How important is it to be at a weight prior to a facelift? Lost 20 lbs. Should I work on the additional 30 lbs first? (Photo)

Thanks for your question, and congratulations on your already amazing weight loss. Yes, I would say if you plan to lose another 30lbs then you should hold off on facelift surgery for now. Thirty pounds is enough weight loss to see a noticeable difference in the amount of excess skin you may see on the face (mainly because of the loss of fat). You want to get a long-lasting result, so get to a stable weight that you are comfortable with and can maintain. Best wishes.

Thank you for your question. You submitted a single photo of the side view of your face, asking about the importance of being at a certain weight before facelift. You state you’ve already lost 20 pounds, and you are intending to lose another 30 pounds.
I can  give you some perspective on how I evaluate people who ask me exactly this question in my practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. Facial aging is a very significant part of my practice, and I perform all types of face lifting surgery from minimally invasive, suture suspension, deep plane face lifting, facial implants, fat grafting etc. so I have a lot of experience with face lifting, so I can guide you on your question.
There are two elements of facial aging that factor into how I evaluate patients for facelift. One is volume loss, which is particularly significant in facial aging at the bone level, but also at the layer of fat under the skin. The second is the degree of sagging, especially for the skin under the neck, skin at the jawline, and cheek tissue. It is generally well appreciated by people over 40 that when you lose weight, you want to lose weight in other parts of your body like your stomach and your hips but concurrently, but you also tend to look like you lost a lot more weight proportionally in the face, which is a significant issue factored into face lifting surgery.
When I talk to patients about this particular topic, someone like yourself who intends to lose about 30 pounds, I tell them if they are within 10 pounds of their target body weight, then that’s a comfortable range for surgery. I feel I can very accurately perform repositioning, lifting procedures, and very often combine them with volume corrective procedures such as injectable fillers, fat grafting, and facial implants - all these things balance out the 2 elements of facial aging.
As someone who also performs body contouring, liposuction as well as non-surgical fat reduction with laser technology, I understand that in general, most people have a target objective for weight loss, but often they plateau at a certain point. If that plateau is somewhere within 10 lbs of your target weight, usually that is acceptable. You also want to think about how stable your weight will be, and if there are concerns about stability, you may want to wait a few months to see if you’re kind of holding steady at a certain level.
To summarize, if you plan on losing 30 pounds more, chances are it will manifest in the facial volume which impacts the surgical approach of repositioning, and restoring volume whether it is at the time of surgery or after surgery. Meet with qualified, experienced cosmetic surgeons who can guide you along the way. If you have 30 pounds you want to lose, a typical, safe estimate for weight loss is about 1 pound per week. You may want to also consider other procedures prior to weight loss so you can look your best, or perhaps do things in preparation for the face lifting procedure. I hope that was helpful, I wish you the best of luck, and thank you for your question.
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Yes, I would urge you to be very close to your goal weight before undergoing a facelift. If you are actively continuing to lose weight, you'll want to reach a point of equilibrium before pursuing surgery. I say "equilibrium" because you want to be at a weight you can easily maintain. The main reason: It's difficult to predict how the face responds to weight loss or gain. For some patients, the face remains essentially unchanged; for others, there are significant volume fluctuations in the face. This can make the results less predictable. Once you are at a comfortable weight that you can maintain, your surgeon will be able to give you a better idea of your expected outcome. Best of luck to you.