgical treatments or an early surgical approach.
Best regards,Dr.Phuc Dinh

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. You have excellent facial structure with beautiful cheek bones, smooth cheeks, a straight, smooth jawline, and minimal banding in your neck.  My recommendation would be to maximize non-invasive treatments of neuromodulators, fillers and skin resurfacing or tightening therapies.  These have either no or minimal downtime and can provide a refreshed look without resorting to surgery.  Once these treatments are not providing the result you seek, then a surgical solution may achieve that.  A detailed consultation with your plastic surgeon should help you understand what surgical option would be best for you at this time, should you decide on that route. Best wishes.

Michelle Zweifler, MD · Answer

The timing to have a facelift is a personal decision. With aging, we see skin laxity and jowling that can be addressed both surgically and non-surgically early on.  Facelift gives significantly longer lasting results than fillers or nonsurgical skin tightening like Sofwave.  Fat grafting helps restore lost facial volume and helps lift.  Even with a facelift, maintenance of the results is enhanced with skin treatments like peels and devices.
Some people opt for early surgery with subtle facial & neck changes, while others wait until conservative options no longer achieve theirdesired results.
As a plastic surgeon who has had a facelift and performs them, timing is truly up to the individual patient

40, female - Timeline for facelift? (Photos)

Answers (10)

More Facelift Questions

38, F, midface descent on profile - blepharoplasty or midface lift first? (Photos)

Conflicting options and opinions from consultations - which procedure will be the most beneficial at this time? (Photos)

Will a facelift help get me achieve a result similar to the second photo? (Photos)

Can over filled lips cause bad smile lines over time? (Photos)

26, female, sudden facial sagging. Is a facelift my only option? (Photos)

Will a facelift help my nasolabial folds and can my nose be fixed? (Photos)

WE SEND PRETTY
EMAILS