Growing-up, when I thought about a facelift, I envisioned rich old ladies with distorted facial features, unnaturally tight skin, and tell-tale scarring. Now, with celebs being more transparent about the work they have had, I, along with everyone else have become more aware of what a good facelift can do. And that offers a natural-looking, yet completely transformative youth boost. Kris Jenner, Sia, Lindsay Lohan (allegedly), and at least a dozen Bravo Housewives have wowed us with their new faces. So, now, as going under the knife has become more normalised than ever before—I’m starting to consider the surgery I once thought I’d never have.
I’m not alone, as according to the British Association of Aesthetic Plastic Surgeons (BAPPS), face and neck lifts rose by 11 per cent in 2025, while brow lifts, which are typically combined with facelifts, increased by a whopping 27 per cent. So, as the reality became not if, but when would I get a facelift, I also started to wonder if I would have to start planning my longstanding and future aesthetic treatments around my desire to go under the knife.
“You absolutely do,” shared plastic surgeon, and Mallucci London founder, Patrick Mallucci. “The road to surgery requires as much thought as the surgery itself, because what many patients don’t realise is that the aesthetic treatments you have in the years, months and even weeks before a facelift can significantly affect the surgery and the outcome.”
Facelifts, explained
Ponytail facelift, deep-plane facelift, SMAS facelift. There is a plethora of terms for what plastic surgeon and aesthetic doctor, Lara De Luca, explains is essentially, “a surgical procedure that repositions and tightens the facial tissues and removes excess skin to restore a more youthful appearance.” What makes the latest facelift techniques better than facelifts of old is that, “modern facelifts focus on lifting and repositioning the underlying structures of the face rather than simply pulling the skin tight. This creates more natural-looking, longer-lasting results and avoids the overly stretched appearance that was sometimes associated with older techniques,” adds De Luca. But like with most aesthetic treatments and surgical procedures, one size does not fit all. “Every surgeon has their own technique, and every technique has its advantages and disadvantages. The buzz surrounding particular techniques on social media can be misleading and a distraction from the more important conversation about which technique suits you best,” adds Mallucci.
What suits you will largely be dictated by several factors: your bone structure, skin thickness, fat distribution, the level of sagging, as well as how much downtime you're willing to accept and your long-term goals. Age doesn’t really play a role, as it's less about how old you are and more about how soon you show signs of ageing. "Some patients may be suitable candidates in their 40s or earlier, particularly if they have experienced significant weight loss (often assisted by GLP-1s), extensive sun damage or have a strong genetic tendency towards early facial ageing. Others may not consider surgery until their 60s or later. Genetics, lifestyle, skin quality and facial structure all play a role," shares De Luca.
The treatments that can complicate things
Timing is key. Not just when you decide to go under the knife, but how you plan the aesthetic treatments that are often booked to push surgery further down the line—and, increasingly, which treatments you've been told to fear versus which ones actually deserve the reputation. TikTok is awash with videos vilifying certain treatments as facelift-ruiners. The truth, however, is far more nuanced than the discourse suggests.
Sculptra, in particular, has become a scapegoat for a problem that's largely historic. Plastic and reconstructive surgeon Dr Ashwin Soni explains that complaints traced back to how the product was used years ago, not the product itself. "Sculptra comes as plant-derived microparticles mixed with sterile water, and very early on, some providers weren't diluting it enough," he says. "Injected too concentrated—and often too deep, in the same plane surgeons later need to work on during a facelift—it triggered a collagen response that could potentially cause lumps, leading to a lasting reputation".
The good news is that dilution protocols have moved on, and most biostimulators now follow far more conservative guidelines. Soni often recommends Sculptra to his own patients, both to improve skin elasticity ahead of a facelift and to maintain results afterwards—provided you're seeing someone who genuinely understands facial anatomy and injection depth. In fact, Sculptra is one of the safest and most robustly researched biostimulators available today, having originally been developed over 25 years ago for medical use and put through rigorous safety protocols.
Threads, however, are a different story. Where Sculptra's reputation has outlived its risk, Soni is unequivocal that threads haven't—he never recommends them, calling the scarring risk, from both the depth they're typically placed at and the way they interact with tissue, too consistent a downside for someone planning future surgery.
Other biostimulators like hydrating Profhilo, regenerative exosomes and polynucleotides are not "a concern," reveals Mallucci, as they're designed to improve skin quality, boost hydration, and stimulate collagen at a superficial level. The same goes for devices like ultrasound-powered Sofwave and Morpheus8, which combines microneedling with radiofrequency to tighten and contour skin.
One category we should be more wary of, says Mallucci, is "deep-acting energy devices" such as J-Plasma and FaceTite, which work at a level that can scar you in the same planes a surgeon later needs. Soni makes a related point about radio frequency microneedling specifically: the risk isn't really the device category, it's whether the person holding it understands anatomy. "You need to make sure that you're with a provider who understands it," he says—the same caveat, really, that applies to all non-surgical cosmetic procedures.
What about dermal filler?
Though dermal filler has arguably been knocked off the top spot with the rise of biostimulators and fat transfers, many aesthetic doctors still believe it has an important role to play when it comes to lifting, and contouring the face—especially in the years leading up to a facelift. "However, large volumes of filler can sometimes mask the true extent of age-related volume loss or tissue descent, making assessment more challenging," explains De Luca. "They’re not a contraindication to surgery, but it’s important that patients disclose their filler history during the consultation so the surgeon can plan accordingly."
And you might not even have to dissolve your filler pre-surgery, “In some cases it might be an advantage to dissolve the filler before the facelift. In other cases, it’s not necessarily required. It depends on where it’s been put and how long ago,” adds Mallucci.
Find one doctor, not five
If there's one piece of advice that cuts across all of this, it's not about which treatment to avoid—it's about who's administering it. Soni is candid that patients hopping between providers make surgical planning harder, simply because no one has the full picture. "People need to have a long-term game plan with a doctor, with whom they're in a long-term patient relationship," he says, pointing out that skin quality and anatomy shift over time regardless of what you have or haven't had done.
His advice for anyone choosing a provider: do your homework and research them in depth. Check before-and-afters, ask about training and experience with facial anatomy, read reviews, and confirm their registration with the various governing bodies like the General Medical Council, or the Nursing & Midwifery Council. The BCAM Pre-Consultation Safety Questionnaire is a handy six-step checklist designed to help you choose safely. It covers practitioner qualifications, insurance, premises standards and product sourcing, and can be printed or sent to a clinic ahead of time.
When to stop tweaking
Whether you choose to get a facelift in your 40s, 50s, 60s or 70s, the healthier your skin is, the better—if we ensure our skin is well-hydrated, collagen-rich and resilient it will make a meaningful difference to both our results and recovery.
What we must do is be totally transparent with our future surgeons and go for our first consult at good amount of time before our ideal surgery date. “As a rule of thumb, stopping treatments at least six months before surgery, and ideally up to a year in some cases, allows for better assessment and surgical planning. Patients also need to disclose all previous aesthetic treatments, as well as any previous facial surgery or trauma. This information can significantly influence surgical planning and helps avoid unexpected findings during surgery,” says De Luca.
I’m planning to create a digital diary of all the treatments I’ve already had (everything from injectables to lasers), and log all my future treatments too, so by the time I have my first consultation with a surgeon I’ll be armed with all the info they need. Let the countdown begin...
This content is for informational and educational purposes only and does not constitute medical advice - always consult with a qualified healthcare professional before treatment decisions.
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