When is the right time to get a facelift, also known as a rhytidectomy? The answer depends partly on a patient’s individual response to aging and sun damage, and partly on his or her overall anti-aging strategy.
Those First Pesky Lines
Small, fine wrinkles may first start appearing during the teen years or 20s. Early wrinkling can be caused by genetics, smoking, and other lifestyle choices, and excessive sun exposure.
Light to moderate wrinkling is not a sign that a facelift is necessary. Depending on where the wrinkles are located and how deep they are, they can be minimized or even smoothed away with injectables, including neuromodulators such as Botox, Dysport, and Xeomin, and dermal fillers, such as Juvéderm and Restylane.
Other treatments that can help improve the quality and appearance of skin include:
- Getting regular chemical peels
- Using a medical-grade skincare regimen
- Using prescription retinoids
- Avoiding the sun
- Wearing sunscreen every day
- Eating a healthy, high-vegetable diet
- Avoiding alcohol and smoking
- Staying hydrated
A Little Bit of Sagging
Even when following a healthy diet and using a great skin care program, the aging process will cause the skin to lose collagen at a rate of about 1% a year, starting between ages 18 and 25. Collagen consists of long strands of protein that creates a criss-crossed matrix that lifts the skin and supports the production of elastin and hyaluronic acid. Elastin makes skin elastic so that it can “snap back” after being pulled or twisted. Hyaluronic acid is the body’s own natural moisturizer, which plumps up the skin and lubricates joints. When collagen degrades, the skin not only loses its support, it loses the elastin and hyaluronic acid that make it plump, moist, and resilient.
The loss of volume caused by collagen degradation is exacerbated by the fact that our faces also lose fat every year. Fat helps skin look smooth and healthy by giving it a cushion on which to rest. When the fat disappears, the cheeks and midface begin to sink.
Signs of lost collagen and facial fat include:
- Loss of volume in the midface
- Droopy cheeks
- Loss of volume under the eyes
- Nasolabial folds
- Marionette lines
- Smile lines
- Slight jowling
At this point, sun avoidance and good skin care aren’t enough to keep skin firm, elastic, and youthful.
The most effective options to reduce early signs of sagging include:
- Laser therapy
- Ultrasound therapy
- Fillers, such as Sculptra and Voluma, to compensate for facial volume loss
- Fillers, such as Volbella and Restylane, to fill in eye troughs
- Fat grafting to restore facial volume
- A mini facelift with or without a neck lift
Laser and ultrasound therapy should be repeated every two to three years to maintain benefits. The results of Sculptra and Voluma treatment can last about two years. Fat grafting may last up to 3 years.
A mini facelift with or without a neck lift will turn back the clock about 8 years and will last about that long, too.
The loss of collagen, elastin, and facial fat can cause such significant skin sagging that the skin may even stretch. Restoring volume may not be enough to reverse the effect of sagging, stretched skin.
Some signs of significant sagging are:
- Soft jawline
- Looking “gaunt” or skeletal
- Turkey neck
- Deeper nasolabial folds
- Marionette lines
- Puckering around the mouth
The ideal treatment plan for significant sagging may include:
- Full facelift
- Fat grafting to restore facial volume
- Neck lift
- Platysmaplasty (tightening the neck muscles)
A traditional facelift (rhytidectomy), dramatically rejuvenates the face and neck, making patients look about 10 years younger. Facial plastic surgeons such as Dr. Jonathan Kulbersh of Carolina Facial Plastic Surgery in Charlotte, North Carolina, ensure a natural result by replicating and lifting the underlying SMAS layer as well as the skin, lifting both upward and outward for a more natural result. Dr. Kulbersh also adds fat grafting to create a full and youthful look (i.e., not pulled or windswept). He frequently administers a chemical peel, which aids healing in the postoperative period and creates extra vitality for a real “wow” effect.
The Advantages of an Early Facelift
Facelifts used to be the last recourse for elderly women and men to reclaim just a touch of youth. These days, however, many women and men opt for a first facelift or lower facelift before the age of 60 and even before 50.
Some advantages of having a facelift before 60 include:
- The skin is more elastic and recovers more quickly from surgery
- More fat and collagen in the skin prevents the over-pulled look
- Results are better and longer lasting
- A patient’s overall health is usually good before 60, making the procedure better tolerated and the recovery easier
The Advantages of a Facelift Later in Life
With all of the effective non-surgical anti-aging options available now, some women and men are delaying facelifts to a later age. Others may not have addressed their aging issues until they became severe enough to warrant a rhytidectomy.
Some advantages of having a facelift later in life include:
- Patients are more certain about what they want
- The clock can be turned back by 7 to 10 years
- With co-therapies, such as fat grafting and chemical peels, patients can achieve faster healing and a more youthful overall look
- The change may be more dramatic and noticeable than a facelift done at an earlier age
- The rejuvenation can last up to 10 years with proper skin maintenance
Learn more about rhytidectomy procedures at WebMD.com.
It’s All Up to You
Whether having a facelift now, later, or decide to honor the character brought on by age — as actresses Annette Benning and Frances McDormand have done — is simply a matter of choice. It is crucial to discuss whether a mini lift or a full facelift will deliver the best possible results with a skilled and board-certified facial plastic surgeon. To learn more about effective surgical and non-surgical options for combating the signs of aging and sun damage, double board-certified facial plastic surgeon Dr. Kulbersh and his helpful staff can be reached by calling our office in Charlotte or filling out our online contact form.
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