Facelift under 50

Patients who are healthy, non-smokers, who have reasonable goals, and whose anatomy is favorable for correction (this depends largely on Dr. Rad’s assessment) may be good candidates for a facelift at earlier ages. This is a very personal decision and Dr. Rad will advise you very candidly about the advantages and disadvantages associated with earlier facelift surgery. The 10 most common reasons patients seek facelifts at younger than usual ages are as follows:

1. Your anatomy and genetics predispose you to have loose tissues at an early age.
2. You are concerned that you look older than your actual age.
3. You have had non-surgical treatments such as fillers, laser, or skin tightening treatments and at this point, you desire a greater degree of improvement than what they can offer.
4. Your schedule doesn’t allow extensive time commitment to non-surgical “upkeep” of your appearance and so you desire a permanent, “one and done” approach.
5. You want to maintain a fresh appearance rather than waiting for greater laxity to appear which may require a more significant “overhaul”.
6. You have a big life event, such as a wedding or major career change, and want to present your “best self” to the world.
7. You want to perfect certain facial areas that have always bothered you such as blunted jawline or weak chin.
8. Subtle changes in your appearance now catch your attention such as a loose neck, downturned corners of the mouth, or nasolabial folds.
9. You have lost a lot of weight and now see looseness in your facial tissues.
10. Success in your career or social circles depends on looking vibrant and you wish to reverse a tired appearance.

First, in our modern digital era of social media and Zoom, we’re paying more attention to our appearances and so the need to look fresh and youthful. Second, many patients have tried non-surgical treatments but have reached a plateau and now want a permanent, “one and done” solution. Third, a facelift in younger years keeps one looking fresh without a dramatic change as compared with an “overhaul” in later years – the transformation, as well as recovery, is less dramatic and oftentimes less involved.

This is a very common question that patients ask Dr. Rad, and gone are the days of waiting until the 60s or 70s when the whole face has dropped and needs an overhaul!

There are many good reasons to consider a facelift at younger ages:

1. Your tissue quality is better at younger ages, so your results hold up for longer.
   2. A subtle refresh is a smaller change as compared with a bigger surgery in later years.
   3. If your appearance bothers you now, then it will only worsen with time.
   4. Future revision facelift is both feasible and safe.
   5. You can enjoy a fresh appearance earlier and for longer!

There’s no right or wrong age for a facelift, and optimal timing is different for everyone. However, with safe surgery, you can enjoy a refreshed appearance at any age.

Yes, a facelift can be done on individuals who are under 40 years old. The decision to undergo a facelift depends on a variety of factors, including individual goals and concerns, skin elasticity, and the extent of aging or sagging skin. In general, individuals who are younger may require less extensive surgical procedures to achieve their desired results, as their skin is typically more elastic and resilient than older individuals. However, each person’s unique anatomy and goals must be carefully evaluated by a qualified plastic surgeon to determine if a facelift is appropriate and to customize the procedure to their specific needs.

Whether or not it is safe to have another facelift depends on several factors, including the patient’s overall health, the extent of the previous facelift surgery, and the goals and expectations for the new procedure. In general, it is possible to have a second facelift safely, but there are some potential risks that need to be considered. The most important factor to consider is the amount of time that has elapsed since the initial facelift. Surgeons typically recommend waiting at least one year after the initial procedure before considering another facelift. This allows sufficient time for the tissues to heal and for the full results of the initial surgery to become apparent.

In summary, the main differences between a mini-facelift and SMAS facelift are the extent of the surgery, the areas of the face targeted, the length of the incisions, and the expected results. Both procedures can be effective in rejuvenating the face, and the choice between them depends on the individual’s goals, the extent of aging, and the advice of a qualified plastic surgeon.

Having a facelift under 40 years old is not necessarily a bad idea, as long as the decision is made after careful consideration and consultation with a qualified plastic surgeon. In fact, some individuals in their 30s and early 40s may begin to experience visible signs of facial aging, such as sagging skin, loss of volume, and wrinkles. Ultimately, the decision to have a facelift should be made in consultation with a qualified and experienced plastic surgeon who can evaluate the patient’s individual needs and provide personalized recommendations for the most effective and safe treatment options.

