People are doing things somewhat earlier and the benefit there is if you're doing this somewhat lesser procedures in a younger, healthier patient, you're getting better results that lasts longer and you're doing somewhat less surgery. What I'm saying is a trend for people coming in a bit earlier and being a little more preemptive rather than waiting. The old business of waiting for a select birthday and then I'm going to do something on that stated age, a lot of people have figured out why am I waiting, that means I'm living with this problem. The other side of the coin is that I'm seeing people coming in much older also because people are living longer and healthier. And I got people in their 80's now who are very active, very healthy. Of course, in that age group, I want the regular doctor to do a medical clearance to make sure they're okay. I'm not playing Dr. Welby and knowing it all, but if they get medical clearance, I'm now finding that the age span has grown from younger to older which makes a bigger population.

If you want to keep it as simple and easy as possible, so in an age group in the 30s, typically you're going to be doing injectable fillers and things that are called neuromodulators to soften muscle action, and exclusive around the eyes. Younger people can get into trouble around the eyes because of heredity, so what I will see is that I will be doing more actual surgical procedures in a younger age group, but it's not face lifting, it's not neck lifting. It's typically very mild, minimal surgery around the eyes or there's a lot younger people that develop problems with their brow falling which makes them look sad and tired as opposed to old. There's not a lot of old-looking 30-somethings, but there can be some sad and tired looking 30-somethings.

In the younger people, if they are quite expressive, that does create a lot of lines and some of those lines are smile lines, that's fine. But a lot of people that are very expressive use their brow to reinforce what they're saying and as they're reacting and pushing more energy into that expression, then when they are at rest, you start seeing some of these lines which sort of say, "I'm not so happy." But they are happy people, so these expression lines do belie what's actually going on. But then there's the genetics of it. Family traits where some people, you look at everybody in the family and do they have bags under their eyes? Do they have droopy eyelids? Do they have a brow that's falling? And that can start quite early. I'll sometimes ask people, "Bring me your high school yearbook photo," and I'll show them, "You started with this a long, long time ago and it's just going to be progressively get worse." So preempting and going earlier in that age group gets you a result, solves the problem, and then because they are younger it gets them a long term result.

It's more fun to be around somebody expressive. I mean, the person that hardly shows any expression, you don't know what you're getting back. There's no feedback. So somebody who's very drawl and doesn't move their face, we don't know what they're thinking. Most of us like to talk to somebody that's throwing their face around. It's more exciting, it's more friendly and people that use their face a lot, you cannot put a switch up here and say, "Turn it off." It's just not the way it works, but there are little tricks of filling the lines or blocking the muscle movement that help. But you don't want to do too much of that because then you don't look normal and looking normal matters.

Should I Get a Mini Lift Earlier or a Facelift Later?

The question of whether to get something small sooner or something larger and more invasive later is completely up to you but Dr. Harold Kaplan extends his opinion on these conflicting thoughts.