Who Is a Candidate for a Facelift?

Not everyone who wants a facelift is a candidate for one. Suitability depends on general health, skin elasticity, the underlying bone structure and what the patient expects the operation to achieve. Age is the least useful of these.

General health

The primary criterion for any surgical procedure is general health. Candidates should not have serious medical conditions that would impair healing or increase the risks of surgery. Uncontrolled hypertension, clotting disorders and significant cardiovascular disease all pose material risk during and after surgery.

Realistic expectations

Realistic expectations about the outcome are essential. A facelift addresses the changes present at the time of surgery; it does not alter fundamental appearance and it does not stop the ageing process from continuing afterwards.

Discussing what you want addressed, and hearing what the procedure can and cannot do in your specific case, is part of the assessment rather than a formality.

Skin elasticity and bone structure

Skin elasticity affects the result. Patients whose skin retains some flexibility tend to achieve better outcomes, as the skin adapts more readily to the repositioned contours.

Underlying bone structure provides the framework over which the soft tissue is repositioned. Where that framework is well defined, the result is more predictable. Where it is not, adjunctive procedures such as chin augmentation may form part of the plan.

Age

Facelifts are most commonly performed on patients between their forties and sixties, but age alone is not determinative. Younger patients may seek a facelift because of earlier changes; older patients may be suitable candidates where their skin condition and general health allow.

What matters is the degree to which the specific findings — skin laxity, deeper creases, loss of tissue support — are actually present.

Skin type

Skin type affects the outcome in two respects:

• Skin thickness. Thicker skin may provide better support for the repositioned contours and can hold the result longer.
• Skin tone. Patients with fair to medium complexions tend to have less noticeable scarring. Patients with darker skin types require specific discussion about scar behaviour and pigmentation before proceeding.

Assessment

Each face presents differently, and the operation is planned around what examination finds rather than around a standard technique. Assessment establishes what is present, what the operation can address, and whether surgery is the right answer at all.