When is a Face Lift the Best Choice?

At what age is a face lift appropriate?

Doctor Answers 76

Facelift surgery involves restoration and tightening of...

Facelift surgery involves restoration and tightening of the underlying facial fascial system (often referred to as SMAS) with excision of excess skin and redraping of the skin/SMAS in an upward vector (i.e. - reverse the natural pull of gravity and aging).

Signs of fallen tissue may manifest as:

  • increasing or deepening of the nasolabial folds
  • marionette lines (corners of the mouth to chin region)
  • jowling
  • excess neck skin with less than ideal neck line, etc.

This is not to be confused with improving the actual quality of the skin itself, in terms of pigmentation (rosacea, brown spots, etc), fine wrinkles, texture, etc. It does not address the actual skin quality. This can be addressed via proper skin care and resurfacing (in the likes of laser or chemical). Furthermore, although an improvement may be seen, a complete reduction in nasolabial folds is not expected. Often times, during the initial phase of healing, fine wrinkles are significantly reduced, but often to the dissapointment of many patients, once the swelling settles, fine wrinkles resurface (as fine wrinkles are more inherent to the skin itself).

It is important to distinguish and understand the aforementioned limitations of facelift surgery. Facelift often implies necklift as well; however, it often does not include the brow/forehead lift. There are several variations of facelift surgery, all with various utilities, depending on the elements involved in the surgery. Classically, facelift mostly involved only the excision and tightening of the skin; however, many surgeons currently perform some degree of manipulation of the deeper structures (SMAS, etc). Ask your surgeon which technique is used.

There is also some minor variations for the incision patterns as well, which determines the the placement of the final scar. Some degree of lipocontouring may be performed as needed. In discussing facial rejuvenation surgery, be familiar with - i.e. ask about:

  • Facelift
  • Forehead lift/ Brow lift (Open, Endoscopic, Limited)
  • Blepharoplasty (Eyelid surgery - Upper and Lower)
  • Midface lift
  • Necklift
  • Facial implants (chin, cheek)
  • Resurfacing (mechanical, chemical, laser - invasive/noninvasive)
  • Role of fillers/botox/proper skin care

From the list above, one, multiple, or none may be applicable to your specific needs/desires. After a proper consultation, you should be clear as to why a certain recommendation was made and for what purpose. If you do not fully understand, then you are not ready and fully informed. Cosmetic surgery is an emotional topic, as we are addressing our appearance, often times reflecting our feelings for ourselves. Do not make an emotional decision, but be methodical and cautious in your approach. There have been many advancements in cosmetic surgery, but be sure to find out if it's right for you.


Corona Plastic Surgeon
5.0 out of 5 stars 26 reviews

Facelift surgery involves restoration and tightening of...

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Facelift surgery involves restoration and tightening of the underlying facial fascial system (often referred to as SMAS) with excision of excess skin and redraping of the skin/SMAS in an upward vector (i.e. - reverse the natural pull of gravity and aging).

Signs of fallen tissue may manifest as:

  • increasing or deepening of the nasolabial folds
  • marionette lines (corners of the mouth to chin region)
  • jowling
  • excess neck skin with less than ideal neck line, etc.

This is not to be confused with improving the actual quality of the skin itself, in terms of pigmentation (rosacea, brown spots, etc), fine wrinkles, texture, etc. It does not address the actual skin quality. This can be addressed via proper skin care and resurfacing (in the likes of laser or chemical). Furthermore, although an improvement may be seen, a complete reduction in nasolabial folds is not expected. Often times, during the initial phase of healing, fine wrinkles are significantly reduced, but often to the dissapointment of many patients, once the swelling settles, fine wrinkles resurface (as fine wrinkles are more inherent to the skin itself).

It is important to distinguish and understand the aforementioned limitations of facelift surgery. Facelift often implies necklift as well; however, it often does not include the brow/forehead lift. There are several variations of facelift surgery, all with various utilities, depending on the elements involved in the surgery. Classically, facelift mostly involved only the excision and tightening of the skin; however, many surgeons currently perform some degree of manipulation of the deeper structures (SMAS, etc). Ask your surgeon which technique is used.

