Facelifts in Your 40s: Longevity, Precautions, and the Truth About Mini Lifts (Patient Reviews Included)
Facelifts in Your 40s: Longevity, Precautions, and the Truth About Mini Lifts (Patient Reviews Included)
Hello, this is Dr. Kim Yong-woo, Head Doctor of Returning Plastic Surgery.
Today, we will discuss Facelifts for those in their 40s, the longevity of results, and the truth about Mini Lifts.
The 40s are a time when facial sagging begins in earnest, and consequently, interest in facelifts peaks. Up until your 30s, laser lifting or thread lifting may have been effective to some extent. However, as you enter your 40s, these methods start to reach their limits, leading many to seriously consider incisional facelifts.
The biggest dilemma usually lies here: "Thread lifts don't seem effective anymore, but an incisional facelift feels burdensome due to scarring. Should I wait until I'm older?"
Many clinics target these specific needs by creating ambiguous procedures named "Mini Lift" or "Mini Lifting." They tempt patients in their 40s by claiming these procedures have "reduced incisions, no swelling, and permanent results."
However, you must be very careful with surgeries named "Mini." This is because while patients can see the incision range, they often have no way of knowing exactly what surgery is being performed inside that incision.
To avoid botched surgeries or ineffective results, you need to understand the anatomy of a facelift and develop an eye for selecting the right clinic.
When is the best time for surgery? Why the 40s?
If you get a facelift in your 40s, you can experience your 30s for 20 years.
It is often said that a facelift makes you look 10 years younger. This means that 10 years after the surgery, or even 20 years later, you will continue to look 10 years younger than your peers.
Assuming a life expectancy of 90: As shown in the chart, if you have a facelift in your 40s, you get to live your 30s for 20 years. You essentially skip the "90s face" and end your life with the face of an 80-year-old. However, if you wait until your 60s to have surgery, you end up living your 50s twice and skip the 90s stage.
"Which would you choose: Living with a 30s face twice, or living with a 50s face twice?"
Because you can undergo surgery when you are slightly younger, enjoy a youthful appearance for 20 years, and live the rest of your long life looking 10 years younger than others, the 40s can be considered the age with the best 'cost-performance' (value) for a facelift.
Anatomical Understanding of SMAS and Platysma Sagging
The SMAS and Platysma are a single unit in the same layer.
If you are interested in facelifts, you have likely heard of the SMAS tissue. The Platysma might be unfamiliar, but it is the muscle responsible for neck sagging. In reality, the SMAS and Platysma are extended tissues and should be thought of as one single block.
Beneath the SMAS-Platysma, there are Retaining Ligaments (marked in blue in the photo above). These create strong adhesions. Therefore, if you pull the skin without releasing (dissecting) these ligaments, the anterior face will sag again very quickly, and various complications can occur at the suture site.
I emphasize this every time: The longevity of a facelift depends on the dissection of the retaining ligaments.
> Please refer to my previous post on the importance of Retaining Ligament Dissection. [Link to previous blog post]
Therefore, when tissues stretch due to aging, the SMAS and Platysma sag simultaneously. This is a crucial fact to consider when choosing and recommending surgery, yet it is often overlooked.
When you go for a consultation regarding sagging in your 40s, you are often told: "You are still too young for a full facelift, but thread lifts have limits, so why not try a Mini Lift?" It is easy to be tempted by promises of quick recovery (like threads) and long duration (like a facelift). You must be very wary of such sweet talk!!
Mini Lift / Mini Lifting: What exactly is this surgery?
"Mini Lift" is not an official medical term. Every hospital defines "Mini Lift" differently and uses different surgical methods. Some clinics claim to perform SMAS dissection but, in reality, use deceptive practices like making an incision, inserting threads, and closing it up.
"Mini Lift" that only involves incision and threads without dissection This method is widely performed by many clinics under the name Mini Lift or Mini Lifting. While immediate satisfaction is high, this is a surgery you should absolutely avoid. Strictly speaking, it is no different from a thread lift, but it leaves you with unnecessary scars. Surgeries that forcibly pull tissues without releasing the retaining ligaments will unconditionally result in sagging again.
They advertise "Mini Lift" as a procedure that combines the benefits of thread lifts and facelifts. However, if they only make an incision and pull with threads without releasing the ligaments, you should think of it as a surgery that combines the downsides of both procedures. Do not be misled!
If you see reviews claiming "no swelling and dramatic lifting" immediately after a Mini Lift, check how much time has passed since the surgery. Most are 1-month post-op reviews; there are rarely long-term reviews exceeding 6 months. There is no such thing as a simple, quick-recovery surgery with great, lasting effects.
Tips for Choosing a Facelift Clinic
Even if you are getting a Mini Lift or Thread Lift, choose a hospital that specializes in Facelifts.
