Increasing numbers of women are going under the knife at an earlier age. Liz Krieger investigates.

Portrait of Tammy Strobel

Increasing numbers of women are going under the knife at an earlier age. Liz Krieger investigates.

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When you think about a typical face-lift patient, chances are you’re not thinking about a woman still well within her childbearing years. But that’s just what Carey*, 35, was last summer. “I have always had a saggy face,” she recalls, in part because of volume loss but also just because of the luck of the genetic draw. “I hated that my peers all looked so much younger than me. And it drove me crazy that people were starting to call me ‘ma’am.’ ” So instead of opting for copious amounts of injectable fillers or other noninvasive techniques, Carey headed to New York facial plastic surgeon Konstantin Vasyukevich (known as Dr. Konstantin) for a face-lift.

Carey is hardly the only premiddle- age woman choosing the most invasive choice, and some experts say it’s arguably the wisest option. “I’ve definitely seen more and more younger women—those in their midto- late 30s and early 40s—deciding to have a face-lift rather than head down the road to that telltale overfilled look,” says Konstantin. Another benefit: By having a face-lift when your ageing issues are still relatively minor, you’re less likely to need a massive transformation—a down-low preference for many who are discreet about cosmetic improvements, says Stafford Broumand, a New York plastic surgeon.

Younger women are also learning that today’s face-lift is not their grandmother’s face-lift. Surgeons used to simply lift the skin and stretch it taut. “Because this didn’t last very long, many doctors would overtighten the skin to try to compensate for the lack of longevity,” says Konstantin, leading to “that crazy pulled look.” Thankfully, doctors now are armed with better knowledge of the underlying bone structure and musculature, and are able to use much smaller incisions as well as “restore fat compartments and tighten muscles that have relaxed, as well as the skin, so you achieve a more natural look,” explains Sachin M. Shridharani, a plastic surgeon in New York. The result is that a modern face-lift will last you at least a decade and be far more understated, asserts Jason B. Diamond, a Beverly Hills facial plastic surgeon who says that in his practice—which includes many Hollywood faces— the average age of a face-lift patient has dropped from the early 50s to the mid-40s, and the pool of patients in their 30s has grown by about 50 percent over the past 15 years. The truth is, your age may have little to do with it, says Gerald Imber, a New York plastic surgeon: “Look in the mirror, not at the calendar.” There are some people who genetically have droopy jowls or sagging cheeks, he says, and it doesn’t matter if they are 33 or 63—the problem is real.

For women with enough patience, and the right facial troubles, “skintightening treatments like Thermage or Ultherapy might be a good choice,” suggests Broumand. But those don’t always work well enough, or fast enough, for everyone, and particularly for extreme sagging. “Some people want one-stop shopping,” Diamond says. “A face-lift—while definitely more costly than a few syringes of filler—is a one-and-done thing, with the biggest, most reliable payoff.” The average cost is about US$7,000. Recovery? Usually one week.

Still, not every expert thinks you should just go for surgery. “There are so many great nonsurgical techniques to achieve facial rejuvenation,” says Shridharani. “While lasers, Botox and fillers are no substitute for a face-lift, women who use them in preventative ways do not seem to age quite as much.” What’s more, there can be a downside to hitting the O.R. too early: “The more surgery you have, the more you risk looking like you’ve had work done,” he says. Diamond counters that surgery “will be really obvious if you wait until later,” and by doing it younger, “you do it subtly, which gives better results.” Alas, the ageing process never stops, so future treatments may be necessary, but they should be less invasive.

Kate, a 32-year-old New Yorker, had spent five years using fillers and other noninvasive treatments before she ended up under Konstantin’s scalpel. “All the fillers did nothing to address the jowls I inherited. I felt like I had a weighty, puffy look to my face.” Just a month after her surgery, she was delighted with the subtle but significant results. As for Carey, the outcome has been even more noticeable. “People immediately started calling me ‘miss’ again.”