Why do facelifts look so unnatural? What prevents plastic surgeons from making seniors look like they did when they were 30?

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When a 70 year old gets a facelift and plastic surgery, it looks like a 70 year old who had a facelift. Why is it impossible to convincingly reverse the effects of aging by tightening skin and re-sculpting?

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Older skin isn’t just sagging, it has different properties compared to younger one. Like not so elastic, thinner and a bit translucent. There’s no way around it really.

This kind of has two answers.

First is because the human brain has developed to recognize and memorize faces. It’s one of the things our brain is best at. Which is why we see faces where there aren’t any, like the front of cars or in the clouds.

So, you have to be really really perfect to trick the brain, because you’re basically trying to convince the brain at what it is best at, that a face is a natural face. Which in on its own is extremely difficult to do.

But even if you did get the face perfect, you have more problems, the rest of the body.

If you see a 30 year old face on a 60 year old neck, that is going to look unnatural, or a 30 year old face with the hair of a 60 year old, that is going to look unnatural. The human body is one whole thing, so when one part doesn’t seem like it matches the rested that looks unnatural to us.

You can’t put everything back where it used to be. For example the skin beneath your eyes, you can’t pull it up and create new eyelids, you have to pull the excess to the side. Same with the skin beneath your nose and mouth and chin. It has sagged straight down, but you can’t pull it back up, you can only pull it to the side.

My dermatologist recommended microneedling to a specific depth that helps your skin create new collagen. I’m nowhere near 70 but seems like a decent preventive plan.

In addition to all the other good answers I can see, I also want to point out the survivorship bias inherent in your question–if someone gets a really good facelift that DOESN’T look unnatural, you probably wouldn’t realize that you’re looking at someone who’s had a facelift. You only notice the people who have not-so-natural looking facelifts.

Also, sub cutaneous fat distribution changes with time. That changes the general appearance of the face.

I actually read an article about this a while back and the answer is, aging does not just cause a wrinkling and sagging to the skin but changes in underlying support structures. In addition to breakdown of our collagen and thinning of subcutaneous fat, we lose bone mass in our face as we age and this loss can be substantial.

I’ve noticed Hollywood actors don’t have drastic surgeries anymore, they make small mm adjustments, jaw a little more angled, cheek slightly higher, if you look at some pictures you’ll see small adjustments that enhances their attractiveness. Look up Charlize Theron and you’ll notice the difference, slight but effective

There’s a lot more to our perception of a person than just their face. One can get that stretched, filled, puffed up, covered in toner, etc. but the rest gives it away. Arms, hands, and the rest of the structure are tough to change.

That’s why you see and recognize what’s obviously 30’s something faces on [60’s something people](https://media-cldnry.s-nbcnews.com/image/upload/newscms/2019_09/2764361/190225-mar-a-lago-trumpettes-cs-916a.jpg).

There are changes to our facial bones as we age. A face lift is lifting and resetting, but over a vastly different structure.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404279/figure/Fig2/?report=objectonly

From here.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404279/#!po=0.694444

Similar: I am a professional seamstress. People often will say, “That’s so well made, I would have never guessed it’s homemade.”
First of all, it’s professionally made, not homemade. (I’ve been sewing for money for over 30 years)
Second, with so many clothes being made in factories with low/no quality control and with very cheap materials, most professionally made clothing is far superior to what it is sold in retail shops.
Thirdly, I often see clothes that are clearly homemade. It’s usually down to lack of skill/knowledge and using the wrong fabric for the garment.

I just talked to a plastic surgeon.

Older methods of facelifts pulled the actual skin and restitched it in hidden locations like along the hair line. The problem with this method is it pulls on the skin too much and looks unnatural Also, over time, the skin stretches again.

Modern facelifts actually take the underlying muscle and pull it tight. She showed me how — they fold it over itself in in the middle and stitch it together. Then, they lay the skin back like a flap and cut it to fit. This allows the muscle to support the load so the skin is not pulled so tight. It increases the longevity and reduces the windswept look.

Slightly off topic, but let’s not forget that plastic surgeons do more than just facelifts and boob jobs to fight off aging.
I had a plastic surgeon who grafted skin from the side of my thighs onto the 3rd degree burns on the other side of my leg. ie; he used a vegetable peeler to peel skin off my leg to cover the open burn wounds with skin.
They also help women who have had mastectomies rebuild breasts so they do not feel self conscious.

People who have been in disfiguring accidents can find a lot of relief when a plastic surgeon helps them reduce the scars, or rebuild a nose that’s not there any more.

They are a lot more than just “facelift and liposuction” doctors.
I just thought I’d throw that out there. Maybe they can’t make a every 70 year old look like a 30 year old, but they can bring normalcy to people who need are suffering too.

I’m trained as a plastic surgeon but I don’t do cosmetic surgery in practice.

1. You don’t notice well done facelifts, just overdone ones.

2. Old skin doesn’t have the same structure as young skin. It isn’t just hanging, it’s saggy and thinner. There’s no way to fix that.

I’m surprised nobody said it, but the skull age, the shapes of your face changes are you get older and we can detect it. One thing you can easily see and notice also is how the eyes starts sinking into the skull’s orbit – adding to the old face.

I’ve always thought that Tom Cruise has actually been getting small procedures done for years and years so that it’s never anything that’s real dramatic and this is what it’s allowed him to age so well.

Supposedly J Lo had a ponytail facelift in her 30s. On someone that age it would not be as noticeable since she would have a lot less to correct or lift wyd she still had her fat pads in place, Probably a small accent of filler as well. I think that the more sagging skin one has, the texture has changed drastically as well as a dramatic loss of fat. To really combat everything it’s replacement of lost fat, lasers to retexture, and lifting of the skin

Have you seen Madonna? It’s honestly trippy. She looks like a 40yr old with too much plastic surgery with her $500k face. She’s 63

Because if a person has good work done, you don’t notice it. That’s why people think procedures = bad, because bad is the giveaway on the procedure. You’ve seen tons of good facelifts, you just didn’t know it.

It’s actually possible to have a facelift that looks normal. Some people just go overboard.

My mom needed medically recommended eyelid lifts (her lashes were turning under, small eyes). So she opted to add on the forehead lift and something else I forget now that she had to pay for as they weren’t medically recommended. But even just after it healed you’d never know she had anything done. Laugh lines, eye crinkle lines, forehead skin still scrunched up like it’s supposed to when you make certain faces.

There’s changes to the bone structure underneath. So plastic surgery can make you look “good for a 60yo” but it can never make you look 30 again.