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For years, facelifts were treated as a last step—something to consider only after injectables stopped delivering results. But in the latest episode of The Beauty Authority, we sat down with London-based plastic surgeon and 111SKIN founder Yannis Alexandrides, MD, who says that mindset no longer reflects how surgeons approach timing today.
“It seems that we have officially entered the golden age of facelifting,” Dr. Alexandrides says. Still, he’s clear that age alone isn’t the deciding factor. “The age of this operation depends on the person who is requesting it because aging is not the same for everybody.”
From his work at London’s 111 Harley Street Clinic to his U.S.-based practice, Dr. Alexandrides says facelift decisions are increasingly guided by facial structure, skin quality and major life changes, rather than a specific birthday.
Ahead, we unpack how those factors—and modern lifestyle shifts—are reshaping the facelift conversation.
Why Timing Looks Different in the GLP-1 Era
Faces age at different rates, shaped by genetics, lifestyle and shifts in the body. One of the biggest accelerators Dr. Alexandrides is seeing right now is weight loss, especially among patients using GLP-1 medications. “That can create a situation where someone might need a facelift prematurely,” he explains.
Rapid fat loss can leave skin without the support it once had, particularly in the lower face and neck. In those cases, sagging or hollowing may no longer respond to nonsurgical treatments the way patients expect.
When Injectables Can’t Replace Structure
Injectables still play an important role, but Dr. Alexandrides stresses moderation. “Injectables in small amounts can give great results, and they are a great tool in the right hands,” he says.
Problems arise when filler is used to compensate for deeper structural loss. “If we try to do too much with injectables, especially with fillers, then we can get into trouble.” That can lead to distorted contours, loss of natural definition and longer-term issues like migration. “The fillers can be displaced in places that they’re not meant to go,” he adds, noting under-eye swelling as a common example.
One of the clearest signs that nonsurgical treatments may be reaching their limit is frequency. “If you feel that you need to see your doctor very frequently for fillers and injectables, it may mean that they’re not working well anymore,” he says.
Skin Quality Still Matters
A facelift can restore structure, but it can’t correct poor skin quality on its own. Texture, elasticity and sun damage all influence how well surgical results age. “There are people who have this leathery type of skin that facelifts cannot correct,” Dr. Alexandrides says, which is why he often pairs surgery with treatments that support collagen and skin tightening.
Across both his European and U.S. practices, patient goals are remarkably consistent. “People don’t want to change when they have facial rejuvenation surgery,” he says. The best results preserve identity—the face still looks like itself, just better supported.
The Takeaway
The right time for a facelift isn’t dictated by age or trends. It’s when the face no longer responds to nonsurgical treatments the way it once did, and when structure—not volume—becomes the limiting factor. With education and planning, surgery becomes a considered choice rather than a last resort.
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