Facial rejuvenation: Options to restore a youthful look, with or without surgery
September 11, 2026
When people talk about facial rejuvenation, getting a facelift may be the first thing that comes to mind. But the range of options is much broader than that.
Facial rejuvenation is a personalized approach to helping you look refreshed while preserving what makes you uniquely yourself. Facial rejuvenation can include nonsurgical or surgical cosmetic treatments that address volume loss, sagging skin and deeper structures, and skin quality, restoring a younger look to the face and neck.
Getting facial plastic surgery should never compromise your health or facial function. Facial plastic surgeons in UT Southwestern’s Otolaryngology and Plastic Surgery departments only recommend treatments that are appropriate for your anatomy, your goals, and your overall health – not simply what’s popular or trending.
If you are considering facial rejuvenation, the first step is to identify how aging has changed your face and what you wish to improve. Then we can discuss which nonsurgical or surgical treatments can help you achieve natural-looking results.
Why the face changes as we age
Facial aging is more complex than wrinkles alone. Several major changes occur over time. These may be influenced by individual anatomy, genetics, environmental exposures, and medications such as GLP-1s.
1. Gravity changes the position of facial tissues
We spend our lives living in gravity, and over the years, it causes the soft tissues of the face to gradually descend. That contributes to drooping brows, sagging cheeks, jowls, and loose skin in the neck. No one is immune to gravity, and its effects are a normal part of aging.
2. Facial volume decreases
As time passes, we naturally lose fat in the face and experience hollowing of facial bones. This can create a less full, hollower appearance around the cheeks, temples, and eyes as well as exacerbate tissue descent.
3. Skin quality changes
Collagen production slows with age, making skin thinner and contributing to fine lines and wrinkles. Years of sun exposure also can lead to uneven pigmentation and changes in skin texture. Hormonal changes associated with menopause also affect the skin’s integrity and hydration.
Because aging affects the skin, soft tissues, and underlying facial structure, facial rejuvenation often addresses a combination of these changes. It is much more than just “tightening.”
Who is a candidate for facial rejuvenation?
While there isn’t a specific age to begin thinking about facial rejuvenation, we tend to see interest in different treatment pathways at different ages.
Age 30 and younger: Many young adults don’t need more than healthy skin care habits, including regular use of a broad spectrum sunscreen. I often tell younger patients that when it comes to cosmetic treatments in younger years, less is more.
30s and 40s: Early treatments may be as simple as establishing a good skin care routine and, when appropriate, considering common nonsurgical treatments, such as those listed below.
Surgical interventions may also be appropriate based on an individual’s unique anatomy and aging pattern:
- Botox or Dysport injections: Smooth fine lines and wrinkles.
- Dermal fillers: Restore volume and fullness to aging skin.
- Laser therapy: Addresses wrinkles, scars, and skin quality.
- Microneedling: Encourages collagen production in specific areas of the face, and may improve the appearance of fine lines, pores, and scars.
- Chemical peels: Treat discoloration, wrinkles, and uneven skin tone.
50s and beyond: Facial cosmetic surgery more commonly enters the discussion in this age group. For example:
- Forehead lift (brow lift): Raises sagging brows using small incisions hidden within the hairline.
- Upper or lower blepharoplasty (eyelid surgery): Removes excess skin and/or fat to rejuvenate the appearance of the eyes and reduce puffiness.
- Facelift: A deep plane facelift restores the deeper structures of the face including muscles, fascia, and fat pads to a more youthful position to address sagging tissues and jowling, with a natural rather than “pulled” appearance.
- Neck lift: Addresses loose neck skin and muscle and possibly deeper structures such as deep fat, muscle, and/or submandibular glands to create a youthful jawline and naturally sculpted neck.
- Lip lift: Shortens the distance between the nose and upper lip to create a more youthful appearance.
- Fat transfer: Uses fat from one part of your body, such as the thighs or abdomen, to restore volume in the face that was lost with aging.
