Add this to the life-isn’t-fair list: The younger your skin looks, the better any kind of rejuvenating treatment will work. “The effects of long-term photoaging—large pores, laxity, irregular pigmentation, dilated blood vessels—make it hard to get a great end result,” admits Manhattan dermatologist Patricia Wexler. (That said, if your skin were flawless, you wouldn’t be seeking any treatment.) Women with darker complexions tend to have an edge—they often look more youthful because the higher levels of melanin (pigment) in their skin offer some built-in sun protection. Note to repentant sunbathers: It’s never too late to start with sunscreen and retinoids. The latter stimulate collagen production, which is the most crucial factor in preventing aging.
Other factors that work to your advantage: high cheekbones, a strong jawline, a chubby face, a healthy, stable body weight (not too thin or too heavy) and—surprise—a habit of sleeping on your back. “Most dermatologists can tell which side you sleep on just by looking at your face,” says San Francisco dermatologist Katie Rodan. “The lines become deeper on the side that’s carrying the weight; your face can even become flatter on that side.”
Another important issue: Are you sinking or sagging as you age? Some faces sag more than they hollow out, and vice versa. If you’re a dramatic hollower, you may never feel the need for a face-lift. If you’re a significant sagger, you may consider surgery early on. “Going to a doctor who knows the difference is key,” says Grossman. “If the MD tries to fix very loose, droopy skin using only filler, you could wind up looking like a stuffed sausage. And if he tries to fix a hollow face with just surgery, you get a tight, wind-tunnel effect or even more hollowing.”
What a face-lift can really deliver is an improved neck and jawline. Decide how much help you need in those areas. Most women, for example, never develop a turkey-wattle neck. So if you can tackle the jawline and other problem areas as they begin to deteriorate, you may be able to forgo a face-lift indefinitely.
On the other hand, if you do have sagging skin and muscles that can’t be fixed by less invasive methods, then it’s best to take action sooner rather than later. “The perfect time for surgery is when your skin is still healthy, and the collagen and elastin are good,” says New York plastic surgeon David Rosenberg. Concurs Wexler: “If you’re open to the idea of a scalpel procedure, early intervention is better. The golden window can be anywhere from 45 to 60, though some people can stretch that a bit if they’ve taken care of their skin. There’s a saying: If you do it in your forties, you’re thrilled; in your fifties, you say, Why did I wait?; and in your sixties, Why did I bother?”
In terms of what treatments to try and when, you might consider looking to Hollywood for guidance. Don’t. Women who have access to everything sometimes blow it, says Ramtin Kassir, MD, a New York City plastic surgeon. “There’s a tendency for celebrities to try trendy procedures and overdo it,” he observes. Rodan offers an interesting insight: “I think what happens in the case of some stars—the ones who look like they’ve gone into the witness-protection program—is that they do things that look good on camera and in magazines. But in real life, their eyebrows are in the middle of their foreheads.”
In the end, what will save you from a disastrous, exaggerated look is keeping your adult perspective—meaning, don’t let your doctor push you into a procedure and don’t try to push your doctor. “Patients constantly tell me, ‘I like how you did my lips last time, but now I really want them larger,’ ” says New York City dermatologist Doris Day, author of Forget the Facelift. “The same thing with Botox—they only want a tiny bit at first, and then they come back and want more. I always say, ‘No, you look beautiful; it is time to stop.’ But it’s easy for doctors to lose track of what normal looks like, and trying to please a patient can override their good judgment.”