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At it’s best a face lift restores the complex three-dimensional structure of relative youth and vitality. In order to accomplish this I like to study photographs that my patients bring to me of themselves at different ages. This helps me to understand each person’s unique facial identity. It is also helpful to look at how a patient’s face is currently put together, so that I can help to educate my patient about what can and cannot be achieved.
I have found that there are seven predictors of success in face lifting that are related to a patient’s existing deep facial structure, skin quality, and overall state of health and well-being. The more of these predictors that are present in a patient, the better the chance of a highly-successful outcome. If you are considering face lift surgery this is important information, since some of these predictors are under your control.
1. Maintain or Increase Good Habits of Nutrition and Exercise
A diet that is low in sugar and refined carbohydrates and high in fresh fruits, vegetables, fish, nuts, and healthy fats benefits the heart and decreases the risk of Alzheimer’s.  This same diet can, in my opinion, speed your recovery from facial rejuvenation surgery and extend the benefit of the results.  Exercise has many physiologic benefits that will also increase the probability of an excellent long-term result. Many of my patients use the face lift operation as a motivator to bring their habits of nutrition and exercise to a higher level.
2. Establish and Maintain a Realistic Optimum Weight
If you are planning to lose a significant amount of weight, it is best to do this before your face lift surgery. If you lose a large amount of weight after the surgery, the skin will loosen and some of the lifting benefit will be lost. Do not use a crash diet to bring your weight to a level that cannot be sustained over the long term as this will lead to an up and down pattern of weight gain and loss that will diminish the surgical result and confuse your metabolism. Extremely thin patients also tend to have less than ideal results from face lift surgery.
3. Exist in an Environment that Is Calm and Stress Free
Although stress cannot be eliminated from the modern urban environment it can be mitigated. Regular exercise, yoga, meditation, and good nutrition can help us to diminish the physiologic damage caused by external stressors. To a great degree internal stress is a matter of choice.
If you are in the middle of a time of great personal stress it is often desirable to hold off on surgery until you are living in calmer times. The more stressed you are going into surgery, the more difficult will be your recovery from surgery.
4. Possess a Well-Defined Bone Structure
Patients who have well-defined facial structure with high cheek bones and a strong clear jaw line will generally get the best long term result from a face lift. As I tighten the deeper structures they will drape beautifully over these high points and provide a contour that is pleasing to the eye and holds its position well over time.
This is not to say that a face lift will not improve the appearance of someone with a softer facial structure – only that the results will not be as dramatic or long lasting.
5. Have a Relatively Thin Facial Structure
The more weight you naturally carry in your cheeks and neck, the harder it is to correct. It is harder to lift heavy cheeks and hard to maintain an excellent result.
Often we can obtain a nice benefit for patients with a relatively heavy facial structure, but the result will not be as powerful as what I can obtain for someone with a thinner facial structure.
6. Possess Good Skin Tone
Some people have skin that is relatively tight and springs back when it is stretched. Other people have skin that has less tone and is very “stretchy.” An extreme example is Abraham Lincoln, who may have had a variant of Marfan’s Syndrome. Someone with Marfan’s has skin that can be stretched a great distance.
There is a great variation in this degree of skin “stretchiness” from one person to another due to inherent differences in collagen structure.
In general, people with very stretchy skin will stretch back out much more quickly after a face lift than people with a less stretchy type of skin. Sometimes a second lift 6 months to a year will lead to a structure that holds its shape better.
7. Possess Overall Good Skin Quality
The skin is a record of our life’s experiences. The kinder we have been to our skin, the kinder it will be to us when we have facial plastic surgery.
Sun exposure, weight cycling, poor nutrition, lack of exercise, and excess stress damage the skin structure over time.  Patients with damaged skin will not maintain the surgical result as long as patients who have optimum skin quality.
It is possible to improve the quality of damaged skin with medical grade skin therapy. I think it is helpful to optimize skin quality prior to a face lift, but it is almost impossible to design a scientific study to prove or disprove this hypothesis. It just makes sense to me.
Much (but not all) of The Result of a Face Lift Is Under Your Control
You can improve the chance of having an excellent result from face lift surgery that will last many years if you take an active role in preparing for your surgery. If you have not already done so, now is the time to establish optimum patterns of healthy nutrition and exercise.  Bring your weight to a realistic optimum level. If there is excess stress in your life take steps to neutralize it. If your skin has been damaged by years of neglect embark on a program of medical grade skin therapy.
All of these measures have distinct benefits for long term health and well-being. Many of my patients have used face lift surgery as a catalyst to bring about positive changes in their lives.