How Best to Maintain a Facelift

I am 62 years old and had a face lift 2 years ago. I use fillers for volume. My skin is smooth and free of sun damage. I have a facial with RF treatment every 3 months. What procedures should I be using to maintain the results of the lift?

Very good question and somewhat individual. But, there are some general principles to think about.

The appearance of youth is equated with energy and vigor in our culture. This is slightly nuts of course, but a reality. So it makes sense to me to preserve when we can.

The 4 facial characteristics of youth are:

1. Adequate Volume (bone and fat)
2. A Robust Dermis (deeper layer of skin)
3. Drape/Elasticity
4. Surface Quality (epidermis)

For a younger person:

1. The volume is distributed usually in an inverse triangle with the wider part across the brow and temples, and narrower at the chin. The fat in the temples and upper cheeks provide lift and bones are strong
2. The skin over the bones and fat has a thick dermis with a lot of collagen, and good circulation
3. The skin drapes immediately over the existing volume with good elasticity and no sagging.
4. The epidermis (surface) is even in color, has a slightly translucent quality and few or no wrinkles.

So if this is our goal (within reason), then here’s what you might want to think about:

1. Is your volume with fillers or Sculptra (technically a collagen stimulator) nicely proportioned to your face, not too heavy in the cheeks, not stiff when your face moves, and does it recreate your more youthful volume? Do you need augmentation in the temples? Experts only on that please. Blindness can result if this isn’t done correctly.
2. Maintaining a thick dermis requires a depth of RF that most superficial treatments can’t provide. I love the idea of your facials which will help the more superficial section of the dermis, but you may want something like Profound once every year or two to really target the deeper dermis. There is “downtime” with this.
3. If there is a lot of sagging on the lower face and neck, either a facelift (which you’ve had), or a series (3-4) of the deep RF like Profound (need 500-600 pulses per treatment) will make a difference (when done correctly) and create a face-lift like effect. Some patients can’t have a FL for medical reasons, or just don’t want one.
4. The outer layer (epidermis).  There are many options for this including Fraxel Dual, CO2, BBL/IPL, or a series of light peels if you don’t have much sun damage. A great home care regimen is essential. Take a look at my AM and PM skin regimen. My vote for someone in their 60’s is a light CO2, about 3-4 days downtime, once a year to refresh the epidermis if maintenance is only the goal.

I hope this helps,

Brandith Irwin, MD