Yes, You May Be Too Old for Botox at 40! These Are the Signs Touch-Ups Won’t Work and You Need a Facelift

Being told “you’re better off having surgery” is not what you want to hear when, fed up with the signs of facial sagging that appear in middle age, you’ve finally worked up the courage to try some of those minimally invasive “touch-ups” – touch-ups that are now so popular that the UK market is worth £3.6bn a year.

The use of injections (such as Botox and fillers) has increased by 7,000 percent in two decades. And with more and more “miracle” non-surgical cosmetic solutions coming onto the market, you’d think there was now a no-scalpel treatment to prevent and correct every cosmetic problem you might have.

One might even think, and not without reason, that this type of procedure will do away with the “need” for more traditional plastic surgery. This was certainly widely suggested in the early days of minimally invasive treatments. Unfortunately, this is not always the case, and for some people, surgery (whether a facelift or eye lift) will be the only effective solution.

It may be why upper eyelid blepharoplasty is one of the most in-demand surgical treatments (Jennifer Coolidge, 62, Matt Damon, 53, and even Taylor Swift, 34, are all rumoured to have had it). And facelifts are also in vogue (Brad Pitt, 60, is said to have just had one), recently described by US magazine Elle as “a hot option right now” and attracting patients in their 40s.

The reality is that no matter how much you love your touch-ups, there comes a point where the skin becomes too saggy and its underlying supporting tissues (fat and bone) too withered for no-scalpel touch-ups (like cushioning fillers or intense heat-induced skin tightening) to make a demonstrable difference.

“It takes an honest look from a doctor to determine this, but think of very thin, dry, wrinkled skin that has lost its ‘lift,'” says cosmetic surgeon and physician Dr. Apul Parikh. The age at which this happens can vary greatly, but may be due to aging, poor genetics, or lifestyle factors such as smoking or sudden weight loss.

That’s when a modern facelift, which works both the superficial and deep layers of the tissues of the face or neck, is the only thing that can satisfactorily reposition and tighten all of its “moving parts”, restoring the firmness and volume of a fresh face, all in one go.

“It’s annoying for people to hear, but it’s preferable to spending thousands of dollars on tweaks that won’t work,” Parikh says.

Eyes tend to stop being treated with non-surgical help earlier. Many people who have taken toxins for years to lift their eyebrows and thus have tired or hooded eyes (this, by the way, works for some people, but not for all – it depends on the strength of the forehead muscles) find that the trick suddenly no longer works when they reach forty-five or fifty-five years of age.

“This also happens when the skin becomes too sagging,” says Parikh. Basically, the toxin-induced muscle volume increase can no longer support the overly sagging eyelids.

Since thermal “lifting” treatments such as plasma and radiofrequency microneedling show signs of risking long-term damage to the skin in the eye area, an upper eyelid blepharoplasty, which surgically removes a strip of eyelid skin surprisingly quickly (the procedure takes half an hour and recovery time a week) seems the most sensible option.

“It’s by far the procedure with the most visible and predictable results,” says oculoplastic surgeon Dr. Rachna Murthy. “And it’s the only safe option if you have a history of eye conditions like dry eye.”

For the under-eye area, filler injections can “successfully correct dark circles caused by sagging, thin skin, but if there are fatty lumps, sagging skin or permanent puffiness, lower eyelid surgery is the only effective, long-term solution,” Murthy says.

Retouches cost between a few hundred and a few thousand pounds, but must be repeated every few months or annually to maintain the results, which are usually quite subtle. The results of surgery last ten years or more and can be much more noticeable.

But they come with significant recovery time, risks and a hefty price tag – an upper blepharoplasty costs around £7,000, while a facelift tops out at £20,000. However, with a decade of tweaks easily costing £30,000, surgery, while hugely expensive, may actually prove to be the more cost-effective option.

A good facelift will also give a much more natural result than the oddly shaped and unnaturally taut faces associated with endemic overuse of fillers and toxins.

So when your cosmetic doctor is honest enough to tell you that the touch-up ship has already sailed, don’t be offended; instead, be thankful that he or she has integrity and isn’t selling you a puppy.

My icon of the week: Celine Dion

The singer likes her makeup to be as dramatic as her music. At the Olympics, her look was Charlotte Tilbury’s own: the diva’s eyes were turned into beacons with the Luxury Palette in The Queen of Glow and the Hollywood Exagger-Eyes Liner Duo, while lips and cheeks were given a peachy hue with the Matte Blush Beauty Wand in Pillow Talk and KISSING, finished off with the Lipstick in Nude Kate.

Cosmetics craving

Jules Von Hep has made it her life’s mission to help women (and men) see the beauty in themselves and stop criticizing their physical appearance.

A tanning expert and much sought-after ‘confidence booster’, she has expanded her Isle of Paradise self-tanning range with a selection of body products that simply radiate joy and will bring radiance to your limbs. Scented and packaged to ‘release happy hormones’, Brilliantly Bright Body Polish has skin-loving ingredients such as vitamin C, niacinamide and hyaluronic acid and, at £18 (boots.com), is a fraction of the price of comparable body enhancers.