Sherber + Rad | Serving the Washington, DC metropolitan area and Potomac
By Dr. Ariel Rad
Q1: Facelifts were once seen as something for patients in their 60s or 70s. What’s changed?
Since opening Sherber + Rad in 2014 with my wife, Dr. Noëlle Sherber, the plurality of my facelift patients has remained in their 50s to 70s. However, over the last five years, the earlier limit of age has shifted toward the 40s—and more recently, into the 30s.
The reasons for this shift, and the broader cultural reframing of facelifting as a “normal” option, are multifactorial.
First, demand has been driven by greater aesthetic literacy, largely fueled by social media. Patients today are far more informed. Second, there’s a growing realization that surgery—when performed with artistic nuance and restraint—can produce more natural outcomes than non-surgical modalities, particularly when compared to the overuse of injectable fillers that volumize rather than lift.
Third, we’ve seen step-change advancements in surgical techniques: deeper anatomical approaches, endoscopic methods that minimize external scars, and the ability to modify facial bone structure with alloplastic (biocompatible) materials.
Fourth, the proliferation of GLP-1–related weight loss has made skin laxity a primary concern for more patients.
Combined with increased visual self-scrutiny—from video conferencing to social media—and a desire for enhancements that are beautifying, not just rejuvenating, the mindset has shifted. Surgery at younger ages is no longer viewed as extreme, but as a thoughtful, proactive option.
From a technical standpoint, surgeons have had to evolve. My approach blends alloplastic skeletal augmentation with soft tissue enhancement to create results that are both natural and long-lasting. This concept—what I refer to as face optimization—is not limited to rejuvenation. It’s about enhancing structure to elevate overall facial aesthetics, and it’s inherently age-agnostic.
Q2: You’ve said fillers aren’t a cure-all. When do you tell patients it’s time to consider surgery?
Patients today understand that fillers are a bridge—not a replacement—for surgery. In my practice across the Washington, DC metropolitan area and Potomac, I see two primary patterns that signal it may be time to transition.
The first is what I call “filler fatigue.” Patients reach a point where volumizing treatments no longer deliver meaningful improvement. Instead, they may notice heaviness, loss of definition, or an unnaturally inflated appearance. Fillers do not provide structural support—they add volume, but they don’t lift.
The second, often overlapping issue, is lack of adequate facial bone structure, particularly in the midface. This can manifest as under-eye bags, tear trough hollows, flat cheekbones, or a bottom-heavy facial appearance—concerns often mistaken for premature aging.
Many patients have spent years using filler to address these areas. While it can temporarily improve surface appearance, the added weight can actually worsen sagging over time when underlying support is lacking.
The more definitive solution is structural:
- Augmenting the underlying bony framework
- Performing a deep plane facelift and neck lift to reposition tissue on a stable foundation
This approach corrects both form and function—creating more natural, longer-lasting results.
Q3: What is the difference between a “beautification facelift” and a traditional rejuvenation approach?
Facial “sameness” often follows cultural trends—whether it’s V-line jaw shaping in Korea, “fox eye” aesthetics in Turkey, or certain nasal profiles in the U.S. These trends can lead to homogenized results if applied indiscriminately.
My approach is fundamentally different.
While I follow consistent technical principles, the artistry is never replicated. Each face is treated as entirely unique. When surgery is personalized to respect a patient’s anatomy and identity, attractiveness can be enhanced in a way that feels natural and individualized.
A rejuvenation facelift restores what time has altered—bringing a patient back to a prior version of themselves.
A beautification or optimization approach goes further. It addresses underlying disharmonies in bone structure, proportions, and facial framing to enhance overall balance. This may involve:
The key is restraint. I focus on millimeter-level changes across multiple areas, blending enhancements that preserve identity while elevating harmony.
The goal is never a “same face”—it’s a more refined version of the individual.
Q4: When patients say “I want my old face back,” how do you approach that?
That’s a common and very reasonable goal—especially among patients in professional, high-visibility environments like Washington, DC.
