We’re all familiar with the unnatural results of some facelifts – people that look like their face got blown back by the wind. That’s enough to give anyone second thoughts about having a facelift! But you can rest easy knowing that facelift techniques have been improved significantly since the “windswept”-look facelift took the spotlight in the 80’s and 90’s. As facial aging has been further studied and understood, plastic surgeons have been able to refine and advance their techniques to create beautiful and natural looking results that will leave you feeling refreshed and rejuvenated.

Things to undo – how your face ages

Because each component of your facial anatomy works together to impact your overall appearance, let’s take a look at how aging affects the anatomy of your face. Think of it like gears in a clock – the gears are each separate components, but they work in harmony, and one gear being out of sync or damaged can stop the whole clock.

Skin loses its ability to produce collagen

Your skin is your first defense against the outside world and it’s also the first thing people notice about your face. It’s the visible layer that can keep you looking young and vibrant, or older and tired.

When you’re young, your skin naturally has thick collagen fibers and special proteins called elastin in it that keeps it thick and supple. These are what give your skin the ability to stretch over your muscles while you’re moving.

As you age, your body loses its ability to create collagen. That makes your skin thinner, and more prone to wrinkling. That’s why older people tend to have such thin crepey-looking skin, because they’re lacking collagen.

Sun exposure and smoking damage your skin

If you’re a sun-worshipper, or if you were in your younger days, you’ve probably noticed a difference in your skin quality compared to people that grew up being more indoorsy. We know now that the sun’s ultraviolet rays can damage our skin and cause cancer, and it can end up making you look older than you actually are.

Smoking cigarettes or any method of smoking tobacco, harms your body in many ways, and it also prematurely ages your skin. Typically, chronic smokers will have heavier under eye bags and cheek sagging compared to nonsmokers.¹

Retaining ligaments weaken and cause sagging

There are ligaments below the surface of your skin that help keep all your underlying tissues in place. They attach your skin to the deeper tissues of your face and create the pockets where your facial fat sits.

These retaining ligaments are constantly fighting against the effects of gravity and as you get older, they start losing that fight little by little. Eventually, they’re weakened and become stretched out and lax, which contributes to wrinkling and facial sagging.

Facial fat volume is lost

When you’re young, the fat in your face sits in different pockets and creates a full and more youthful appearance. Some people have more facial fat than others, which also affects how young or old you appear.

As you age, you lose some of that fat, which creates a hollow appearance in certain areas of your face. This can be especially noticeable in people that have had relatively little facial fat to begin with. These individuals can end up looking gaunt or skeletal, especially around their eyes.²

The remaining fat sags

What fat does remain in your face eventually sags and creates little puffy fat bags in certain areas. Since your skin is thinner, and your retaining ligaments are weak, there’s nothing to combat the weight of the remaining fat. That’s what contributes to under eye bags, festoons, and jowls. In your cheeks, that sagging fat also exaggerates your nasolabial folds, or the lines that run down from the corners of your nose to the corners of your mouth.

Muscle movements create deep lines

Your facial muscles move nearly constantly throughout your life. Everytime you smile, laugh, speak, chew, you’re moving those muscles. Eventually, your muscles become stronger from constant use and creating the same expressions over and over. In certain areas of the face, like on your forehead and between your eyebrows, you might notice deep lines even when you’re not actively trying to make an expression. Since your muscles have become stronger in those areas, they’re basically in a constant state of semi-contraction that leaves your face with deep lines. The way your muscles move also contributes to fat loss, and also influences the movement of fat under and between muscles. The loss of this fat volume can contribute to the appearance of these lines.

Facial bones are continuously changing

Bones in your entire body go through a process called “remodeling” where calcium is both deposited and taken away from the bone. In your face, this becomes especially noticeable as you age. Generally, older people tend to be longer, rather than wider, compared to younger people, because their facial bones continue to grow in that direction.

In the midface, though, bone resorption is especially noticeable. That makes one’s front and side cheek area look more sunken in. Typically, loss of bone volume happens around the eyes, nose, and jaws. This is why older people tend to have more noticeable hollows around their eyes, and why their noses appear larger and droopier.³

Getting the most natural results

Understanding facial aging

In the past, scientists didn’t understand facial aging as well as they do now. Surgeons believed that facial fat was just one sheet that could be pulled and tightened. That’s why some patients ended up looking “fake” and unnatural. A plastic surgeon that understands how each facial component ages, and how they all work together to create your overall appearance will be better able to give you a natural-looking, satisfying facelift. 

Customized techniques

An experienced plastic surgeon knows that each facelift is unique to the patient, that your needs might be different from another patient’s. Your plastic surgeon should be able to adjust their technique based on the specifics of your unique facial anatomy, and what you would like refreshed in your face. This is especially important when it comes to facial fat removal.

Don’t remove too much

For patients with under eye bags, jowls, and saggy cheeks, facial fat removal probably sounds like a great idea to have done with a facelift. But, now that you know the importance of facial fat in creating a youthful contour, you can understand how removing too much fat from the face could contribute to making you look older. Removing too much fat can actually cause you to look more hollow and skeletal, which makes you appear older. Repositioning fat, and actually adding more fat will refresh your face by replenishing what you’ve already lost through aging.⁴

Fat transfer can create a more natural result

Fat transfer with facelift is a way to combat facial aging by adding volume to your face. Facial fat transfer acts similarly to injectable fillers, which also restore volume lost with aging. But while fillers are only temporary, fat transfer is permanent.

Fat transfer also has the added benefit of bringing stem cells from your fat to your face. This can help revitalize your complexion, improve your skin quality, and even minimize bone loss in your face.

Avoid unnatural results with an experienced surgeon

The key to getting the best possible results is to pick the right plastic surgeon. Your plastic surgeon should have a firm understanding of facial anatomy and aging, the experience necessary to give you a satisfying result, and techniques that will help to enhance your facelift results.

Conclusion

Schedule a consultation appointment with your plastic surgeon to discuss your facial aging concerns. Make sure to see before and after photos of their facelift patients in order to get a better idea of their abilities and whether you’ll be satisfied with their results. Facial surgery is a true artform. Done well, it will give lead to a more balanced, gentler, and more pleasing appearance that will make you happy every time your look in the mirror. You will want to choose a surgeon who is both a meticulous artist and a knowledgeable clinician.

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. 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.
4. Barton Jr, Fritz E. “Aesthetic surgery of the face and neck.” Aesthetic Surgery Journal 29, no. 6 (2009): 449-463.