Facelifts are commonly performed on patients from their 40’s all the way until their 80’s! Some patients who prematurely aged due to weight loss, extensive sun exposure, and due to genetic variability have come in for facelifting in their mid-40’s, while, there are many that come in much later. It really varies in terms of age. Initially people present with facial soft tissue sagging in their cheeks, jowl area,and necks. They notice loose skin as well. Some of these patients show early signs of aging and quite often can benefit from facial fillers to stave off surgical intervention. Eventually, facial rejuvenation surgery is warranted. I see many patients that have seen doctors that can not perform surgery that have overcompensated by overfilling a patients’ faces and these same patients can look a bit “puffy.” I always tell my patients that I have a “full tool belt” of potential treatments that I can offer. While I do not think that everyone needs surgery, I think many require a delicate balance of filler products, neuromodulators like Botox, and facial surgical rejuvenation procedures. Over the past several years, I have added facial fat grafting to many procedures because I think that facial aging is a combination of both deflation and sagging. I do not think that one specific procedure or non-surgical intervention is right for every patient. Many times it is a mix of both to get a very natural long lasting result.