We all age differently and at different rates. As with all signs of aging, the manner and rate at which our faces age is determined by genetics and environmental factors. I do not think that age, itself, determines candidacy for a facelift. There are, however, certain signs of aging which are the most amenable to a facelift. In order to better understand our candidacy for a facelift, it is best to understand the different dimensions of how our faces age. It is important to have an appreciation of these different components both as the surgeon, of course, and as the patient. I’ll first discuss the most superficial aspect of our faces—our skin. There are predominantly two different types of wrinkles which form in our faces: dynamic and static wrinkles. Dynamic wrinkles are mostly due to the repeated contractions of our facial muscles along with sun damage, these wrinkles manifest themselves as fine wrinkles. The most beneficial treatment for these wrinkles includes muscle relaxants such as Botox and Dysport as well as resurfacing of the skin with lasers or chemical peels. Static wrinkles are those which are caused by the laxity of the skin and its attachments to the underlying muscles and tissue. The most prevalent of these wrinkles are what is commonly referred to as our smile lines. These are the lines which form around our mouth from the decent of our cheeks. These “lines” and wrinkles need to be distinguished from the sagging skin where a facelift is of most benefit. The sagging of our skin which causes the loss of the definition of our jawline and neck is
best addressed with a facelift. A facelift allows for the re-draping of this sagging skin giving our jawline and neck line better definition. A facelift otherwise has a limited role in addressing the aforementioned static and dynamic wrinkles themselves. Therefore, someone who is a good candidate for a facelift is a patient who is in good general health and who has loss of definition of their jaw and neck line. There does not exist an exact cutoff age for when this occurs as we all age differently; however, these changes are typically seen in people who are in there mid forties or older. The results of a facelift should leave you with a ‘refreshed’ appearance. These changes are accomplished with the technique of tightening the underlying tissue and not creating tension on the overlying skin itself. It is by tightening the underlying tissue whereby the overlying skin becomes restored to a more youthful appearance after a facelift without appearing over-pulled or wind-blown.