- Earlobe reduction: Reshapes stretched or elongated earlobes that commonly change with age.
- Rhinoplasty: Resizes or reshapes the nose to improve appearance, function, or both.
Laser therapy, including laser skin resurfacing, or chemical peels are frequently performed during surgery to help improve fine lines, wrinkles, and sun damage.
Whether you are a good candidate for surgical treatments depends more on your facial anatomy than your age. Increasingly, patients in their 40s are choosing surgery if anatomy and goals are aligned.
What should you know before choosing cosmetic surgery?
Time marches on
Facial plastic surgery sets back the clock, but you will continue to age. So, you’ll want to consider how long you can expect the results to “last.” For example, a recent study found that the average lifetime of a facelift before a patient seeks another one is about 11 years. This is not the time at which effects are “lost;” rather, it’s the time when patients most commonly seek another facelift. After a facelift, you will always look younger than you would otherwise.
It is important to remember that mild aging changes produce mild surgical results. If you’re noticing only subtle signs of aging, even a major operation will create relatively subtle improvements.
Overall health counts
We also consider several other factors before recommending surgery, including:
- Your overall health and ability to receive anesthesia: Some surgeries take several hours to complete, and comprehensive rejuvenation with multiple combined procedures may take 6-8 hours.
- Whether your weight is stable: This is especially important if you take a GLP-1 medication and may continue losing weight or are noticing a lot of fat loss in the face. Weight stability is important after surgery to avoid early return of laxity or volume loss.
- Whether you smoke: Tobacco use introduces too much risk during healing and may disqualify patients from getting surgery.
- Whether you have support at home: During recovery, patients generally benefit from physical help as well as mental health reassurance as their appearance changes throughout the early healing process.
Choose an experienced surgeon
Choosing a qualified surgeon is one of the most important decisions you’ll make when undergoing facial rejuvenation procedures:
- Plastic surgeons complete general surgery training followed by plastic and reconstructive surgery training. They may perform cosmetic and reconstructive procedures throughout the body, including the face.
- Facial plastic surgeons complete residency training in otolaryngology/head & neck surgery followed by fellowship training focused exclusively on facial plastic and reconstructive surgery. Their training is dedicated entirely to the face, head, and neck.
Both specialties include outstanding surgeons. When choosing a provider, ask about their board certification, training, and experience with the specific procedure(s) you’re considering.
Considering a facelift someday? Avoid these procedures.
If you think you may want a facelift in the future, there are a few procedures we recommend against. Not having these procedures will help you achieve the best surgical outcomes if you do opt for a facelift:
- Thread lift, which includes inserting barbed threads below the skin to tighten the face in a minimally invasive procedure. Thread lifts often provide limited improvement and can create scar tissue that may complicate future procedures.
- Filler injections and Sculptra within two years of a facelift. Depending on where they are placed, fillers should often be dissolved before surgery so your natural anatomy can be accurately evaluated. Fillers can also lead to prolonged swelling during surgical recovery. Based on more recent studies, we now know that hyaluronic acid fillers may last much longer in the face than initially described.
What should you expect after facial plastic surgery?
Facial tissues are sensitive, and these are major surgeries. You should expect swelling and possibly bruising during the first couple of weeks after surgery – I sometimes refer to this stage as the “alien phase” because patients don’t yet look like themselves.
While this is a normal part of healing, it can be emotionally challenging. Swelling gradually resolves over time. I encourage patients to have a trusted family member or friend available during those early weeks for practical help and emotional support. You can also improve healing by following postoperative instructions from your doctor, such as eating a healthy diet, reducing salt intake, avoiding alcohol, and following postoperative activity limitations.
The goal of facial rejuvenation isn’t to make you look like someone else. It’s to understand what concerns you have so we can develop a personalized plan to help you achieve dramatic yet natural-looking results that still look like you.
To talk with an expert about facial rejuvenation, make an appointment by calling 214-645-8898 or request an appointment online.
