Cosmetic treatments are the perfect gateway to facial rejuvenation: Botox, dermal fillers, and Protégé skin tightening can address the early signs of aging, without a single incision being made. At some point, however, the magic of Botox and Juvéderm is no longer enough to preserve a fresh, alert appearance. Though these treatments can smooth crow’s feet and smile lines, and even subtly lift the mid-face region, they aren’t designed to tackle visibly loose skin around the jaw and neck.
Depending on your individual health and skin elasticity, relying solely on injectable compounds after age 50 can lead to underwhelming results, including a puffy or “frozen” look. Knowing when to make the switch from cosmetic treatments to facelift surgery can preserve your youthful, natural expression. Likewise, while surgery may seem like a big commitment, it can actually save you time and money over the long-term: Injections need to be administered every six months, but just one facelift can change your appearance for a decade or longer.
The effectiveness of facelift surgery is confirmed by our patient results and by this procedure’s continued mainstream success: Though facelift surgery doesn’t get the same amount of media attention as non-surgical cosmetic treatments, it’s steadily rising in popularity. According to the American Society for Aesthetic Plastic Surgery, the number of people receiving facelift surgery rose by 28% between 1997 and 2015.
Why Are Facelifts More Effective After 50?
Facial aging is progressive: While most of the early signs of aging are literally “skin deep,” eventually, collagen loss starts to affect facial fat, connective tissue, and muscle tissue below the dermal layer. Just like collagen depletion makes the skin weaker and prone to creasing and sagging, declining levels of this integral compound cause the deeper tissues that support the face to slacken and sag. As connective tissues lose their tensile strength, they become unable to hold the fat pads around the cheeks and eyes in place. These fat pads slowly migrate downwards and hollows form where fat used to fill out the cheeks and orbital area. In most cases, sagging fat deposits eventually collect along the lower cheeks and jawline, where they contribute to the formation of heavy, hanging jowls.
During your 30s and 40s, changes in overall facial contour are usually subtle, and they may actually be flattering: Many people like the reduction in facial fat they start to notice by about age 35 as it makes their cheekbones and eyes look more prominent. As such, those in early middle age are usually completely satisfied by the results of Botox and fillers, which eliminate their superficial wrinkles and replace lost volume along the cheeks and lips. By age 50, however, age-related changes in facial structure start to make faces look gaunt or bottom-heavy, and creases become too deep to be addressed with fillers alone. At this point, facelift surgery becomes necessary to elevate fallen facial features. Injectable compounds and RF treatments can’t alter muscle tissue or remove loose skin, so they simply aren’t equipped to tackle the more advanced aspects of aging.
Unlike dermal fillers and RF treatments, which stimulate collagen production in the skin, facelifts go much deeper to restore a truly youthful look. Modern facelift techniques avoid stretching the skin (which is why facelift surgery no longer produces a “windswept” look); instead, they’re designed to adjust specific muscles and put facial fat pads back in their original position. Likewise, today’s facelifts completely avoid pulling the skin around the mouth to reduce the appearance of deep nasolabial folds, so you won’t have to worry about your smile being changed by this procedure. Nasolabial folds are minimized naturally during facelift surgery as the cheeks are raised, and they may be further corrected after surgery through the continued use of dermal fillers or facial fat transfer. (A facial fat transfer can also add permanent volume to your cheeks if you want to ditch regular injections altogether.)
When Dr. Singer performs a facelift, he makes small incisions around the ears and hairline to permit access to the muscles that support the cheeks, chin, and forehead. If you also have a neck lift, he’ll make a few incisions around your lower hairline to facilitate the removal of excess neck skin. Once the necessary incisions have been made, Dr. Singer releases specific facial muscles, removes excess muscle tissue (if necessary), and tethers the muscles back into place with self-dissolving sutures. Adjusting these muscles pulls sunken fad pads higher on the cheeks, recreating fuller, more youthful facial contours. After altering the muscle and connective tissues beneath your face, Dr. Singer will carefully re-drape the skin covering them, without stretching it. This approach ensures the skin lies smoothly, but it won’t alter your individual features. After having a facelift from Dr. Singer, you’ll look more like your younger self – not like a different person.
