Age appropriate facial procedures from Cleveland's best plastic surgeon

At what age is it appropriate to have a cosmetic procedure done? The answer may surprise you.


People who begin working with a cosmetic or plastic surgeon at the first sign of wrinkles or loose skin can delay aging of your skin and avoid costly corrective procedures later in life. For most men and women, the best time to start thinking about cosmetic procedures is early to mid-thirties. In the younger years, less work is needed to achieve the desired look because the skin is still healthy and elastic. Aging skin loses its elasticity over time, so older patients generally require deeper, more aggressive procedures.


Dr. Bahman Guyuron is an internationally recognized teacher and innovator in the field of plastic surgery. He specializes in facial procedures including non-surgical and surgical facial rejuvenation. His recommendation for younger-looking skin at any age is to practice healthy skincare habits and invest in laser skin resurfacing as needed. In this article, you will read about his recommendations for cosmetic procedures for people in their 30s, 40s, 50s, and 60s, followed by a brief overview of each procedure.


Age: 30-39 years


As mentioned above, the first signs of aging typically show up in the early or mid-thirties for most men and women. At this point in life, the need for a facelift or anything major to preserve the youthful look is very rare. Non-surgical facial rejuvenation with injectables and skin resurfacing can deliver subtle improvement in all the right places.



  • Avoid unprotected sun exposure
  • Skincare
  • Injectables
  • Laser skin resurfacing



  • Eyelid surgery for removal of fat bags that often run in families
  • Neck contouring with the removal of fat
  • Mini facelift (for professional actors/actresses/models/etc.)


Age: 40-59 years


Men and women in their forties and fifties commonly have fine lines and wrinkles around their eyes and eyelid bags may develop. The recommended treatment plan for most people is to continue doing what was being done in their thirties, or start now if it was not done already; follow a daily skincare routine using high-quality products and try injectables (Botox® and Juvaderm®) or light laser therapy.


Individuals who have not taken good care of their skin when they were younger, or if they smoke or used to smoke, may require surgery. In this situation, surgical facial rejuvenation can be considered. For many patients, sometime between 35 to 45 years is the ideal age for surgical facial rejuvenation.



  • Avoid sun exposure without ultraviolet protection
  • Skincare
  • Injectables (fillers and neurotoxins such as Juvaderm and Botox)
  • Laser skin resurfacing



  • Eyelid surgery
  • Neck lift and contouring by removal of fat
  • Forehead lift (or brow lift)
  • Facelift with fat injection


Age: 60+ years


Patients in their sixties are beginning to show advanced skin aging. They have deeper wrinkles around the eyes, nose, and mouth, and a loss of elasticity and volume in other areas of the face. Loose skin may sag under the eyes or jaw bone. The age-appropriate recommendations are similar to younger patients, but older patients will need more aggressive treatment with lasers, fat injection, and surgery to remove loose skin and unwanted fat.



  • Skin protection against sun damage
  • Skincare
  • Injectables (Botox, Juvaderm)
  • Deeper skin resurfacing with the CO2 laser



  • Eyelid surgery to remove bags under the eyes
  • Neck lift to remove unwanted fat under the chin
  • Forehead lift (or brow lift) for deep wrinkles
  • Facelift with fat injection


Non-Surgical Facial Rejuvenation


Skin Care


Even in their twenties, men and women should be careful about sun exposure and their daily skincare routine. Avoiding smoking cigarettes and adhering to a healthy diet can also impact the health of aging skin. Taking good care of the skin early in life will always result in looking younger than your real age, especially compared to individuals who were less protective of their skin.


At any age, if you are struggling with a skin condition such as acne or rosacea, consider using medical-grade skincare products to repair or protect your skin. Certain types of chemical peels and laser treatments may also be helpful in improving these skin conditions.




Injectable products such as Botox are commonly used to relax facial muscles, thereby smoothing and reducing the appearance of wrinkles and folds. The toxin blocks the nerve impulses that cause the muscles to contract and result in wrinkles. Botox and other neurotoxins effectively reduce frown lines, crow’s feet, creases along the forehead, and even vertical bands across the neck.


Dermal fillers are used to fill fine lines and deep wrinkles. Fillers can also be used to plump the lips and fill in skin depressions and scars by restoring lost volume in the face. Juvederm, for example, is composed of hyaluronic acid, a naturally-occurring substance that maintains the moisture of the skin. As the body ages, the production of hyaluronic acid diminishes, causing loss of volume, lines, and wrinkles. Juvederm replaces the hyaluronic acid to reverse the unwanted effects of aging. Several dermal fillers, such as Sculptra, trigger the body’s natural production of collagen, which improves the quality of the skin over time.


The effects of dermal fillers and injectables will eventually diminish, so repeat treatment is recommended.


Laser Skin Resurfacing


Skin resurfacing treatment can improve the following concerns:


  • Mild to moderate wrinkles and fine lines
  • Areas of sun damage
  • Age spots
  • Brown spots
  • Blotchy complexion
  • Acne scars
  • Superficial scars from a facial injury
  • Large pores


During a laser skin resurfacing treatment, Dr. Guyuron will use a carbon dioxide, fractional, or erbium laser to gently ablate the damaged outer layer of skin that is wrinkled, scarred, lined, abnormally pigmented or otherwise flawed. The laser light penetrates the surface of the skin to a very precise depth; then, it vaporizes the outermost skin cells. The laser energy will also stimulate the body’s production of collagen, which is essential to healthy-looking skin.


