As women enter and move through middle age, wrinkles and facial lines become more prominent and the skin begins to sag. A host of new treatments are available to address these changes in their early stages, but beyond a certain point (typically when women are in their 50s) a facelift is the best remedy.
We’re all attracted to quick fixes and new technologies, and these have their place in cosmetic treatment. For minor aging changes, some of these nonsurgical approaches can work wonders for a period of time. But the gold standard in facial rejuvenation has always been the facelift, and no other treatment can so dramatically turn back the clock. And with improvements to the procedure over the past 20 years, today’s facelifts are nothing like those we saw in our mothers’ generation. In the hands of a skilled plastic surgeon, a modern facelift produces subtle and natural-looking results that take years off your appearance — and that last for years too.
How Our Faces Change With Age
As we age, our skin changes, most visibly on our faces. This is due to several factors. Collagen gives our skin tone and elasticity, and we produce lots of it when we are young. As we age, the collagen in our skin breaks down and we don’t produce enough to fully replace what is lost. As a result, our skin loosens and sags. It stretches without springing back. The pull of gravity drags that loose skin down, creating jowls that make the jawline look square, hooded eyelids that make us look tired, and wattles and bands on the neck that makes us look older than we feel. Plastic surgeons refer to this as “descent.” With less collagen, the skin also becomes less elastic. Facial movements and expressions cause momentary creases which, over time, settle into permanent lines and wrinkles.
Below the surface, other aging changes are also taking place. The facial muscles that hold the skin in place stretch and loosen too, accentuating the appearance of aging.
How to Know if You Are Ready for a Facelift
If lotions and spa treatments no longer make much of a difference, or if the skin on your neck and jawline is too loose and droopy for nonsurgical skin tightening, it might be time to consider a facelift. Ask yourself a few questions:
- Do you feel self-conscious about the way sagging skin makes your face and neck look?
- Do you wear turtlenecks and scarves not because you like them but to hide your aging neck?
- When you look in the mirror, does your face make you look much older than you feel?
- Are you worried that your aging appearance is holding you back in your career or affecting your social life?
A facelift can bring your appearance into synergy with how you feel about yourself, and give you a refreshing boost of self-confidence.
What a Facelift Can Do That Cosmetic Treatments Can’t
Cosmetic treatments can rejuvenate the surface of the skin, fill in wrinkles and hollows, and stimulate the production of collagen to create skin-tightening effects, but only to a limited degree. Once skin has loosened beyond the point where minor skin-tightening boosts are effective, a facelift is needed to tighten facial muscles and remove excess skin.
A facelift works by tightening the skin around the neck and jawline to get rid of unattractive pouches, and by tightening the underlying connective tissue and muscles of the face to pull up and smooth the skin on the cheeks and under the eyes.
Look at before-and-after pictures of facelifts and you’ll see the dramatic rejuvenating effects — and the subtlety of the changes. Sagging jowls, double chins, and lines on the neck disappear; the jawline and cheeks are smoothed and softened, and creases to the sides of the nose and mouth are erased. Look at the mouths, too, and see how the stern expressions of the resting faces are replaced by happier ones. That’s because the procedure lifts the outer corners of the lips.
Take special note of the effects on the neck and under the chin. This is the area where a facelift sets back the aging clock in ways that nonsurgical cosmetic treatments can’t. A millimeter or two of skin tightening from microneedling or radiofrequency therapy won’t come close to producing these results.
An artful facelift can make you look 10 to 15 years younger without broadcasting the fact that you’ve had cosmetic surgery. Friends and colleagues will look at you and notice that you look great — more lively and energetic — but they won’t be able to put their finger on the reason for the change.
The other important difference between a facelift and nonsurgical cosmetic treatments is in the permanence of the results. Injectable fillers, Botox®, and collagen-stimulating therapies are short-term fixes. Their results last from a few months to as long as two years then must be repeated. The rejuvenating effects of a facelift last for 10 years or more. After that, you might consider a minor touch-up procedure or noninvasive treatments to refresh your appearance.
How Facelifts Have Improved in Recent Years
You’ve probably seen examples of facelifts from the past that made you cringe — the over-stretched “wind-tunnel” look that was so unnatural it screamed plastic surgery. And you’ve probably seen dozens of women with more recent facelifts without even realizing they’ve had treatment. That’s because facelifts have changed in recent years. Where the procedure was once limited to tightening just the surface skin, a skilled plastic surgeon now goes deeper, making adjustments to the muscles that move and hold the skin in place.