Some potential benefits of having a facelift at a younger age include: more natural-looking results, delayed signs of aging, increased confidence and self-esteem, better surgical outcomes, and long-lasting results. It’s important to note that while there are potential advantages to having a facelift at a younger age, the decision to have the procedure should be based on individual goals and concerns, as well as a thorough consultation with a qualified plastic surgeon. The surgeon can assess the patient’s individual needs and recommend the most appropriate treatment options for achieving their desired outcome.

Undergoing a facelift at a younger age does not guarantee that you will age well in the future. Aging is a natural and ongoing process that affects everyone, and the results of a facelift procedure can vary depending on individual factors such as genetics, lifestyle, and sun exposure. However, having a facelift at a younger age may allow you to age more gracefully by delaying the onset of more significant signs of aging. It can also help you to feel more confident and comfortable in your appearance, which can have positive effects on your overall well-being.

Facelift procedures require anesthesia to ensure patients’ comfort and safety during surgery. The choice of anesthesia depends on various factors, including surgeon preference, the extent of the procedure, the patient’s health status (presence of heart, lung, kidney or endocrine illnesses), and patients’ preference. The 3 most common types of anesthesia used for facelift surgeries are:

General Anesthesia (GA)

Patients are asleep and are unaware during the surgery. During GA, the anesthesia team administers a combination of anesthetics to optimize the depth of anesthesia while minimizing side effects. This usually involves propofol for quick induction, and inhaled gas anesthetic for stable maintenance, and an array of anti- medicines to reduce nausea side effects, the most common issue with GA.

In terms of what patients experience, your last memory of the process is rolling into the OR, and then the next memory is waking up in the recovery room. You feel nothing or experience nothing of surgery. Dr. Rad’s anesthesia teams are exceptionally skilled in ensuring comfort and safety. Patients do not experience “waking up” episodes, nor do they have any memory of the procedure.

GA involves administering intravenous medications and inhaled anesthetic to induce sleep and keep the patient pain-free throughout the procedure. This involves an airway tube (“endotracheal tube”) which serves two purposes: (i) to deliver the inhaled anesthetic which gives long lasting anesthesia, and (ii) protects your windpipe preventing any fluids, secretions or phlegm from getting into your lungs which can cause a pneumonia or airways spasm/constriction (“laryngospasm”). Without protection of your airway, such as with IV sedation only, the risk of airway/lung problems is higher.

Patients awaken quickly because the depth of anesthesia is not nearly as deep as required for other types of surgery (think liver, kidney or heart surgery). Within 15-20 minutes you are awake enough to remove the airway tube, and then you are rolling to recovery. Typically patients stay for a couple or a few hours in recovery before going home.

This type of anesthesia is needed when deep plane face and neck lift with deep neck sculpting (gland reduction) is being done.

Dr. Rad advises not thinking of GA as “being on a breathing machine” or being dangerous. Rather, the anesthesia machine is supporting your natural breathing and protecting your airway. In fact, GA is for comfort and safety. In the hands of a board certified anesthesiologist (with whom Dr. Rad always works) in the safest possible environment (accredited hospital-based surgery centers) GA is very safe, in fact it is much safer than the cumulative risk of driving a car every day.

IV Sedation with Local Anesthesia

In some cases, combining sedation with local anesthesia (injected numbing medicine) is used. In this case, patients often receive propofol for the IV anesthetic to induce sedation and which helps them relax and feel drowsy during the procedure. While the patient is not fully unconscious with this approach, they are generally not aware of the surgery and experience little to no discomfort.

This does not involve the inhaled anesthetic as in GA, and does not require an airway tube. You are breathing on your own and the anesthesiologist will maintain your level of anesthesia with propofol and other IV medicines. Oxygenation is supported with supplemental oxygen.

Patients may be a candidate for this type of anesthesia for shorter procedures and neck lift that does not involve deep neck sculpting.

Local Anesthesia Only

This type of anesthesia is the simplest of all, and involves injecting numbing medicine throughout the tissues to be lifted. Dr. Rad uses local anesthetics routinely in the office and this does not require going to an OR.

We start with applying topical numbing which dulls sensation, then injected numbing medicine is given while you are awake.

