“I heard you should get a facelift in your early 50’s”
“I’m going to get fillers until I get a facelift when I turn 60”
Whenever I give a talk to a group of people, I usually receive a question about the right time to proceed with surgery vs non-surgical techniques. Let’s look into a few of the considerations for this decision.
Patient expectations are a big determinant of what procedure is performed. If someone has a large amount of neck sagging, for example, and wants a sharp neckline, we are going to focus on a surgical procedure such as a necklift/facelift to tighten those muscles and remove skin. If their expectations are in a male that just wants a little less hanging over the collar of his shirt while wearing a tie – then maybe he would be happy with something that gives him more of a mild improvement.
If you are wanting the “neckline you have never had before” then you are traveling down the route of a surgical necklift. If you are wanting to roll back the clock 10 years on your neck, then you are probably also looking at a surgical necklift. If you are just looking for a bit of tightening or mild amount of fat reduction, then you may be a candidate for a less invasive option.
Another example is under eye bags. This tends to be a little more complex of an issue and does usually require a consultation (in-person is ideal). If you are okay with 50-60% improvement then fillers may be a viable option. Keep in mind also the fact that fillers need to be repeated annually. If you are looking to get rid of the bags permanently then surgery is probably best.
The cost of a procedure can definitely be a determinant of whether a patient undergoes fillers vs surgery. However, although the up front cost of fillers may be lower than surgery most patients surpass spending on fillers compared to surgery by their fifth year of treatment. Therefore, a long term solution should be considered. I usually tell patients that need surgery for the best outcome just to save their money for surgery as they will be happier with the outcome (if the surgical outcome would be better than the nonsurgical outcome).
Not all results are created equally. Oftentimes we are comparing apples to oranges. Using filler to conceal jowling is very different than lifting the lower face with surgery and re-establishing the more youthful facial shape. So when comparing the two techniques, although both may be acceptable, they are oftentimes not doing the same thing. An example of procedures that may have comparable results would be fat transfer vs fillers, which aim for the same outcome, but with each procedure having different pros and cons. (See Total Facial Volume Replacement – Sculptra and Fat vs Gel Fillers for more information)
Speed and Signs of Aging
The youngest patient I have ever performed a necklift on was in her mid 30’s. Although this seems young, you must also consider that this patient recently underwent massive weight loss and had a significant amount of skin laxity. On that same note, there have been 60 year olds that were not ready for a surgical necklift. I told a 63 year old patient recently that she wasn’t needing the surgery yet!
Recovery is an important consideration in the decision. If a patient does not have time to recover for surgery then surgery is probably not an option. Patients may have childcare duties or hectic work schedules that simply don’t allow for it. The caveat is that for dramatic results, THERE WILL BE RECOVERY TIME! You have to put in the recovery time for there to be a significant improvement. Minimal downtime procedures can tout surgical results, but if you ask anyone that has had a thread lift, their result is not a facelift.
So to sum it all up – everyone ages at different rates dependent on genetics, photoaging (sun damage), diet, and underlying illnesses to name a few. Therefore an individual approach is important when considering your options. We discuss each of the above topics in detail at a consultation. The question of when to go “under the knife” is a big one. Undergoing anesthesia, having incisions, and the 2 week recovery time may sound intimidating, but our patients that undergo surgery often say it is easier than they expected and are thrilled with the results. Any more questions? Send us an email at firstname.lastname@example.org to schedule your consultation.