Today, facelift surgery is significantly muscular. The plastic surgeon goes under the cheek fat and works on the platysma, the sheet of muscle that supports the lower face, disconnecting it and reattaching it a little higher. Fat tissue below the skin is also recontoured. The procedure makes changes to the surface of the face from below, giving results that are softer, smoother, and more feminine.
The other big change has been in the aesthetics of the surgery. When a facelift was a skin-only procedure, tighter was considered better. The skin stretches with time, and a tighter adjustment was expected to last longer. The results were dramatic — and obvious. Plastic surgeons have refined both their technique and their aesthetic goals since those early days. They now work to create a natural look, eliminating pouched and saggy skin and restoring a soft and well-defined youthful appearance. That’s why the results of a top-quality modern facelift look as if you’ve magically reset the aging clock.
Combining a Facelift with Other Procedures and Treatments
A facelift is a remarkable and effective procedure to correct the effects of aging due to sagging skin in the neck, chin, and lower face. By tightening up the lower face, it can often reduce creases in the forehead, but that is not its focus. If you are also concerned about aging effects around your eyes and in your forehead, you might consider combining a facelift with a brow and forehead lift or eyelid surgery. Depending on the condition of your facial skin, these procedures can work together to give you a more complete rejuvenation.
A brow and forehead lift smooths and tightens facial skin above the eyes. The procedure removes horizontal forehead lines and vertical frown lines and raises the eyebrows to give them a more arched and youthful look. It can also reduce “hooding” over the eyes that results from a sagging brow.
Eyelid surgery can correct overhanging upper eyelids and eliminate wrinkles and bags under the eyes — other effects of loosening skin due to aging.
A facelift by itself does not address the texture and tone of the skin, discoloration from age spots, hollowness caused by loss of facial fat, or certain lines and wrinkles, such as crow’s feet or fine lines around the mouth. You might consider following a facelift with other procedures, such as laser treatments, micro-fat grafts, or dermal fillers to correct these other issues. Liposuction to remove fat under the chin may also be needed.
If You’re Not Quite Ready for a Facelift
If you’re concerned about the effects of aging on your face but aren’t quite ready for a facelift, you might consider a combination of nonsurgical cosmetic procedures. These won’t have the same age-resetting effect as a facelift, but you may not need that yet. Their effects are also more temporary, so you’ll probably need to repeat the treatments periodically for sustained effect.
Dermal fillers, including Juvederm®, Juvederm® Voluma XC, and Restylane®, are injected under the skin to restore volume and fill in lines and wrinkles. They are commonly used in areas that have a sunken appearance due to fat loss from aging — in the cheeks, temples, lips, and under the eyes. They can also be used to soften facial lines that have hardened with age, especially along the sides of the nose and mouth. The effects of treatment with dermal fillers typically last from a few months to more than a year, then will need to be repeated.
Micro-fat grafts are another way to restore lost facial volume and soften lines and wrinkles. In this procedure, fat is harvested from another part of the body, such as the waist or thighs, and processed for injection into the treatment area. Micro-fat grafts last longer than dermal fillers, and they have the advantage of using your own tissue. The treatment reduces a pocket of fat in one part of the body, using liposuction while adding volume where it is needed in your face.
Botox® and Dysport® reduce facial wrinkles by temporarily relaxing the muscles that cause them to form. These treatments work well on wrinkles and lines caused by repetitive facial expressions, such as crow’s feet, forehead creases, and frown lines. The effects take a few days to appear and generally last for three to four months.
Protégé skin tightening uses radiofrequency technology to heat the deeper layers of the skin. This causes the skin to contract and stimulates the production of collagen, resulting in a skin-tightening effect and a more resilient skin tone. Protégé treatments can be used to address mild skin looseness and sagging. Best results are obtained with a series of two to four treatments at two- to three-week intervals.
Other nonsurgical facial treatments include chemical peels, microdermabrasion, and laser resurfacing to improve the quality of the skin and correct uneven coloring.
Choose a Plastic Surgeon with Experience and Skill
A facelift is a delicate surgical procedure that will change the appearance of your face for years to come, and you’ll want to choose your plastic surgeon carefully. Dr. Robert Singer, in La Jolla, CA, is known worldwide for his expertise and skill as a facelift surgeon. Call us at (858) 455-0290 or contact us today to schedule a consultation.