There is also some minor variations for the incision patterns as well, which determines the the placement of the final scar. Some degree of lipocontouring may be performed as needed. In discussing facial rejuvenation surgery, be familiar with - i.e. ask about:

  • Facelift
  • Forehead lift/ Brow lift (Open, Endoscopic, Limited)
  • Blepharoplasty (Eyelid surgery - Upper and Lower)
  • Midface lift
  • Necklift
  • Facial implants (chin, cheek)
  • Resurfacing (mechanical, chemical, laser - invasive/noninvasive)
  • Role of fillers/botox/proper skin care

From the list above, one, multiple, or none may be applicable to your specific needs/desires. After a proper consultation, you should be clear as to why a certain recommendation was made and for what purpose. If you do not fully understand, then you are not ready and fully informed. Cosmetic surgery is an emotional topic, as we are addressing our appearance, often times reflecting our feelings for ourselves. Do not make an emotional decision, but be methodical and cautious in your approach. There have been many advancements in cosmetic surgery, but be sure to find out if it's right for you.


Corona Plastic Surgeon

Facelift timing

This is a wonderful time in aesthetics as we have tools available to address aging which were previously unavailable to us.
We recognize aging to be a combination of volume loss of the face, loss of elasticity of the skin and structural changes of the face. A true rejuvenation needs to address all of these issues. The process is a continuum which begins in the late 30's.
Where you fall in this continuum will dictate the best intervention for you.
Botox fillers and lasers are wonderful devices to address volume loss and changes of the skin. Some structural changes can be addressed with fillers as well such as restoring volume to the jawline adjacent to the chin which we call the prejowl.
However, once the jowl is present and laxity of the skin is seen in the neck a facelift is the only recourse to reposition the tissue and address the excess skin.
This is a quick over view and I would encourage you to seek out a board certified plastic surgeon to help you understand the best correctove action for you.
Good luck

Facelift timing

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This is a wonderful time in aesthetics as we have tools available to address aging which were previously unavailable to us.
We recognize aging to be a combination of volume loss of the face, loss of elasticity of the skin and structural changes of the face. A true rejuvenation needs to address all of these issues. The process is a continuum which begins in the late 30's.
Where you fall in this continuum will dictate the best intervention for you.
Botox fillers and lasers are wonderful devices to address volume loss and changes of the skin. Some structural changes can be addressed with fillers as well such as restoring volume to the jawline adjacent to the chin which we call the prejowl.
However, once the jowl is present and laxity of the skin is seen in the neck a facelift is the only recourse to reposition the tissue and address the excess skin.
This is a quick over view and I would encourage you to seek out a board certified plastic surgeon to help you understand the best correctove action for you.
Good luck

Facelift: When is it the Best Choice?

This question is frequently asked in my practice.

If performed properly and for a patient with the right indications, Facelift is a wonderful procedure. Surgical indications for Facelift are: jowls, plasma banding ("ropes" that fall down under the chin and extend toward the chest), facial and neck skin laxity, obliquity of the angle the neck makes with the chin. When a patient has these indications, and a desire to address them, there is no replacement for a Facelift. There is no filler, no peel, no laser, and no amount of Botox that, in good hands or bad, will effectively address these issues.

Ask your surgeon to show you pictures of work that he/ she has performed, find out about his/ her Anesthesia provider (I currently use a Board Certified Anesthesiologist). In addition, make sure that the facility in which you are having your procedure performed is accredited by AAAASF, AAAHC, ACHA, or JCAHO to ensure the consistency and safety of the environment in which you will have your surgery.

Facelift: When is it the Best Choice?

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This question is frequently asked in my practice.

If performed properly and for a patient with the right indications, Facelift is a wonderful procedure. Surgical indications for Facelift are: jowls, plasma banding ("ropes" that fall down under the chin and extend toward the chest), facial and neck skin laxity, obliquity of the angle the neck makes with the chin. When a patient has these indications, and a desire to address them, there is no replacement for a Facelift. There is no filler, no peel, no laser, and no amount of Botox that, in good hands or bad, will effectively address these issues.

Ask your surgeon to show you pictures of work that he/ she has performed, find out about his/ her Anesthesia provider (I currently use a Board Certified Anesthesiologist). In addition, make sure that the facility in which you are having your procedure performed is accredited by AAAASF, AAAHC, ACHA, or JCAHO to ensure the consistency and safety of the environment in which you will have your surgery.

What is the best age for a facelift?

