When should I start plastic surgery of the face?

As a general rule most plastic surgeons agree that starting early is better.  But keep the procedures minimal and more frequent.  This will help to maintain a NATURAL look.  Find a plastic surgeon who will help you keep the procedures reasonable and appropriate.  Use your own good judgement too.  Stay away from “cosmetic or aesthetic” doctors who have little training, experience, or judgement and are not real plastic surgeons.  Stick to board certified plastic surgeons. The best source for fully trained, board certified, ethical plastic surgeons is the American Society of Plastic Surgeons -  www.plasticsurgery.org.

Chronological age is not as important as your physiological age.  People develop the stigmata of aging at different times and at different rates.  Fortunately, today, we have many different options to maintain a youthful appearance.   Patients in their 20’s and 30’s should be using sunblock, a good skin care program, and possibly doing laser treatments. Botox and/or fillers may be helpful, but be conservative.

For most people, from 40 years on, the skin begins to sag, sun damage is more apparent, pigmentation irregularities occur, there are volume shifts and volume loss.  When these factors first become apparent it is time consider more aggressive maintenance and correction.  Because botox, fillers, and lasers are simple and quick they are common treatments in my office for patient who are 40+ years old.  Again it is important to avoid being overdone.  In my opinion, fillers do NOT cause significant lifting unless they are overdone leading to a “balloon” look.   For sagging and drooping, lifting procedures are best.  Ultherapy (ultrasound) is a non-surgical office procedure to tighten and lift.  It is great for minimal to moderate sagging.

I am doing many more “mini face lifts”, neck lifts, and fat injections in patients in their 40‘s and 50’s than ever before.  Although I still do “full” face lifts,  this is usually in older patients who have not done any maintenance.  Consider two 45 year old patients- one doing nothing for 15 years and then having a full face lift, the other having 2-3 mini lifts during this same 15 year period. In my opinion it is better to do 2 or 3 mini lifts over 15 years, than wait until everything is severely sagging and be forced to do a full face lift.  Obviously,  if you do multiple mini procedures you will look better during the 15 years. In  addition, at the end of the 15 years,  the patient doing minimal maintenance procedures will have a better and more natural look.

Mini lifts are very simple procedures that involve less surgery and minimal down time (usually 2-3 days).  A mini lift is performed with local anesthesia or sedation.  There are many options regarding the components of the min lift  and possible additional procedures.  I tailor my recommendations to the individual’s particular problems and preferences.  My priorities are safety, keeping a natural look, and maximal improvement, in that order.

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When done appropriately by skilled, board certified, artistically trained doctors, fillers and Botox® administered in the office are simple, safe, 10-15 minute treatments that can significantly refresh and rejuvenate the face.