"A craftsman with only one tool solves every problem the same way, but a skilled master chooses the optimal tool for the situation."
Clinics that only perform Mini Lifts have no other options, so they try to solve everything with Mini Lifts, which may not be the best choice for you. However, at a specialized hospital that performs full facelifts, if they recommend a thread lift or Mini Lift after consultation, it is likely the optimal choice for your specific case. You will receive a higher level of professional care.
Make sure to check if the surgeon is a Board-Certified Plastic Surgeon with specialized knowledge. Dexterity is important in facelift surgery, but the surgeon's level of knowledge is crucial. Unfortunately, many non-specialist clinics popular on SNS engage in absurd and unconscionable marketing. Primarily, you should verify if the doctor is a plastic surgery specialist with expertise in facelifts.
"Our clinic performs Mini Lifts that release retaining ligaments!!" -> What is the reality?
Nowadays, almost no clinic admits to doing the "thread-lift-style" Mini Lift described above because patients have become smarter. Everyone claims to use "minimal incisions but with ligament release." The diagram below represents the "Mini Incision Facelift with Ligament Release" that many hospitals claim to perform.
Diagram of Mini Lift with SMAS Dissection // Is it truly effective? They divide the face into three parts (Mid-face / Lower-face / Neck), make small incisions in 3 sections, and claim to perform SMAS lifting. In fact, I view this surgery very skeptically for the following reasons:
Doubt 1: Is ligament release possible through such a small incision? Realistically, it is difficult to dissect down to the retaining ligaments via the Deep Plane through such a small incision size. While not impossible, releasing ligaments requires very precise dissection to avoid damaging nerves and blood vessels. Doing this through a small keyhole would be an extremely challenging surgery due to visibility issues. Even if they succeed in avoiding nerve damage and releasing the ligaments, if bleeding occurs due to vessel damage, hemostasis (stopping bleeding) could become a catastrophic situation.
Doubt 2: What is the longevity of a "Partial Ligament Release"? Let's assume the surgery above was successful. Even if a specific area was successfully "mini-lifted," as mentioned earlier, the SMAS and Platysma are continuous tissues that sag as a whole unit. Would pulling only a specific dissected part provide good longevity? Due to the drag and resistance from the un-pulled (un-dissected) SMAS-Platysma tissues, you cannot expect good longevity even in the lifted area.
Returning Plastic Surgery's Differentiated "Mini Lift"
Returning Plastic Surgery also performs Mini Lifts. However, our incision is about twice as large as what other places call a Mini Lift. We treat it equivalent to a face-neck lift, utilizing the Deep Plane method to release all retaining ligaments before pulling.
"For a Mini Lift with good longevity, the SMAS-Platysma dissection must be identical to the range of a Full Facelift." - Returning Plastic Surgery
Returning Plastic Surgery's Mini Lift Diagram At Returning Plastic Surgery, we divide it into two categories.
- Mini Facelift: In reality, you can think of this as what other places call a "Facelift." The incision goes from the temple to behind the earlobe.
- Mini Neck Lift: The incision runs from the front of the ear to behind the ear. We make it a rule to cut (release) retaining ligaments in all areas. Only with this extent of incision can we safely lift the SMAS-Platysma tissue and neatly remove the excess skin.
[Diagram of Returning Facelift & Neck Lift] Our Face-Neck Lift incision extends from the temple to behind the ear. If you are considering a facelift in your 40s, you must check the scope of the SMAS dissection.
Returning Plastic Surgery: Reviews of Patients in their 40s
[Mini Facelift Case] Returning Plastic Surgery
- Case 1: A female patient in her 40s underwent a facelift for general sagging of the mid and lower face. (Photo taken 7 days post-op).
- Case 2: This patient is in her 20s, but due to previous facial contouring surgery, she exhibited sagging equivalent to someone in their 40s. We improved the sagging mid/lower face through a Mini Facelift.
- Case 3: A female patient in her 30s who also had a history of contouring surgery. We improved the sagging tissues after the facelift.
[Mini Neck Lift Case] Returning Plastic Surgery
- Case 4: A foreigner in her 40s underwent a Mini Neck Lift to address neck sagging. In this case as well, we dissected and lifted both the SMAS and Platysma tissues to ensure a long-lasting result.
- Case 5: A patient in her 40s with general sagging of the lower face and neck. Through a Mini Neck Lift, we were able to create a sharp and defined neckline.
Writing about facelifts for the 40s, longevity, and Mini Lifts has resulted in a rather long post. I wanted to capture all the thoughts I've had while treating patients and convey the truth sincerely to those worrying about sagging. I hope everyone chooses a good hospital and resolves their stress effectively.
This has been Dr. Kim Yong-woo, Head Doctor of Returning Plastic Surgery. Thank you for reading this long post!
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