Thank you for the great question! The answer, in my opinion, is "it depends." Each of us age differently -- some people have noticeable changes in their 20's, while others sail into the 40's and 50's.  A facelift is right for you when these three things are true: 1) you are mentally prepared -- and even excited -- to refresh your look, including going through the healing required; 2) you have the time to dedicate to proper healing and aren't trying to squeeze this into a weekend; and 3) it makes sense for you financially. In terms of the specific procedure(s) needed, this will depend on your anatomy.  Basically, a facelift is most successful at tightening the jawline, elevating or eliminating the bands in the neck, and reducing the fullness under the chin and in the jowl region.  Please see a few consults before deciding to move forward. A good relationship with your surgeon is essential!

What is the best age for a facelift?

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Thank you for the great question! The answer, in my opinion, is "it depends." Each of us age differently -- some people have noticeable changes in their 20's, while others sail into the 40's and 50's.  A facelift is right for you when these three things are true: 1) you are mentally prepared -- and even excited -- to refresh your look, including going through the healing required; 2) you have the time to dedicate to proper healing and aren't trying to squeeze this into a weekend; and 3) it makes sense for you financially. In terms of the specific procedure(s) needed, this will depend on your anatomy.  Basically, a facelift is most successful at tightening the jawline, elevating or eliminating the bands in the neck, and reducing the fullness under the chin and in the jowl region.  Please see a few consults before deciding to move forward. A good relationship with your surgeon is essential!

When you are tired of looking at yourself in the mirror

If you can look at yourself in the mirror every day and not pull and push on the wrinkles, the jowels or the "granny bands" in the neck then you are pretty well adjusted to growing old.  Very few of my facelift patients report that they don't mind lookiing in the mirror before surgery but afterwards it is so easy to llok at what they see in the mirror or the wondows or in their rear viwe mirrors...putting on makeup is a lot more fun again.

Mostly, you are ready for a facelift when it bothers you enough and the surgeon shows you how much change you will get from surgery that it just seems right.  There is no specific age to get a facelift.  As long as you are healthy enough for surgery and don't consume nicotine, the best time is when it bugs you.

When patients are done healing and come back a few weeks after the surgery the one thing they all say to me is "I love the way I look now."  They don't say, "I wish I had waited." or "I don't notice any difference."  That is because they were ready to take that step finally and it didn't depend on someone else telling them to do it.  They just made the decsion to jump in finally.

When you are tired of looking at yourself in the mirror

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If you can look at yourself in the mirror every day and not pull and push on the wrinkles, the jowels or the "granny bands" in the neck then you are pretty well adjusted to growing old.  Very few of my facelift patients report that they don't mind lookiing in the mirror before surgery but afterwards it is so easy to llok at what they see in the mirror or the wondows or in their rear viwe mirrors...putting on makeup is a lot more fun again.

Mostly, you are ready for a facelift when it bothers you enough and the surgeon shows you how much change you will get from surgery that it just seems right.  There is no specific age to get a facelift.  As long as you are healthy enough for surgery and don't consume nicotine, the best time is when it bugs you.

When patients are done healing and come back a few weeks after the surgery the one thing they all say to me is "I love the way I look now."  They don't say, "I wish I had waited." or "I don't notice any difference."  That is because they were ready to take that step finally and it didn't depend on someone else telling them to do it.  They just made the decsion to jump in finally.

Facelift to improve sagging in a patient, fillers and fat

Facelifting is used to remove excess skin that produces sagging.  It is extremely valuable when it is necessary and performed by a qualified caring surgeon.

Aging changes can be broken up into 3 classes:

1.)  Sagging skin- treated best in all cases with facelift.  There are only a couple of types of lifts that are used.  Your surgeon can explain what type is best for you.  The gold standard lift is a SMAS Imbrication Lift.

2.)  Volume loss- Beginning as early as 30, we start to show signs of atrophy or loss of the underlying fat, muscle and bone of the face.  Remember that fillers such as fat or hyaluronic acid can replace this.  We always want to strive for the youthful heart-shaped face.  That avoids a pulled or "operated" look.

3.)  Texture-  Sundamage produces fine wrinkles and irregular pigmentation.  Always use sunblock to prevent this as much as possible.  Chemical peels, abrasions, and lasers treat this issue nicely.

You may have issues with one or all of the above.  In all areas of medicine, making an accurate diagnosis is the key to developing a plan.  You should find success.

