Decades ago, women would come for plastic surgery consultation in their 70’s looking for “TWT” – The Whole Thing! – including Browlift, Blepharoplasty, Face and Necklift, and Skin Resurfacing. Times have changed! Now women and men are appearing at younger ages looking to do gradual procedures and address focal areas as needed, moving onto the next area at a later time to get ahead of aging and achieve a less drastic, more refreshing transformation. As I tell my patients, this surgery should allow you to see the “You” you expect to see in the mirror, not a different person. How traumatic that would be!

Facelift is not just one procedure, but a spectrum of procedures designed for individualized treatment. Procedures range from tucks around the ear for jawline tightening under local anesthetic to more comprehensive face and neck lifts, possibly with fat transfer, to address a broad range of individuals pursuing facial rejuvenation.

Starting at the less dramatic end of the spectrum, jawline or temple lifts under local anesthesia are wonderful, subtle procedures to help tweak the signs of early aging. With hidden incisions around the ear or in the hairline, the jawline can be pulled more taut to treat jowls or the temple can be lifted and reduced to elevate the upper cheek to brow, indirectly improving the lower lid. These procedures are appropriate for individuals in their 40’s – maybe younger in weight loss patients with advanced aging – to beyond. I have a patient in her 70’s who has opted to do these local lifts serially rather than commit to a full facelift.

Women and men in their 40’s to 80’s (healthy 80’s) are candidates for comprehensive face and/or necklifts. Necklift incisions travel in creases around the ears and under the chin – well hidden and imperceptible-  with liposuction of neck fat and tightening of the neck skin and underlying muscles, treating sun damaged skin and neck bands and improving the angle between the neck and chin. This looks so much better in photos- youthful, thinner, more sculpted. Facelift includes incisions from around the ear up to the temples. Facelifts elevate deeper tissues – think of re-elevating the apple of the cheek – converting an inverted V to a V when perceiving the face and its parts. This does a great job of improving the appearance of the lower lid as the cheek merges back to the lower lid and makes it look less baggy and tired. I have seen with face and necklift that sun damage, old acne scars and generally aged appearance to the skin improves greatly secondary to the healing process of the surgery which recruits growth and healing factors. My patients often know exactly how much they hope to achieve with surgery and I meet their request.

Fat grafting to the face has become a wonderful primary rejuvenative procedure and adjunct to facelifting. Anatomically there are defined fat compartments in the superficial and deep facial tissues that deflate with age. Grafted fat from a remote body region like the abdomen can restore these compartments. The fat not only brings in volume but also a stem cell effect which magically improves skin quality. Fat transfer to the face is great for weight loss patients who age with weight reduction. It is also great for patients undergoing other surgical procedures who want to dip their toe in the pool and freshen their face without any major incision or recovery. Fat transfers from one body region to another and heals in, adopting its new home. It will remain in its new home forever and will grow or reduce with weight gain and loss.

So– the short answer to the best age for facelift? From the 30’s to the 80’s, as long as the individual is healthy for surgery. And facelift will not mean the same thing in all patients. If you have been considering facial and/or neck rejuvenation please give my office a call and schedule a consultation to see what your best options are.

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