40’s: The JOWL decade. Patients who seek improvement in the appearance of the aging face in their 40’s are most frequently interested in elimination of early jowls. Of course, aging changes vary tremendously between patients of different skin types, bone structures, genetics, ethnic groups etc., but the earliest correctable sign of facial aging, not including the eyelids, is frequently the appearance of jowls, or at least the sagging of the lower cheek, even if there is not yet an actual jowl. The skin elasticity in these patients is usually of good quality and surgical correction is usually excellent.

50’s-60’s: The JOWL and NECK decades. Patients seeking an improvement in the appearance of the aging face in their 50’s and 60’s have often developed both changes along the jawline (jowls) and changes in the neck. The other category of patients in this time period is the re-do or revision facelift patient; that is, the patient who had a facelift procedure previously and returns either because of dissatisfaction or because the aging changes have progressed. Skin elasticity in this age group is still good and the results are usually excellent.

70s-80’s: The JOWL and NECK and DEFLATION decades. Patients seeking improvement in the 70s and 80s often have the triad of jowls, changes in the neck and deflation (fat loss) in certain areas. As mentioned above, the other category of patients in this age group are those who have had previous procedures. Patients in the 70s-80s often require elimination of the jowls, improvement of neck laxity, and replenishing of facial fat with fat grafting. Different facial shapes age differently: The thin face tends to lose fat and require fat grafting. The heavier face tends to sag more than the thin face, and may not require the fat grafting that the thinner face might. The results in this age group are also gratifying although the skin quality is not as good as younger patients and some residual excess skin is often seen under the chin when the swelling has resolved. This age group is also extremely pleased with facelifting.