woman touching her face while looking in the mirror


Looking ‘done’ is out. The windswept appearance that used to be the telltale sign of a post-facelift patient is just too drastic for many women. Aging gracefully now means looking “rested, clean and refreshed,” according to plastic surgeon Dr. Michele Koo, with the Aesthetic Surgery Institute. And that look often can be achieved through procedures known as ‘tuck-ups’ or ‘mini-lifts.’

    “I have been doing ‘mini tuck-ups’ for face, eyes and brows for 15-plus years,” Koo says, noting that she often recommends her patients to consider a ‘tuck-up’ every two to three years, starting as young as 35. “Do it before you look like you’re always tired and need something done. This is the best way of not creating a drastic change, but just maintaining freshness.”

    Maintaining that fresh, youthful appearance also relies on proper skin care and non-surgical procedures, such as the use of Botox and facial fillers that require little downtime and create a subtle yet effective change. “The skin is the place to start with peels, laser, products, Botox and Juvederm to keep the face looking deceptively young and smooth,” Koo says.

    Yet only so much can be accomplished with surface treatments. For many women, the first major complaint regarding an aging appearance involves the natural sagging of the neck and jowls, says Dr. Charles Nathan, a plastic surgeon with Parkcrest Plastic Surgery. “If the neck can be corrected without making the cheeks look worse, those people are candidates for a mini neck lift,” he says.

    Sometimes, however, tightening the neck makes sagging jowls more obvious. “You have to look at the whole picture,” Nathan says, adding that it is the surgeon’s role to assess the patient’s complaint in context of the entire appearance. In some cases, fixing just the area that the patient is concerned about won’t provide the best overall outcome, and the surgeon needs to communicate that to the patient and explain what options exist.

    “If you ask me what provides the most bang for the buck, I’d say the eyes,” Nathan says. Eyelid lifts and the use of facial fillers around the eyes can rejuvenate one of the most noticeable facial features.

    Koo also points to the eyes and neck as two primary targets for mini-lift procedures. She can remove excess upper and lower eyelid skin in the office to create a “crisp, clean eyelid, getting rid of the tired look without ever looking ‘done.’ ” Similarly, she says that the neck often simply needs to be smoothed with a minor neck lift to remove crepey skin, lines and bands.

    Koo maintains a less-is-more philosophy, stressing the importance of skin maintenance with products and occasional minor procedures, such as peels and Botox injections. “I always address the single components of the face: upper and lower eyes, brows, cheek, forehead, jawline, neck and skin, creating a delicate, precise change that is unique for the individual and extremely subtle,” she says.   

    Taking a similar approach, Nathan strives to provide quicker recovery and shorter scars through facial rejuvenation procedures that include mini-lifts and tucks. He notes that these procedures are performed in various ways by different surgeons. Some perform the procedures in a surgery center, while others use light sedation or a local anesthetic in an office setting. In general, the procedures are outpatient and do not require general anesthetic. Within a couple of weeks, the patient will be able to wear make-up and there will be no bruising.

    No matter what you hope to achieve, the key is to make sure you understand all your options and choose an experienced surgeon. The result, Nathan says, will be that “you’ll still look like yourself—just a fresher version.”  LN