A facelift will refresh and rejuvenate your appearance, but it can’t stop the process of aging. Time marches on, and your face will continue to age, but from a younger looking starting point than before your facelift. Let’s take a brief look at how aging affects your face, and what a facelift will do for you.

Understanding facial aging

Each aspect of your facial anatomy – your skin, fat, muscle, and bone – ages independently, but they also all impact each other and your overall appearance. That’s why a facelift needs to address more than just one aspect of your anatomy. It’s also one of the reasons why you can look older than you are. Also, facial aging never stops, which is why the results of a facelift aren’t permanent.

Skin quality affects how old you look

The skin on your face is constantly exposed to the elements, and that’s why you’ll typically notice signs of aging in your skin first, especially if you have a fair complexion. People with fair skin are more susceptible to sun damage, and their skin is thinner than someone with darker skin. 

Why does skin thickness even matter? Because thick skin usually has more collagen in it.  Collagen thins out as you age and eventually, you lose your ability to form collagen. As your skin thins, it starts wrinkling and sagging. So if you’re someone with thin skin, you may have noticed wrinkles and other signs of aging earlier in your life than someone with thicker skin.¹

Facial fat sags or is lost as we age

When we’re young, we typically have more fat in our faces which gives our cheeks a round fullness and creates a “baby face.” As we age, that fat starts to lose its fight against gravity, and sags down. Since your skin is thinner and sagging, your fat creates bulges in your face that can make you look older. These bulges usually form in the under eye area and in the lower cheeks, creating jowls.

Not all of your fat ends up sagging though. Some of your facial fat deposits just shrink as you age, due to weight fluctuations and from resorption from your body. So when you lose fat in your face, that contributes to skin sagging and appearing deflated, but it also makes your skeletal structure more obvious under your skin. This makes you look gaunt and aged.²

Facial muscles cause deep lines to form

Remember when your mother told you that if you make a certain face, your face would end up stuck that way? We know that’s not exactly the case, but as we get older, there’s a tiny bit of truth to that statement. When we make the same expressions over and over throughout our lives, eventually the muscles that are used to make those expressions become stronger. At a certain point, when those muscles are strong enough, it’s like they’re in a state of constant contraction, even when you’re not actively trying to make that expression. That’s what causes those deep “etched in” lines to form, like the crow’s feet, forehead and between the eyebrows, .³

Bone remodeling changes the foundation of your face

The bones throughout your body are constantly going through a process called remodeling, where the body adds calcium to the bone, takes calcium from the bone, and repeats the process. This happens in your face too, but, at a certain point, your body starts absorbing more calcium from certain parts of your facial bones, which contribute to you looking older. Bone resorption happens usually in the front and sides of your cheeks, around your eyes, nose, and jaw. Bone resorption can make you look skeletal and hollow especially around your eyes,which is compounded by the loss of fat volume or sagging fat.⁴

A face lift “resets the clock”

When you have a facelift done, your plastic surgeon repositions your soft tissues and skin to create a more youthful contour. The process can also include fat transfer to certain areas of your face that have lost volume. Your surgeon also removes excess skin that’s sagging and causing wrinkles.

But nothing can “stop the clock”

The results from your facelift can set you “back in time”, so to speak, but gradually, you’ll start noticing drooping and sagging again, because a facelift can’t stop the aging process that happens every day. For some people, with poor elasticity or heavy tissues, it happens faster than others.  

Your skin quality isn’t changed with surgery alone

If you’re just having a facelift without any kind of adjuncts, your skin will continue to age without improvement in overall quality. So you’ll continue to lose what collagen you have, and your skin will continue to thin. Laser treatments or chemical peels can help improve skin quality after you’ve healed from your surgery. They can resurface your skin and also stimulate collagen production to further combat signs of aging.

Muscle tone usually stays the same

The strength of your muscles isn’t affected by your facelift procedure, so a facelift can improve the appearance of deep lines but it won’t get rid of them completely. The appearance of these lines can be minimized with injections of Botox, which will prevent the muscles from being activated to form certain expressions.

Bone resorption continues

The loss of bone in your midface will continue, exaggerating the hollows around your eyes. Injectable filler can temporarily combat the hollowness caused by bone resorption.

Fat transfer is a more permanent enhancement.

Fat transfer can help slow the clock

Fat transfer will restore volume that’s been lost by aging, but it also has the added benefit of bringing stem cells from your fat to your face. This can improve the overall quality of your facelift.  The fat will not only restore volume and create that youthful contour, but the stem cells can improve the quality of your skin and improve your complexion which your facelift alone can’t do. Stem cells may even stop the resorption of bone in your face.

With time, you’ll notice signs of aging again

A facelift can give you satisfying results for a while, but eventually the signs of aging will bother you again. Schedule a consultation appointment with your plastic surgeon to discuss your particular needs, and your expectations for your facelift. Also, discuss any additional procedures that you might be interested in to enhance the results of your facelift, including fat transfer.

1. Okada, Haruko C., Brendan Alleyne, Kaveh Varghai, Kimberly Kinder, and Bahman Guyuron. “Facial changes caused by smoking: a comparison between smoking and nonsmoking identical twins.” Plastic and Reconstructive Surgery 132, no. 5 (2013): 1085-1092.
2. Fitzgerald, Rebecca, Miles H. Graivier, Michael Kane, Z. Paul Lorenc, Danny Vleggaar, Wm Philip Werschler, and Jeffrey M. Kenkel. “Update on facial aging.” Aesthetic Surgery Journal 30, no. 1_Supplement (2010): 11S-24S.
3. Barton Jr, Fritz E. “Aesthetic surgery of the face and neck.” Aesthetic Surgery Journal 29, no. 6 (2009): 449-463.
4. Mendelson, Bryan, and Chin-Ho Wong. “Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation.” Aesthetic Plastic Surgery 36, no. 4 (2012): 753-760.