In some cases, Dr. Singer may recommend more advanced techniques to help his patients get the results they want. Very prominent lower cheeks, jowls, or a double chin may indicate the need for facial liposuction or buccal fat removal. Alternately, patients with very gaunt or flat cheeks may need a facial fat transfer to recreate more youthful contours. When you visit us for a consultation, Dr. Singer will assess which facial changes are causing your aesthetic concerns, then explain the best way to address them. Whenever possible, he combines surgical procedures to reduce his patients’ expenses and total recovery time.
What Are the Signs You Need a Facelift?
Not everyone needs a facelift as soon as they turn 50, though this is the average age most people should start thinking about one. Aging is a highly individual process; some people retain good skin elasticity until their mid-50s or early 60s, while others require surgical rejuvenation during their 40s. Knowing the signs you need a facelift (along with scheduling a professional consultation), will help you determine when it’s time to transition from cosmetic treatments to surgery:
Botox No Longer Gives You the Alert Look You Want.
Having a tired, sad, or angry expression that doesn’t respond to Botox indicates significant brow and forehead sagging that relaxing the muscles around the eyes and brows (which Botox does) can’t correct. This issue is caused by loose skin and weak, elongated forehead muscles. In some cases, drooping upper and lower eyelids also contribute to this look.
Combined facelift, brow lift, and eyelid lift surgery correct an aged expression by removing excess skin and shortening the levator muscles that support the eyelids and forehead. This specialized procedure can also remove deep forehead lines and improve your peripheral vision.
If you have hanging jowls that have obscured your jawline, you almost certainly need a facelift. The presence of visible jowls indicates advanced collagen loss, which cannot be corrected with fillers or RF skin tightening. Other signs you need a facelift include deep lines around the mouth and having a mouth that turns downward at the corners even when your face is at rest.
Bands of Neck Skin
Bands of loose, hanging skin that extend from below the chin to the collar bone are another obvious sign of severe skin laxity. While RF treatments can raise sagging skin by a couple of millimeters, only combined face and neck lift surgery can truly eliminate the telltale signs of “turkey neck.”
If you don’t have loose neck skin, but you feel like dermal fillers aren’t enough to correct sagging along your mid-face region, a “mini” or mid-facelift might be all you need to achieve your desired result. During a mini facelift, the muscles and fat pads along the cheeks are gently adjusted through small incisions near the ears, but the neck and forehead remain unchanged. This procedure is a great way to address mid-face aging while reducing postoperative swelling and ensuring a swift recovery.
The “Stretch Test”
One of the best ways to tell you’re ready for a facelift consultation is to try the stretch test: Stand in front of a mirror and place both hands along the outer edges of your face. Gently pull your skin upward (toward your forehead), stopping before you feel any discomfort. If you like what you see, you’re probably a good candidate for a facelift.
Feeling Emotionally Ready
Deep down, we all know when we need to make a change. If you feel you no longer look like “you,” or your appearance is preventing you from enjoying life fully, then it’s probably time to consider surgery – especially if non-surgical treatments aren’t giving you the confidence you seek. Good facelift candidates also understand the risks and benefits of surgery and feel prepared to adjust their lifestyle before and after surgery. You should also speak to your doctor and, if possible, a trained therapist to make sure you’re physically and mentally ready to take the next step.
Before you schedule your procedure, make sure you have a solid support network in place, too. You’ll need someone to care for you for a few days after your operation, and you’ll need people you can talk to during recovery. Make sure your plastic surgeon provides regular follow-up care, so you can share any questions or concerns you have with a professional.
Talk to Dr. Robert Singer in La Jolla, California about Facelift Surgery
At Singer Plastic Surgery, we understand that trying a facelift for the first time can feel intimidating. That’s why we offer a range of different facelift procedures, from minimally invasive “mini” or mid-facelifts to full face, neck, and brow lift surgery: We believe in giving our patients a variety of options that allow them to balance their aesthetic needs with their recovery preferences.
To learn which procedure will benefit you the most, schedule a consultation with Dr. Robert Singer by phone at 858-455-0290 or through our online portal. We look forward to caring for you at our state-of-the-art clinic in beautiful La Jolla, California.