Best wishes,

Dr. Todd Hobgood

Facelift to improve sagging in a patient, fillers and fat

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Facelifting is used to remove excess skin that produces sagging.  It is extremely valuable when it is necessary and performed by a qualified caring surgeon.

Aging changes can be broken up into 3 classes:

1.)  Sagging skin- treated best in all cases with facelift.  There are only a couple of types of lifts that are used.  Your surgeon can explain what type is best for you.  The gold standard lift is a SMAS Imbrication Lift.

2.)  Volume loss- Beginning as early as 30, we start to show signs of atrophy or loss of the underlying fat, muscle and bone of the face.  Remember that fillers such as fat or hyaluronic acid can replace this.  We always want to strive for the youthful heart-shaped face.  That avoids a pulled or "operated" look.

3.)  Texture-  Sundamage produces fine wrinkles and irregular pigmentation.  Always use sunblock to prevent this as much as possible.  Chemical peels, abrasions, and lasers treat this issue nicely.

You may have issues with one or all of the above.  In all areas of medicine, making an accurate diagnosis is the key to developing a plan.  You should find success.

Best wishes,

Dr. Todd Hobgood

Am I a good candidate for face lift surgery?

Great question. depending on your age, severity of wrinkles or loose skin on face and neck area. If you're in your early 40's non-surgical lifts such as Botox or fillers are best choices. However people in their late 40's and older might be good candidates for mini face lift. People with sagging neck tissue and presence of neck bands may also require neck firming procedure in addition to their mini face lift.

Am I a good candidate for face lift surgery?

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Great question. depending on your age, severity of wrinkles or loose skin on face and neck area. If you're in your early 40's non-surgical lifts such as Botox or fillers are best choices. However people in their late 40's and older might be good candidates for mini face lift. People with sagging neck tissue and presence of neck bands may also require neck firming procedure in addition to their mini face lift.

It depends which area concerns you most and if it is the jowl and jaw line some facelift maybe appropriate treatment for you.

Facelifts essentially reverse the gravitational changes to the face which occurs with time.

They tighten the skin and elevate the tissue to its original position.

Traditional facelifts however, do not access other aspects of facial aging such as loss of volume in the lower part of the face, active lines caused by muscle contraction and the appearance of the skin.

Overall, it depends which area concerns you most and if it is the jowl and jaw line some facelift maybe appropriate treatment for you.

It depends which area concerns you most and if it is the jowl and jaw line some facelift maybe appropriate treatment for you.

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Facelifts essentially reverse the gravitational changes to the face which occurs with time.

They tighten the skin and elevate the tissue to its original position.

Traditional facelifts however, do not access other aspects of facial aging such as loss of volume in the lower part of the face, active lines caused by muscle contraction and the appearance of the skin.

Overall, it depends which area concerns you most and if it is the jowl and jaw line some facelift maybe appropriate treatment for you.

A Facelift is "worth it" when the benefits outweigh the risks

And that's a very personal assessment.  Technically, a facelift sharpens the jawline by elevating / smoothing the jowl, softening the nasolabial fold, smoothing the cheek skin, and defines the neck by removing fat and tightening skin and underlying muscles.  The direct risks of the procedure are related to the necessary incisions and resultant scars, the possible loss of facial skin (which is a greater risk with a history of smoking), and possible damage to the facial nerves.  It is the only procedure that addresses global aging of the lower face (cheek bones down to the collarbones).  All other less invasive types of procedures (neuromuscular agents, fillers, resurfacing) are temporizing measures that camouflage aging rather than reversing the changes.  It is wise to use some of these measures while their benefits outweigh their risks, but don't use them forever.  Eventually the side effects of the temporizing measures will cause some alterations in anatomy that will not be easily correctable by a facelift.  (For instance, performing multiple or deep facial peels will smooth the skin, but if there is underlying contour irregularities [such as jowls], these will be "starched" into the skin with the new collagen, and will be harder to re-drape naturally with a facelift.)  Consult with a plastic surgeon who performs all types of facial rejuvenation, and create a global plan for maintaining your youthful facial characteristics.

