Facial aging rarely shows up as one isolated issue. Skin loses elasticity, deeper tissue shifts, and volume disappears from the cheeks all at once, which is why so many patients feel like they woke up looking older overnight. Dr. Michelle Lee, the Harvard-trained, board-certified plastic surgeon behind PERK Plastic Surgery in Beverly Hills, focuses her practice on understanding how these changes occur and how to reverse them with refined surgical technique.
Recently featured by Haute Living on the topic, Dr. Lee shared her clinical perspective on when a facelift makes sense and when it doesn't. This blog draws on her insight to walk you through the facts every prospective patient should understand before booking a consultation.
Why Aging Feels So Sudden
A facelift, or rhytidectomy, is a surgical procedure that repositions and tightens the deeper structures of the face and neck to improve sagging skin, jowls, and lost definition along the jawline, according to the American Society of Plastic Surgeons. Thinning skin, shifting fat pads, and loosening ligaments all progress simultaneously, and Dr. Lee has noted this compounding effect as the primary challenge patients face. It's why many people say they no longer recognize themselves in the mirror.
That's why an effective approach addresses all three layers: skin quality, volume restoration, and underlying support structures. A thorough consultation examines each component to create a coherent result.
Signs a Facelift May Be the Right Fit
Not every patient needs surgery. Nonsurgical options can meaningfully improve mild to moderate concerns like early laxity and the first signs of jowling. For significant sagging in the face and neck, Dr. Lee relies on the deep plane facelift, which delivers more lasting and natural-looking improvement than traditional SMAS techniques.
A few signs suggest surgery may be worth discussing at a consultation:
- Noticeable jowling along the jawline that nonsurgical treatments haven't resolved
- Loose or crepey skin on the neck, sometimes called a "turkey neck"
- Deep nasolabial folds or marionette lines that persist despite fillers
- A desire to restore foundational structure and definition, beyond what surface treatments can address
- Facial volume loss that makes the cheeks look flat or hollow
What Makes the Deep Plane Technique Different
The deep plane facelift works below the SMAS layer, the connective tissue that supports the facial muscles, repositioning deeper structures rather than simply tightening skin. This approach maintains its results over time and reads as naturally refined, which is why Dr. Lee considers it the gold standard for significant sagging.
Volume restoration happens at the same time. Dr. Lee pairs facelift surgery with fat grafting to replenish volume lost through natural aging, creating dimension where it's faded. This integrated approach honors a foundational principle: structure and volume work together to produce a rested, refreshed appearance.
When Nonsurgical Treatment Makes More Sense
For patients in their thirties or forties noticing early changes, preventative treatment takes priority. Neuromodulators such as BOTOX, Dysport, and DAXXIFY soften expression lines before they become permanent. Regenerative treatments like PRP, PRF, and nanofat build collagen production and skin thickness from within and work best when started early and maintained consistently.
Timing and the extent of change determine the path forward, which is why an individualized consultation yields far better guidance than a generic recommendation.
Dr. Michelle Lee Is Here to Guide Your Next Step
The decision to pursue a facelift rests on understanding your anatomy and goals, grounded in medical reality rather than external pressure. Dr. Lee's training at the University of Pennsylvania, her plastic surgery residency at Case Western Reserve University, and her fellowship in aesthetic breast surgery at Harvard Medical School's Beth Israel Deaconess Medical Center provide the foundation for her approach: combining surgical precision with an artist's eye. If you're weighing your options for facial rejuvenation, schedule a consultation with Dr. Lee to talk through what's realistic for your face and your goals.
