05/07/2026
The main reason to have a facelift when you’re pre-menopausal as opposed to post menopausal is directly correlated to estrogen and the amount of estrogen that you have in your body. Estrogen does a lot more than just regulating reproduction. In the skin, it actively maintains collagen. It plays a role in skin thickness and moisture, and overall skin elasticity. When estrogen levels drop after menopause, collagen breaks down rapidly. The skin loses its bounce and the deeper tissues lose structure, including bone. Bone absorption also happens as a result of estrogen loss. We know this in osteoporosis, but it actually happens to the bony skeleton of the face.
A 2019 study using 3-D facial mapping showed that men and women for the most part age along a very similar trajectory up until the age of around 50. After the age of 50 (around menopause), the female aging trajectory was significantly sharper than that of men! Why is that?! Well, it’s because post menopausal women experience rapid bone absorption in the mid face and the mandible or the jaw. And this is directly correlated to a loss of estrogen. The skeleton itself, which is the very foundation of a facelift starts to shrink.
This is why the data on younger facelifts is so striking. There is a 30 year study of deep plane facelifts that found that patients who are operated on at the age of 53 or younger didn’t return for a revision facelift until about 12 1/2 years later. But patients who were older than the age of 53 on average returned at nine years. The older they were at the time of surgery (and the further they were from
Menopause) the shorter the time to wanting a revision.
Other long-term studies show that younger patients at the time of facelift were consistently happier and more satisfied with their results. So that’s why I advised my patients, if they have a choice to have a facelift when they’re pre-menopausal as opposed to post menopausal you want to intervene when your collagen, your deeper structures and the bone are still in favorable condition.