This is one of the most common questions asked by patients. Almost everything in life wears out - the car, the washing machine, etc. - so they want to know when their facelift will finally wear out too. They would appreciate a definite answer, but the answer is more complex and requires an understanding of what a facelift does (reduce apparent age) and what it does not do (stop the aging process). By lifting and restoring tone to the face, a facelift can reverse many of the effects of time and gravity. Combined with other techniques, one's apparent age may be reduced. Our study found that combined facial rejuvenation reduced apparent age by an average of 6 years, so a 56 year-old now looks 50. In ten years, she will appear to be 60 years old, not 66. So the facelift turns back the clock. Patients will always look younger than if they had not had the lift.
So, when might a patient return to have another facelift? If she is unhappy with the way she looks now and can expect to have a similar appearance in six years, it makes sense that she might return at that time for another lift. However, in practice, few patients return before ten years, and, in some areas such as the neck, the surgical improvement may hold up much longer than six years: (See B.W. and B.K. in Patient Photographs).
The six-year reduction does not consider maintenance procedures along the way. In fact, patients do return for touch-up procedures after their lifts. They may return every few years for a light laser resurfacing or fat injection. With such maintenance, they may look better in six years than they did before surgery today. I have patients in their fifties and sixties who think they look better than they did a decade ago and some fifty-somethings (Patient B.W. in Patient Photographs) who say they never looked better.
Some surgical changes may persist beyond a decade. Double chins are an example. Fat removed under the chin does not come back, although the skin will gradually loosen. Patients treated simultaneously with a chin or chin/jowl implant will always have a more balanced and pleasing profile. If skin is protected from UV exposure, the skin quality may actually improve. The results of eyelid surgery may well last beyond ten years. Frequently, the eyelids look better than they did in pictures ten years ago. It is important for the reader to maintain a healthy skepticism- that is why long-term follow-up photographs are important and included in the Patient Photographs section.