Facelift—Is It Time? 

A woman contemplating getting a facelift.

“How do I know when I should have a facelift?” is one of the most common questions I hear as a board-certified plastic surgeon. My patients also frequently ask questions such as, “What is the difference between a mini lift, a fast lift, and a liquid lift?” and “Who is the best surgeon to do it?” That’s not to mention the questions patients have about healing and recovery and all the rest that goes into a consultation for a facelift at my Columbus, Ohio, practice. 

The consultation for facial rejuvenation is probably the most complicated one of all because the spectrum of patients is so varied by age and the type of aging that has happened to that patient. On any given day I might have a consultation with a 50-year-old who was a  lifeguard—before we knew about sun protection—and also a 70-year-old who feels like a 50-year-old on the inside and “wants to look natural and better” but not “done!” And then I might see a male patient who is concerned about maintaining an edge at a competitive job followed by a Columbus, Ohio, boomer … you are not alone! 

What is the best age to have a facelift?

No textbook pinpoints an exact age when a facelift is allowed or appropriate. The unique qualities of each patient affect the answer to this question. But in general, these patients start to come to my office in their late 40s concerned about jowls and neck issues.

At this consultation, I often chuckle and ask if they have read the book by Nora Ephron I Feel Bad About My Neck. Ephron nails it, stating we don’t even think about our neck until this time and then seek a consultation from a plastic surgeon. (If you have a chance to read it, I think you will enjoy this book!)

My answer about the best age for a facelift depends on the individual patient. Sometimes the solution is to buy some time and delay the facelift. Other times, it is more advantageous to just go ahead with the surgery. This is a complicated question to answer and depends on each patient’s anatomy and history, And really, there is not a single best answer.  

When the cheek, jowls, and neck are all aging, and the patient has already done some other treatments like skin tightening with the Venus or fillers to lift the skin, it can be appropriate to move to surgery.   

Baby Steps and Making a Plan! 

Step 1: Skin Care

Often patients would like to develop a plan for their unique facial aging issues. We like to start with the basics, like getting them on the very best skincare products. We carry both Obagi and SkinMedica. Our aesthetician performs a skin analysis and helps guide the patient on how to best begin—and stay—on the skincare regime. These products maintain and improve the result of all the other aspects of the plan. When this part of the program is overlooked or skimped on, the results will show it.   

Step 2: Injectables

The next part of the plan is usually injectable fillers and BOTOX® Cosmetic. These are added while the skincare regime is getting started, and they’ll enhance the result of the surgical procedure. The best results for facial rejuvenation come with both lifting and filling. In fact, a “liquid” facelift using fillers and BOTOX receive a 100% Worth It rating on RealSelf.com.

If you look at a picture of yourself from 20 years ago—you see it! Our faces are rounded, and there are no gullies or deep crevices. As we age, the fat in our faces begins to shrink, giving us the gaunt, hollow look of aging. This is corrected with fillers, and the skin is further tightened with facelift surgery. The plan is to fill and lift and keep filling.

Typically, the comprehensive plan we outline for each patient includes all aspects, from skin care to injectables and then to surgery and a maintenance regime! Every so often a patient does not want to continue with the fillers, and that is their choice. But the clock keeps ticking, and the aging process continues, so ongoing maintenance is the best approach to your best outcome. 

Step 3: Surgery  

This step is made in consultation and discussion with me—the surgeon. As a professional, if I really feel that it is too early for a facelift, I will be honest and tell you.

Occasionally we have a patient who is feeling pressured for other reasons, too, and having the surgery will not improve these aspects—so this is when I have to tell a patient to wait a while. 

But honestly, the typical patient in my practice has waited and wanted the procedure for quite a while, has done all the baby steps, and it IS time.

As a board-certified plastic surgeon in practice in Columbus, Ohio, for over 24 years, I have seen many gimmicks come and go. And I have changed my routine when I have discovered a new and improved method. You can see some of my patients’ results in our facelift  gallery.

The “SmartLift” 

SmartLift is the name we have given the mini facelift we perform in our office OR suite. It is one of our favorites as it’s adaptable to each patient, focusing on the jowls and neck.

The important part of a SmartLift is not the skin but the underlying muscle layer. We lift the muscle layer and remove any excess skin. If the muscle layer is not addressed, the skin will just stretch back out. I walk you through what to expect before, during, and after a Smartlift in this educational video. 

We hope you have found this information helpful! All of us at Aesthetica look forward to meeting you and helping you on this journey to a refreshed you. Feel free to call us at (614) 569-2649 to schedule an appointment or contact us online to request a consultation.

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