Patients are candidates for this approach when undergoing in-office mini-face lifts, upper blepharoplasty, buccal fat reduction and direct brow lifts.

Overall, the choice between these types of anesthesia will be discussed during the pre-operative consultation with the surgeon. The surgeon will consider the patient’s medical history, the complexity of the procedure, and the patient’s preference when deciding on the appropriate anesthesia.

You may hear that the safest plastic surgeons have “operating privileges” at major hospitals. “Operating privileges” allow surgeons to perform surgery at that hospital, and they are granted following a 6-month process of evaluating a surgeon’s background.

Dr. Rad’s credentials have rigorously been vetted by the top hospitals in DC and northern Virginia, specifically Sibley Hospital (DC), Inova Fairfax Hospital and Fair Oaks Hospital (northern VA), and George Washington University Hospital (DC). This means that his training, board certification and safety record meet the high standards of these top hospitals in DC and northern Virginia.

Proper skin care is critically important as your tissues will be inflamed after surgery. “Inflammation” is a common term that is commonly associated with harmful internal processes. However, inflammation is a normal process whereby the immune system is activated to heal tissue trauma caused by surgery. This is a normal part of healing. However, too much inflammation can be harmful and so we must be sure to avoid anything that can irritate your skin or worsen inflammation.

It is important to use the right products immediately after surgery. Dr. Rad recommends avoiding products that have stimulatory ingredients such as retinols and using gentle skin care with products that have high concentrations of antioxidants to calm and soothe inflamed skin. Drs. Sherber and Rad recommend the following curated, science-backed products for daily use after facelift surgery (you may order products online or ask our staff for these products from our Boutique). Products are at different price points but we have vetted these products for their high quality ingredients and calming formulations for optimal facelift healing.

• Cleanser: use a high quality oil-based cleanser. Drs. Sherber and Rad recommend Eve Lom Gel Balm Cleanser or Sturm Facial Cleanser. Follow the instructional video on the website. Massage a grape-sized amount of balm or 2 pumps of foam onto dry skin for 60 seconds, then enter the shower. Apply a warm/moist muslin cloth to your face for 30 seconds, repeat twice more, then buff your skin on the last application.
• Incision Care: La Mer The Concentrate
• Face and Neck Care: Sturm Face Cream (fragrance free, best for sensitive skin), Creme de la Mer (contains fragrance), Augustinus Bader The Rich Cream for dry skin (fragrance free), Augustinus Bader The Cream for oily skin (fragrance free), or Caudalie Premier Cru (contains fragrance)
• Eyelid Care: using a separate eye cream such as Sturm Eye Cream, La Mer Eye Concentrate, Augustinus Bader Eye Cream, or Caudalie Eye Cream for eyelids is important to prevent milia, small bumps that can develop when using thick face creams or ointments.
• Lip Care: Sturm Lip Balm, La Mer Lip Balm

In Dr. Rad’s DC practice, the cost for facelifts starts at $40,000 for “deep plane” or ponytail facelift, $50,000+ for surgeries combining other procedures (blepharoplasty, brow lift, fat grafting, etc.), $75,000+ for complex anatomy, corrective work and up to $150,000 for extensive facial surgery requiring multiple operations (such as adding rhinoplasty, facial bone augmentation or shaping, custom facial implants, etc.). Note that pricing is customized for each patient and these guidelines do not necessarily apply uniformly. Also keep in mind these are approximate ranges and total cost depends on multiple factors: your unique anatomy, goals, complexity of the procedures, recommended techniques, whether corrective work is needed, in-office or hospital-based operating facility, and combining multiple procedures (increasing concessions apply for multiple procedures).

Although you may receive varying cost estimates from other practices, keep in mind that your surgeon’s education and training, plastic surgery board certification, his/her experience (at least 8 years of experience after residency is recommended), and the “X” factor of aesthetic artistry and surgical skill (i.e., talent) of your surgeon are important factors in pricing. Dr. Rad’s goal for every patient is to achieve nuanced and natural results with minimal recovery, and we have mechanisms in place to bring your goals in financial reach.

Dr. Ariel Rad strives to deliver the best facelift Washington, DC has to offer. To find out more about facial cosmetic surgery and our financing options, schedule your consultation by contacting our office today.