My role is to translate that into a precise surgical plan.
This begins with an in-depth consultation where I review photographs from earlier in life and compare them with current anatomy. We look at how the face has changed over time—descent, volume loss, skeletal shifts, and contour differences.
From there, I develop a plan that may include:
- Deep plane facelift to reposition midfacial fat
- Deep structural neck lift to restore jawline definition
- Microfat grafting to restore volume
- Endoscopic brow lift and blepharoplasty to reframe the eyes
Equally important is setting realistic expectations. Surgery has limitations—healing variability, visible scars, and recovery time must all be considered.
I prioritize safety and ethics above all. If expectations are unrealistic, or if surgery is not in a patient’s best interest, I will decline to operate. The goal is always a natural, balanced result.
Q5: Is a facelift at 40 different from a facelift at 70?
Fundamentally, yes.
Facial aesthetic surgery exists on a continuum, and patient age significantly influences both indication and technique.
For younger patients (30s–40s):
- The goal is often preventive or optimization-focused
- Concerns include early laxity, under-eye hollowing, and facial proportions
- Techniques may include:
- Endoscopic brow and midface lifts
- Minimal-scar deep plane approaches
- Structural augmentation
For older patients (60s–70s):
- The goal is restoration
- There is typically more significant skin laxity
- Treatment often involves:
- Full deep plane facelift
- Skin redraping and removal
- Combination procedures
Across all ages, my priorities remain the same:
natural results, longevity, safety, and discretion.
Q6: Do you use different language with younger patients instead of “facelift”?
The term “facelift” isn’t inherently stigmatizing—it’s more accepted than ever. However, it can evoke an outdated idea of simply lifting what has fallen.
For many younger patients, that’s not the goal.
My approach is better described as aesthetic sculptural refinement, which is why I use the term face optimization. It reflects a more accurate concept: enhancing facial structure to elevate overall aesthetics.
These conversations require a more nuanced vocabulary. I often use terms such as:
- Negative vector morphology (set-back midface structure)
- Aesthetic proportion effects (how structure influences perceived feature size)
- Ogee curves (the natural contours of the face)
- Concepts like definition, angularity, and Sfumato
These help patients articulate a vision that goes beyond simply looking “younger.”
Q7: How do you manage social media–driven expectations?
Social media often promotes unrealistic narratives—dramatic transformations, minimal downtime, or results that mimic filters or celebrity appearances.
In consultation, my role is to reframe that perspective.
Surgery is not a filter. It is a permanent, medical intervention that requires judgment, restraint, and a commitment to safety.
At Sherber + Rad, I prioritize:
- Performing procedures in accredited, hospital-based settings
- Working with highly trained anesthesia and nursing teams
- Selecting patients carefully
Not everyone is a candidate. If a patient’s goals are unrealistic or misaligned with safe practice, I will not operate.
My philosophy is simple:
the right procedure, for the right patient, at the right time—even if that means saying no.
Q8: Is this shift toward younger facelifts unique to the U.S.?
No—this is part of a broader global trend, with notable activity across the U.S., Brazil, South Korea, Turkey, and Latin America.
However, aesthetic ideals vary by region, and in some markets, the demand for procedures has led to commoditization and a proliferation of underqualified providers.
That presents real risks.
Patients who come to Sherber + Rad—often from across the country and internationally—are seeking something different:
- A focus on safety
- A commitment to natural, refined outcomes
- A high level of surgical judgment and restraint
In a sophisticated market like the Washington, DC and NYC metropolitan area, the standard is not transformation—it’s precision and subtlety.
Final Thought
The modern facelift—particularly the deep plane facelift—has evolved into a structurally driven, highly individualized procedure.
Earlier intervention. Greater precision. More natural results.
Under the direction of Dr. Ariel Rad, the philosophy is clear:
Enhance the structure. Preserve the identity. Elevate the outcome—quietly.
To schedule a private consultation at Sherber + Rad, contact the office to explore deep plane facelift and facial optimization options tailored to you.