Facelifts Part 2: Is There An Ideal Age For One? And What Are The Real Costs For The Best Surgeons

Let me break it down for you.

Hey Charlotte’s Book readers! Thanks for sticking around as I move to substack. For my  inaugural post, I am kicking it off with part 2 of my facelift series. I received such an overwhelming positive response about the move, so thank you! And a special thank you to all of you that quickly became paid subscribers.

You will still find all my existing content on this platform (like understanding the pillars of facial aging, supplementing for sexual health, and the brain chemistry behind taking just one bite of a cheat food). Plus there is so much more to come.

I reached out to Dr. Amir Karam earlier this year to help me with all my burning facelift questions. In addition, I received so many reader questions that have piled in. This discussion on lower and vertical facelifts brought a ton of value to my readers! Thanks for putting me on the quest. I have done my best to parse out the information into a relevant, digestible, and straight to the point facelift series.

In addition to Dr. Amir Karam (whose work I am totally obsessed with), I have also included a perspective from Dr. Doris Day, one of the most highly respected and sought after dermatologists in New York City. The interplay of injectables versus surgery is very interesting to me and I wanted to include some insights on this as well. So be on the lookout for a broader discussion of this in part 3.

I have narrowed part 2 of the series to costs and the ideal age. Enjoy. And as always, please comment and email me after the read with any questions that I can include in Part 3.

So What Is The Best Age For A Facelift?

Is there an “ideal” age for a facelift? Is that even a thing or is it personal to you? Is there a point where filler and botox just can’t get the results you want anymore? These are all things going through my mind as my enter into the latter half of my 40s. Right now I am happy with the results I am getting from filler and Botox, but I can certainly begin to see the parts of my face that are starting to droop. It’s no longer about little fine lines. Forehead lines and crow’s feet will soon be the least of my concerns. So when should I be thinking about surgery? It turns out that the late 40s to early 50s is the sweet spot for the best results. Results that are going to be the most impactful for you long term. And here’s why:

Dr. Karam makes the strong point that catching aging in the early stages is really helpful as “patients will appreciate not seeing their face age as time goes on.” You can really slow the facial aging process. “50 typically is a great time to do the first one as results last in two different ways: the facial aging process is diminished and slowed for the rest of your life. So there is never a catch up to where somebody who is 70 will ultimately look like when you are 70, you'll look more like you're in your 50s or early 60s, but you won't look like you are a typical 70 or 80 year old.“

Personally, when I have brought up the discussion that I was looking at a facelift in the next few years, so many of my friends have been shocked. The response (as you might expect) is that I am too young. But from my perspective, I would rather catch these facial changes at the start and have the results not be overly obvious.

I used to think facelifts were for women approaching 60. Not so says Dr. Karam. He confirms that the average age of his patients is late 40s to early 50s. Not that 60 is too late, as Dr. Karam says “…it is never too late.” As a personal anecdote, I have had several friends in their late 50s who have had facial surgery, and they look great. But they have admitted to me they really wish they had done it a lot sooner rather than put it off. For exactly the reasons Dr. Karam notes here.

From a dermatologist’s perspective,” It’s not so much an age, as an amount of laxity of the skin. It also depends on the patients frame of mind. The first question I ask patients who are considering non-surgical options is: "would you have a facelift?" For those patients who are considering a facelift, I refer them to appropriate surgeons for a consultation before treating them so they can review all options before committing to any treatment. We can have outstanding results with non-surgical approaches, but the idea is not to compete with a facelift or replace a facelift, it's to naturally and authentically enhance your appearance and help you age beautifully.”

Dr. Day adds, “The better the skin quality, the better the results will be. This is why many plastic and facial surgeons say it's best to have the procedure done at a relatively younger age, meaning there is less estrogen depletion and the breakdown of collagen that goes with it.”   

Well, that makes a ton of sense to me.

So how much is a facelift going set you back?

In my own research and looking into my own consultations of the “good doctors” I have found that a facelift is going to set you back around $80,000. I asked Dr. Karam if my numbers were in the ballpark. Dr. Karam let me know that my research had proved correct.  Ugh. What a bummer. If I am planning to get one in the next 5-8 years, I need to start my facelift fund. But this is no area to skimp. Let’s be real here, someone is cutting into your face.  

Dr. Karam added, “I can't speak for the nation as a whole, but generally speaking, in our circle of close colleagues, who have dedicated themselves to the subspecialty of facial rejuvenation, and do a very quality, very reproducible and consistent surgical result, charge in the $80,000 to $100,000 range for a face and necklift. This price is largely an indication of the demand for the particular surgeon and is a reflection, often of the quality of their work. No surgeon can build a demand for their outcomes, if their results are not exceptional. Why would anyone pay that for an average outcome?”

You have to agree with this consistency argument by Dr. Karam. Fillers and botox which can often be dissolved or will simply wear off eventually, you just can’t reverse the results of a bad facelift. So to reiterate, you want a doctor that has an amazing record of consistent and natural results. Not only natural results, but consistent is a key here as well. So ask to see as many before and after photos as you can get your hands on. Don’t be convinced by one set.

Dr. Karam adds, “You want to be able to look at the outcomes that the surgeon produces, and look at lots of them, because there should be a consistency in the quality of the looks that you get. It's very conceivable that any surgeon can create a homerun looking outcome once in a while, but the important thing is can they do that essentially every time because when you go under the knife, you want to have that consistency as your insurance that you're going to get an excellent outcome.”

Now, when I have spoken to Dr. Doris Day about my urges to enter surgery, she reminds me of of one other important consideration: just because you are getting a facelift, this does not necessarily mean you are going to stop getting Botox and fillers. “Everything needs to be maintained, even surgical rejuvenation procedures like a facelift. I make a calendar for every patient where we map out their skin care and treatments for the year so they can plan and look forward to the treatments and to maintaining any work they've had done. Using neuromodulators, like Botox, fillers and devices, we can enhance and maintain surgical results.”

Dr. Karam also highlighted this to me as well. So don’t make the mistake of thinking a trip to the plastic surgeon’s office is going to release you from your trips to the dermatologist’s office. Yes, sometimes surgery needs to intervene as Dr. Karam notes that “Botox and fillers etc can only go so far with aging skin.” But, this doesn’t mean a facelift is a cure all. “Botox and skincare, lasers etc. are necessary for maintaining the quality of the skin because skin aging is happening simultaneously to facial shape aging. Facial shape aging happens at the fascia level, where the fascia loosens up and the shape of the face becomes transformed into jowling and neck laxity. When this happens, that's the time when surgery is necessary. However, this doesn't exclude or eliminate the need for doing the things that you need to do for your actual skin, because collagen loss in the skin results in thinning fine lines, wrinkles, discoloration etc, and that is something that you would always need to do.” He adds.

So when will you really know it’s the right time? Dr. Karam says, “Telltale signs are basically when you see jawline and neck laxity and you find yourself trying to physically lift your face with your fingers up towards your temples. That motion when you do that in front of the mirror is usually a good indication that it is time.”

To Dr. Day’s point, you also need to be mentally ready. While I am starting to see this a bit now in my face, I can tell you that I am not quite mentally ready to go in for surgery. But when I am there I want to be fully researched and make the best decision.

Stay tuned for Part 3.