Facelift for a 24year Old?

No matter what age, if a surgery has a high probability of making you look better than you would have without the surgery, for the rest of your life, -- and therefore make you feel better about yourself for the rest of your life -- then, in my opinion, it should be considered appropriate surgery. Beyond the surgeon offering surgery as an appropriate option, it should then be the adult's well-informed choice as to whether to have the surgery or not. However, some people have a self-perception disorder called "body dysmorphia syndrome" -- and unfortunately, some surgeons will do surgery on patients whether they believe the patient will actually look better or not. So what looks "better" can't be determined by either the patient or the patient's surgeon.

The surgeon has to be able to dissociate, as best he/she can, their clinical judgement as to what would be "best" for the patient, from his/her desire to do surgery and to profit from it. In other words, each surgeon has to wear a "clinician's hat" and a "surgeon's hat" -- and wear ONLY the clinician's hat when helping you decide on whether to have surgery or not. In this regard, the surgeon should try to get into the head of and therefore present the opinion of the hypothetical "average person". I personally imagine corralling 100 people off the street at random and imagine them seeing you as you look now and as you will look after the surgery. If I sincerely believe that over 90% of them would say that you look better with the "after" result, then I offer the procedure as an option -- again, no matter what age.

In considering the benefits of a facelift, it helps to place all your fingers in front of your ears and along your neck and push up and back. If it's obvious to you that you look better with this lifting maneuver, than a facelift just might be appropriate even at the age of 24. The main obstacle to you benefiting from a facelift in this situation is what your peers might think of you doing this relatively major procedure at such a young age -- something that may be a factor in your decision-making process or not.

Getting a facelift at 24 years of age would be unusual, but is more common then most people would think.   It would need to be a fairly signifcant laxity for most plastic surgeons to contemplate doing the procedure.  I have personally seen multiply people who have shed an extreme amount of weight who require significant correction of facial laxity.  Whether you  can achieve the results with Ultherapy, Exilis and or fillers.  Or do you truly need a mini face lift needs to be discussed with your surgeon.

Good luck, and thanks for the question.

Sincerely,

Anire Okpaku MD 

When I was a resident, I trained in Los Angeles and it was not unusual to see women coming in for a face lift consultation in their late 20's.  At that time, there were far fewer tools to address aging.  Now, fortunately there are a great many more things available to combat early aging.  My advice is to seek a consultation with an open mind.  Focus on what you are unhappy about rather than asking about a specific procedure.

   If you had massive weight loss, a facelift may not be unreasonable.  Kenneth Hughes, MD Los Angeles, CA

I have to agree with your other surgeons, and tell you that 24 years old is simply too young for any type of facelift.  The risk of scarring due to your elastic skin is greater than the improvement that is likely.

Brow lift surgery is appropriate for some young individuals who have inherited their low brow position which is unrelated to aging. We developed an irregular hairline incision to hide the incision within the hair and maintain or improve the hairline position. It is very unusual for a 24 year old to need a facelift, even after weight loss. Alternative, less invasive skin tightening procedures can improve the skin. Pictures are always helpful when evaluating people and discussing alternatives over the internet.   

It is concerning from my perspective that a surgeon recommended that you’d undergo a brow lift as brow lifting procedures are typically performed on people with significant facial aging changes. It would be a rare instance when a person of your age would be a candidate for brow lift surgery. In my practice I have performed eye lift surgery on people of your age and younger so it is not unusual to have someone their mid 20’s consider eye lift surgery. As far as the idea of having having a facelift of at your age in my experience as a surgeon for over 20 years I’ve never performed a face lifting procedure on someone in their mid 20’s.  I had used a facelift approach in order to remove materials that have been injected such as a silicone in people in your age group but that was more to treat a complication of a previous procedure rather than for the purpose of lifting sagging skin. It sounds like your concern is more about volume loss in the face which is probably best addressed with fillers such as Sculptra or Radiesse. In addition you may consider option such as facial fat transfer.

I'd have to see you in person to comment on any rejuvenative procedure, no two people age the same way, therefore there is no algorithm for treatment. I doubt that you'd need a facelift; most of the patients that I've performed facelifts on are at least 50 years old. Perhaps you should start with non-invasive procedures such as neuromodulators(Botox or Dysport), Injectable fillers( Restylane, Perlane, Radiesse, Fat, Juvederm), and ultherapy. If you could send some photos, I'd be happy to give my recommendation.

I get this sort of question all the time, usually on the other end of the scale- "am I too old for a facelift"?  But I see it on the younger side too, just not with patients in their 20's.  My response is always the same- there is no specific or definite age when a facelift is or is not appropriate.  The answer is "it depends."  No this is not a wishy-washy answer.  It reflects the fact that faces and circumstances are all individual, and require individual consideration.  With sudden or profound weight loss (for example, from chemotherapy or bariatric surgery), loss of facial fat and changes in the skin integrity can yield a face that is chronologically not age-appropriate.  Photos and a physical exam are absolutely necessary for an accurate recommendation, but I would expect your face to respond well to volume repletion (fat grafting, cheek implants, or Sculptra) without having to tighten/remove any draping loose skin.

Browlift and upper eyelid surgery are very commonly performed. Many young people have heavy upper eyelids and heavy brows at a young age. This it is likely that browlift and upper blepharoplasty could be helpful. It's impossible to say though without photos. On the other hand, it is unlikely that you need or would benefit from a facelift at 24 years old. Often a full face filler such as Sculptra to replace lost facial volume can provide a very natural appearance in younger patients without surgery. I hope this helps.

Stephen Weber MD, FACS