Surgical Facial Rejuvenation


Eyelid Surgery


Eyelid surgery can address these problems:


  • Loose skin on the upper or lower lids that droops (possibly obscuring the field of vision)
  • Excess fat deposits that make the upper eyelids look puffy
  • Bags or dark circles underneath the eyes
  • Fine wrinkles along the lower lid with dark discoloration
  • Stretched eyelid muscle, which reduces the opening of the eyelids


To treat the upper lids, Dr. Guyuron makes an incision within the natural crease of the upper eyelid. Through the incision, he will reposition/remove any fat deposits, tighten the eyelid muscles and tissue and remove excess skin. To treat the lower lids, Dr. Guyuron makes an incision just below the lower lash line or in the inner surface of the eyelid, and removes or repositions excess skin/fatty tissue, tightens skin if needed, and makes the eyelid skin thicker and smoother with injection of one’s own fat or use of laser, or both.


Neck lift


A neck lift is performed to fix:


  • Double chin
  • Loose, sagging skin, sometimes referred to as “turkey wattle”
  • Extra fat deposit under the chin
  • Protruding glands


A neck lift is an outpatient procedure, usually performed with general anesthesia or a combination of medications to keep the patient comfortable. Dr. Guyuron will vary his surgical approach and incisions based on what is best for the patient’s particular case.


Forehead lift (or brow lift)


A forehead lift can improve the following:


  • Sagging eyebrows
  • Lines and wrinkles across the forehead
  • Frown lines (vertical creases between the eyebrows)
  • An older or unintentionally sad/angry appearance
  • Elongated forehead
  • Eyebrow asymmetry


A forehead lift is performed on an outpatient basis. Patients will receive medications to keep them comfortable and relaxed during surgery. Dr. Guyuron first makes five incisions, each about ½ of an inch, all within the hairline. Alternatively, he may suggest making a long incision along the hairline to shorten and lift the forehead at the same time. He may move, rearrange or weaken the wrinkle-causing muscles in the forehead and brow area. Then, he will lift the brows to a desirable level and may remove excess, loose skin. For patients who need forehead shortening and the lift or shortening alone, Dr. Guyuron may make the incision at the hairline. For those who have frown lines but do not need eyebrow lift, he may trim the muscles through an eyelid incision.




A facelift can fix:


  • Jowls that are the result of sagging tissues
  • Wrinkles or folds in the skin
  • Creases extending from the nose to the corners of the mouth
  • A tired expression
  • Marionette lines
  • Patchy skin discoloration


Facelift surgery concentrates on the mid and lower face. It can be combined with other procedures for more dramatic and comprehensive results around the eyes. For example, facelift patients can also opt for a brow lift to elevate the brow line and smooth forehead wrinkles/furrows, or blepharoplasty to refresh the upper and/or lower eyelids.


A facelift is typically performed as an outpatient procedure at Dr. Guyuron’s state-of-the-art surgical facility. To begin surgery, Dr. Guyuron makes incisions along the hairline at the temples, continuing around the ear and extending into the hairline behind the ear. These incisions are designed in such a way that after the healing is complete often you can style your hair any way you wish without the scars being clearly visible. Through the incisions, he redistributes fat in the face, jowls, and neck, and repositions the tissue. Dr. Guyuron may tighten the facial muscles. He will re-drape the facial skin and remove any excess. If need be, Dr. Guyuron will make an additional incision underneath the chin for better access to the neck, and contour it during a procedure known as a neck lift or submental lipectomy. Dr. Guyuron often injects fat, which contains stem cells to improve the skin elasticity and replace the lost volume.



Fat Injection


Fat transfer is commonly performed to improve the following:


  • Facial creases – laugh lines, smile lines, crow’s feet
  • Thin lips
  • Depressions/indentations in the skin
  • Acne scars
  • Hollow cheeks
  • Jawline contour
  • Hollowing in the temples
  • Hollowing under or above the eyes


Dr. Guyuron also uses dermal fillers to replenish volume to areas of the face where fat has been lost or displaced. However, dermal fillers only provide temporary results. Fat transfer provides longer-lasting results. Once the fat receives blood supply from the surrounding structures, it will receive the proper nourishment for survival. Not all of the injected fat survives, so Dr. Guyuron may over-inject the area, or occasionally perform touch-up procedures.


Fat transfer is typically performed on an outpatient basis and takes place in several steps. First, Dr. Guyuron will harvest the donor unwanted fat from the pre-determined location. (This could be the abdomen or thighs.) Most patients have enough donor fat, even if they are thin. After he has obtained enough fat from the donor area, he will process the fat and prepare it for transfer. This involves spinning and purifying the fat through a filtration process. Then, Dr. Guyuron will inject the purified fat into the treatment area using small syringes. He will repeat the injections in very small amounts, creating a grid of grafted fat, until he achieves the desired correction. The number of injections and the amount of fat used depends on the degree of correction necessary.