What treatment makes sense at each age?

Age matters less than how the face is changing. But the changes do arrive in order.

Answered by

Dr. Simon Ourian, M.D.

Published

January 4, 2027

Reviewed

January 4, 2027

In the twenties, the priority is learning your skin. From about thirty, bone and support start to decline, and after forty skin begins to sag. Dr. Ourian tells patients in their thirties and forties they do not need a facelift, and many in their fifties are not ready for one either. Surgery usually becomes the answer in the sixties or seventies.

Twenties

Build a routine you will keep, using ingredients with a track record.

“You have to learn what works for your skin, what doesn't work for your skin.” “And start with ingredients that have been shown to work.”

Thirties and forties

Structure begins to decline in the thirties, and sagging follows in the forties. Neither calls for surgery yet.

“Over the age of 30, we start to lose our bone structure and I need to replace” “I think everyone over the age of 40, we start to get a little bit of a sagging skin.”

Fifties

If you have looked after your skin, probably still not a facelift.

“But, and even in your 50s, if you have been taking care of your skin, you're not ready for a facelift or a major surgical deep plane or SMAS facelift.”

Sixties, seventies, and when surgery is the answer

When the neck is hanging and heavy sagging has set in, especially when nothing has been done before, surgery is the honest answer.

“If you wait long enough, you're gonna need surgery.”

Decade	What is changing	What usually makes sense
20s	Little structural change	A routine you keep, with proven ingredients and SPF
30s	Bone and support begin to decline	Restoring structure, skin care, resurfacing
40s	Skin begins to sag	Non-surgical lifting and tightening
50s	Sagging and volume loss	Usually still non-surgical, if the skin has been cared for
60s and 70s	Hanging neck, heavy sagging	Surgery, especially if nothing has been done before

Looking like yourself

At any age, the goal is the patient, improved. Not someone else.

“Nobody wants to go out there and look like someone else. In fact, it becomes a huge ordeal.”

Back to Ask Dr. Ourian for more answers from Dr. Simon Ourian.

The figures in this answer reflect Dr. Ourian's observations in his own practice
and are not drawn from published research. This content is for information only
and is not a treatment recommendation. Book a consultation to discuss your own case.

Dr. Simon Ourian is founder and medical director of Epione Beverly Hills, with close to 30 years of practice.

Frequently asked questions

When does facial aging start?

Dr. Ourian says bone and support begin to decline from about thirty, and skin begins to sag after forty.

Do I need a facelift in my 40s?

Dr. Ourian tells patients in their thirties and forties they do not need a surgical facelift. Non-surgical treatments address the changes at that stage.

Am I too old for non-surgical treatment?

Not by age alone. Surgery becomes the right answer when the neck is hanging and heavy sagging has set in, most often in the sixties or seventies when nothing has been done before.

What should I do in my 20s?

Learn what works for your skin, use ingredients shown to work, and use SPF.