Dr.B

A Facelift is "worth it" when the benefits outweigh the risks

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And that's a very personal assessment.  Technically, a facelift sharpens the jawline by elevating / smoothing the jowl, softening the nasolabial fold, smoothing the cheek skin, and defines the neck by removing fat and tightening skin and underlying muscles.  The direct risks of the procedure are related to the necessary incisions and resultant scars, the possible loss of facial skin (which is a greater risk with a history of smoking), and possible damage to the facial nerves.  It is the only procedure that addresses global aging of the lower face (cheek bones down to the collarbones).  All other less invasive types of procedures (neuromuscular agents, fillers, resurfacing) are temporizing measures that camouflage aging rather than reversing the changes.  It is wise to use some of these measures while their benefits outweigh their risks, but don't use them forever.  Eventually the side effects of the temporizing measures will cause some alterations in anatomy that will not be easily correctable by a facelift.  (For instance, performing multiple or deep facial peels will smooth the skin, but if there is underlying contour irregularities [such as jowls], these will be "starched" into the skin with the new collagen, and will be harder to re-drape naturally with a facelift.)  Consult with a plastic surgeon who performs all types of facial rejuvenation, and create a global plan for maintaining your youthful facial characteristics.

Dr.B

How to Time a Facelift

Facelift surgery generally treats laxity of the skin of the cheeks and jawline, and loss of definition of one's neck and its timing depends upon many factors.  In those patients that have significant sun damage from early or continuous sun exposure, that have relatively less than pronounced cheekbones, and maintain a low body weight, facelift surgery often indicated in the early 40's.  Modern facelift surgery techniques should elevate the facial fat that descends with age, forming jowls and causing the hollowing of the eyes beneath the orbits.  Often these changes are more pronounced in the mid to late 40's and begin to be seen more rapidly in the 50's especially with the onset of menopause in women.  I personally perform facelifts in the late 30's into the late 70's and 80's if medically healthy with realistic expectations.  In Arizona, where I practice, we seem to see patients at an early age that desire the benefits of facelift surgery due to significant sun exposure, and a predominance of a relatively fair skinned population that like to stay thin, making them look more gaunt at an earlier age.  Facelift surgery is a generally very comfortable procedure with minimal pain and swelling, and depending upon what other procedures are performed (such a eyelid and browlift surgery) ranges between 3 to 5 hours.  I am associated with a spectacular recovery center where patients generally stay overnight and are discharged the following morning without dressings or drains.  All sutures are out by 10 days at which time most patients can comfortably start socializing.  
In those patients that require only a small amount of treatment for just cheek laxity, a minifacelift or "cheeklift" may be possible with much less cost and downtime, and this can usually be performed in an office setting. Other patients may benefit from fat transfer to the face to increase lost facial volume.  The best way to tell if you are ready is to seek the opinion of a Board Certified Plastic Surgeon.  Hope this helps.

How to Time a Facelift

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Facelift surgery generally treats laxity of the skin of the cheeks and jawline, and loss of definition of one's neck and its timing depends upon many factors.  In those patients that have significant sun damage from early or continuous sun exposure, that have relatively less than pronounced cheekbones, and maintain a low body weight, facelift surgery often indicated in the early 40's.  Modern facelift surgery techniques should elevate the facial fat that descends with age, forming jowls and causing the hollowing of the eyes beneath the orbits.  Often these changes are more pronounced in the mid to late 40's and begin to be seen more rapidly in the 50's especially with the onset of menopause in women.  I personally perform facelifts in the late 30's into the late 70's and 80's if medically healthy with realistic expectations.  In Arizona, where I practice, we seem to see patients at an early age that desire the benefits of facelift surgery due to significant sun exposure, and a predominance of a relatively fair skinned population that like to stay thin, making them look more gaunt at an earlier age.  Facelift surgery is a generally very comfortable procedure with minimal pain and swelling, and depending upon what other procedures are performed (such a eyelid and browlift surgery) ranges between 3 to 5 hours.  I am associated with a spectacular recovery center where patients generally stay overnight and are discharged the following morning without dressings or drains.  All sutures are out by 10 days at which time most patients can comfortably start socializing.  
In those patients that require only a small amount of treatment for just cheek laxity, a minifacelift or "cheeklift" may be possible with much less cost and downtime, and this can usually be performed in an office setting. Other patients may benefit from fat transfer to the face to increase lost facial volume.  The best way to tell if you are ready is to seek the opinion of a Board Certified Plastic Surgeon.  Hope this helps.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.