Facelift Surgery: Respecting the Person’s Identity

More and more people are looking for a face that appears fresh, well-rested, and natural. But when is the right time for a facelift? And, above all, is there an ideal age? With trends, social media, and increasingly accessible aesthetic treatments, it’s easy to confuse prevention with excess.

Dr. Giuseppe Colombo, a specialist in plastic, reconstructive, and aesthetic surgery, a member of SICPRE, who practices in Lugano and Zurich, Switzerland, and occasionally in Italy, explains why facial rejuvenation should follow one guiding principle: respecting the individual’s identity.

«In recent years, we’ve seen a growing demand for procedures that all aim for the same goal: achieving a natural-looking result – says Dr. Colombo – If we distinguish between aesthetic medicine and aesthetic plastic surgery, one of the most requested surgical procedures is the cervicofacial facelift. Among the most common procedures for both women and men are upper and lower blepharoplasty, which correct excess skin on the upper eyelids and certain lower eyelid concerns, such as protruding fat pads».

There Is No Perfect Facelift, Only the Right One

Choosing the most suitable facelift technique depends entirely on the individual patient. Dr. Colombo highlights several factors that must be considered, including skin quality, the degree of sagging in the deeper tissues, and each person’s unique anatomy. «One fundamental concept is the patient’s bone structure. Two other aspects that must be carefully evaluated are biological age and the patient’s expectations – he explains – Personally, I believe the most important factor isn’t the technique itself, but respecting the patient’s anatomy. A good facelift should reposition tissues that have descended over time without altering the person’s facial features».

The objective is not to create a different face, but to restore a more rested and harmonious appearance. «When a face looks overly tight, it’s a completely pointless success because that’s not what we’re aiming for. Facelifts should restore and reposition tissues through refined techniques, research, and careful planning, not by stretching the skin as much as possible. That concept is outdated, and I don’t think anyone should still practice it because the aesthetic outcome is simply poor».

A Facelift at 35?

In the United States, some surgeons offer facelifts to patients as young as 35. But does it really make sense to define an ideal age?

According to Dr. Colombo, the answer is no. «Chronological age alone is not a particularly useful parameter. There are 35-year-olds with significant tissue laxity and 60-year-olds who absolutely do not need a facelift. The real question isn’t how old the patient is, but what signs of ageing they present».

He also believes that both operating too early and waiting too long should be avoided. «Surgery should be performed when the patient feels ready and when the physician identifies the correct indication, never by forcing the decision. Otherwise, it stops being medicine and becomes nothing more than commerce».

Fillers, Botox, and Surgery: What Really Works?

Facial rejuvenation is not based on a single treatment. Each technique has specific indications and delivers different results. «Botulinum toxin is extremely effective for dynamic wrinkles; surgical blepharoplasty is irreplaceable for correcting excess skin on the eyelids. A facelift remains the gold standard for treating sagging of the face and neck – Colombo emphasises – I believe the idea that every sign of ageing can be corrected simply by adding volume with filler is largely ineffective. In some cases, fillers are extraordinary, a wonderful entry-level option, but they must be selected carefully, because excessive use to lift the tissues is completely unacceptable».

Each treatment works best when it is used for the purpose it was designed for. «I consider all methodologies effective when they respect anatomy and correct imperfections in a concrete, genuine, and scientifically supported way. And we should always remember that what matters most is the indication for each treatment, which a good doctor should provide without following trends or commercial interests. It is medicine. Nothing more», Colombo concludes.

The Ethics of Rejuvenation

Ultimately, facial rejuvenation is not just an aesthetic issue but an ethical one. Cosmetic surgery should not create a new face; it should help people rediscover a younger version of themselves while preserving their identity.

«A better version doesn’t mean the previous one wasn’t already good – Dr. Colombo reflects – I often remember a phrase I learned in classical high school: Kalòs kai agathòs, the beautiful is linked to the virtuous. Beauty is not just our calling card or our face. Plastic surgery can help us overcome small insecurities that appear over the years and gradually undermine our self-confidence. That should be the true purpose of ethical plastic surgery».

His philosophy is simple: «Ageing is not a disease to be fought against. It is a natural process that should be accompanied with intelligence».