Age v. Lasting Results of Facelift

Hello Dr. Yang: I’m so impressed with what I’ve read about and from you. My questions to you at the moment are this:

  1. Is it true that the younger you are when you get a face lift the longer the result will last? I’m 50.

  2. I’m very interested in the Millenium lift you perform – especially because it doesn’t involve the use of general anesthesia. Is this a rather recent procedure you are performing? I’m wondering why a doctor in my area insists that I would need to have general anesthesia in order to get a face lift – it’s the one aspect of all of this that scares me the most.

Thank you for all you do Dr. Yang – you obviously must love your work!


Hi Sirvivhor,

Good Question.
Is it true that the younger you are when you get a face lift the longer the result will last? I’m 50.

Here is a prior post about how long a facelift should last: … php?e=2898

You’re question is slightly different, but I think answering it will make a good point, so here it goes:

Some plastic surgeons will say that, but I don’t know that I believe it. The surgeons who believe this are the ones who perform facelifts on younger patients (30-40.) If this is true then if you perform a facelift on a 20 year old or 15 year old it should last the longest. In some ways this is true, but not because of the facelift, but inspite of it. The earlier that you perform the facelift the longer it is before they reach menopause (sudden facial aging.) But strictly speaking will the 35 year old facelift patient look 25 and continue to maintain this “10 year facelift gap” and look 35 at age 45, I don’t know, but I highly doubt it.

I feel that facelifts are for sagging, and that as soon as the last stitch is placed on the facelift, the face continues to age. So, if the visual improvement in your neck and jawline after the facelift is about 5 or 10 years then it should take 5 or 10 years to “age back” to your original appearance. Also you have to bear in mind that a facelift does not include the eyelids, brows, and for some surgeons the cheeks are not included. If you have a facelift prematurely at 38 and the “facelift gap is only 1 to 2 years (after the swelling is gone) then your neck and jawline will look 38 again when you turn 39 or 40. The facelift improvement gap is smaller at a younger age than it is at an older age, because there is less sagging to lift.

If you don’t believe that performing a facelift on a young person would essentially not make much of a difference, I ask you if you are pulling on a string straight between your fingers, how much “straighter” can you make it. You can pull on the string really, really hard, but the string won’t look any different. It still looks straight. No difference. This analogy applies to performing a facelift on a young person with no sagging. All you give them is 3-5 months of nice facial swelling which fools them into thinking they had good work and facelift scars.

What would a mini-facelift or facelift do for this woman?

So does it really last longer? Does the fact that a facelift was performed “freeze time” so that the 38 year old will somehow continue to looking 38 for the following 10 years? I don’t think so. Maybe some cosmetic surgeons might believe that, but most plastic surgeons will say that the aging continues as soon as the last stitch is placed.

I have seen several patients for consultation where the patient does not have any obvious signs of sagging, but when they pull on skin on their face the skin stretches out a lot like the picture above, but because they are young still when they let go the skin snaps back completely to the point where you can’t see any sagging. When I look at them, their jawline still looks relatively straight, no obvious marionette lines, and their neck contour looks fine.

Here is the dilemma. If they have a facelift or mini-facelift to improve their jawline and marionette area, my question is, “What improvement?” Will they be happy with their facelift in the first few months? Absolutely, but are they happy because of the facelift or because of the swelling? This is the gimmick of all the mini-facelifts which show very early results. The real question is when the swelling settles, will they be happy or will they feel that their improvement is less than 10% and not worth doing (See my 10% rule for whether or not to have a cosmetic procedure). This is why when looking at before and after photos you should ask if the after photos is at least 9 to 12 months after the facelift, to ensure that all of the swelling is completely gone.

The only improvement that the patient may see is that if they pull on the skin on their cheeks that the skin is tighter, but visually the improvement is minimal if any (after the swelling is gone, of course.)

To take it to the extreme, lets say we perform a facelift on a 23 year old woman (Previous Post: 23 too young for a mini-facelift? ) Will this 23 year old woman look 13? No. There is a limiting factor. The less sagging there is, the less improvement will be seen. Most likely after all the swelling is gone, the 23 year old woman will look exactly the same. So how long did that facelift last?

If you read my post is 23 too young for a mini-facelift, I talk about waiting until certain life events change your face and body, before having these rejuvenation procedures. One example is if a woman has a slight pooch on her belly, at 20 should she get a tummy tuck to get rid of it, or should she wait until after having children and actually developing stretch marks and worsening of the belly pooch before having a tummy tuck. In this tummy tuck example, it makes a lot of sense; however, women seem to be in a much bigger rush regarding their faces.

So how can we apply the tummy tuck example to facial aging surgery. Well, listening to many of my patients describe their facial aging, I think that there is another major life event that changes womens faces around age 50. You guessed it: Menopause. I hear the same story over and over. I looked younger than my age, then all of a sudden over 2 to 3 years my face lost volume, my jawline, cheeks and neck started to sag. So using the same analogy, lets say that you could plan your facelift either before or after menopause. Which would give you the most “bang for your buck”? To have a facelift at 45 before menopause for a minimal improvement, then go through menopause and lose the “facelift improvement gap.” You might look 2-4 years better than your age only to lose 10 years after menopause (10 years minus 2-4 years.) Most likely you will want another facelift after menopause.
Would the more prudent and patient to wait until after completing menopause and after the most facial aging occurs, then having the facelift/necklift at that point.

I hope that lengthy explanation made some sense. I have several patients who I feel are too early for a facelift, and I spend a lot of time convincing them to wait. It would be much easier and more lucrative for me to “give in” and perform the facelift, and not talk so much.


Dr. Yang