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Lower and Vertical Facelifts. Part 1. 


March 22, 2023

When is it time for a real facelift? No more fillers. No more botox. Straight to surgery. Is 45 too young? 50? 55? 60?

I have been seeing “vertical” facelifts and lower facelifts all over instagram (look at this gorgeous before and after). What stands out to me is that the women in these before and after photos seem young to me. They look like people I know. My peer group. I have never thought about surgery before. In fact, it’s never even crossed my mind as an option. Not at my age…not at 45. Isn’t that way too young? Maybe it isn’t.

The days of waiting for a facelift until you are 65 are gone. An older woman goes in for surgery and comes out transformed with pulled taut skin. This isn’t the narrative anymore. Women are going for surgery at younger and younger ages and getting little nips and less severe tucks that result in subtle changes. But these subtle changes create massively impactful results. The woman above is only 47. I am no surgeon, but I have to think that the change in her jawline and the lift in her jowls is something that simply cannot be achieved with more filler.

I don’t look in the mirror and think I look old. But after seeing the difference that a little vertical surgical lift can make, it’s certainly making me rethink this option.

I have been scouring the internet for more information. For the first time I am really wondering…when is the time for me to go in and see a surgeon? I find myself analyzing before and after photos on instagram of vertical and lower facelifts and then staring in the mirror, pulling back my jowls, and trying to decide if I am crazy to think that maybe I should go get surgery.

When I google “when do I need a facelift” the internet gives me back this answer, “ The common signs that you might need a facelift are excess skin on your lower jawline and the formation of deep lines on your face.” I don’t have the deep lines yet….but the excess skin is certainly forming. My jowls are an issue I have been fixing with a combination of filler, Ulthera, and other tightening and lifting techniques. But is it time for me to address this problem surgically? Should I do it now before it gets worse so it’s not that noticeable later? If I go see a surgeon, will he be honest? Or will he just be selling me a surgery appointment?

When I google “what age is too early for a facelift”, the following results come up in search, “When you get to 45 years, then you can start to consider a facelift. Getting a facelift at this age gives you better and long-lasting results.  At this age, your skin still has enough elasticity and good circulation.” Ok Google. That makes a lot of sense to me actually. I turn 45 this year and Google is telling me that I am not crazy! Maybe it is better to go now rather than wait!

I have been getting Botox since I was 30. Little baby botox. And in my late 30’s little bits of filler. And then into my 40s, more and more of each. I feel like every time I go in for a little “touch up” I see less and less results. I am worried about this slippery slope. Botox and filler and the best doctor can only do so much. They can’t take you back in time.

I know…I know…most people have told me I am nuts for even thinking about surgery. I definitely look way younger than my years. I am usually told I look 35, not 45. But this is because I started these anti-aging protocols so young. Even more of a reason to look into a lower facelift now, right? But I am also completely terrified of surgery and it’s something I never, ever thought I would consider.

As you age, the scaffolding (As Dr. Shereene Idriss always puts it), wears away. And the lack of volume in my temples and cheeks combined with the sagging in my jowls is causing my face to simply not look like me anymore. And I am starting to think there is only so much filler and botox can do. They help. But they have their limitations. 

In addition, something else to think about is the economics of this whole thing.  I am beginning to do the math and at some point won’t it just make economic sense to get surgery?  How often do you get Botox and filler? How much do you spend every year? Now, if I got a facelift, could I save myself all this money for the next 15 years or 20 years?

I have a ton of questions! As I embark on this information quest I have lined up some of the country’s best doctors to help me with everything I need to know. Dr. Amir Karam, a double board certified plastic surgeon who specializes in this very issue, is going to assist me. I also wanted to reach out to my readers to see what questions they have.  I want to make this series of articles the most effective and informative as I can for my readers. Do you have specific questions? ‘Cause I have a ton. Below are just a few. Email me or let me know in the comments what you are dying to know. And I will make sure they are addressed in future installments.

Coming Soon: 

  1. What is a “vertical restore” facelift that I see on instagram? Is this different from a regular facelift or a lower facelift?
  2. What age should I really be thinking about a facelift?
  3. How much does a “good” facelift really cost?
  4. Are there good and bad candidates for a facelift?
  5. Is it better to get a small lower facelift now or wait for a larger procedure when I really need it? Will this make it easier or more complicated in the future?
  6. Is a “vertical facelift” safer than a regular facelift? Where are the incisions made?
  7. Should I stop getting botox or fillers ahead of a facelift?
  8. When does a doctor turn down a candidate for surgery?
  9. I have been studying facial threads, how does this compare to a surgical lift?
  10. What causes people to look “pulled” after a facelift? How can a candidate prevent this from happening?

Photo credit: Death Becomes Her is a 1992 American satirical black comedy fantasy film directed and produced by Robert Zemeckis. It’s one of my favorite comedic films and has the most amazing cast. It stars Meryl Streep, Goldie Hawn, and Bruce Willis.  Meryl Streep and Goldie Hawn fight for the affection of Bruce Willis while drinking a magic potion that promises eternal youth, but this youth potion has unpleasant side effects. Just like any youuth restoring treatment, one must proceed with caution!

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