02 Jun Facelifts, Fillers, and What Actually Works: A Plastic Surgeon’s Take on Midlife Skin with Dr. Anthony Youn
If you’ve been scrolling through social media lately, you’ve probably noticed something: facelifts are everywhere. Celebrities are talking about them openly, your feed is full of before-and-afters, and suddenly every woman over 50 is asking herself the same uncomfortable question — do I need to do this? Is this what it takes now?
I’m 54, I’m in menopause, and I see my face changing in the mirror every single day. The jawline softening. The skin shifting. All the things. And I wanted real answers — not what’s being marketed to us, not what sounds good on an Instagram ad, but what actually works and what is complete hype. That’s exactly why I sat down with Dr. Anthony Youn, board-certified plastic surgeon out of Detroit, known as America’s holistic plastic surgeon, and the man behind one of the most trusted voices on anti-aging with over 13 million TikTok followers. His approach to beauty is rooted in health first, and that is exactly the kind of conversation midlife women need to be having.
Here’s everything he shared — and none of it is what the beauty industry wants you to hear.
Why Facelifts Are Having a Moment Right Now
Facial plastic surgery jumped 19% last year, and 45% of surgeons now say menopause is what’s driving it. So this isn’t just a celebrity trend — it’s a midlife women’s health conversation.
According to Dr. Yoon, facelifts have always been happening behind the scenes in Hollywood. The difference now is that certain celebrities — Kris Jenner and Denise Richards among them — have been open and honest about the procedures they’ve had. That transparency, combined with improved techniques and shorter recoveries, has made facelifts feel more approachable to everyday women.
But it’s more than just celebrity culture. Dr. Yoon believes midlife women are finally feeling empowered to advocate for themselves, in part because the medical establishment has ignored this population for so long. Women are done being told their concerns are “just aging.” They’re asking better questions and demanding better answers, and that energy is spilling over into conversations about cosmetic procedures too.
The Modern Facelift Is Nothing Like You Imagine
Most of us picture the wind-swept, pulled-tight look when we hear the word facelift. That look is a relic of outdated techniques. Modern facelifts look completely natural because the approach has fundamentally changed.
Old-school facelifts focused almost entirely on pulling and lifting the skin. The result was that telltale swept look — the elevated sideburns, the overly stretched cheeks. Today’s surgeons work with all three layers of the face: the skin, the fat underneath, and the underlying muscle. By addressing all three, and by adding volume strategically rather than just pulling everything upward, results can look genuinely refreshed rather than obviously surgical.
Dr. Yoon also cleared up the deep plane versus SMAS facelift debate that’s taken over social media. Deep plane surgeons claim their results last longer and reduce smile lines more effectively. SMAS surgeons counter that their technique carries fewer complications and heals faster. The honest truth, according to Dr. Yoon? No clinical studies have shown a meaningful difference between the two in terms of results or longevity. Both can produce beautiful, natural-looking outcomes. What matters most is picking the right surgeon, not the right technique label.
There’s also the “ponytail lift,” which is a combination of brow lift, cheek lift, upper eyelid work, and fat injections — popular among younger celebrities in their 30s and early 40s who don’t yet need lower face tightening. Dr. Yoon is cautious about it though, noting that some versions of the surgery can run 10 hours or more under anesthesia, which is a serious commitment for someone who may not yet need that level of intervention.
How Long Does a Facelift Actually Last?
Studies show results last anywhere from 7.5 to 15 years — a wide range that comes down to a few key factors.
The biggest variable is how well you take care of yourself. Skin quality, sun damage history, diet, and overall tissue health all play a role. Women in their 50s with good skin who follow anti-inflammatory diets and prioritize skincare are likely to maintain results far longer than someone who hasn’t taken that approach.
Age at the time of surgery matters too. Dr. Yoon firmly believes most people can have a facelift no more than three times in their lifetime before the accumulation of scar tissue begins to create an unnatural appearance. That’s why he advises younger patients to think carefully — trading loose skin for scars and potentially needing a second procedure in their mid-50s is a real consideration.
The way he describes it is simple and worth remembering: a facelift turns the clock back, but it doesn’t stop it from ticking.
What Actually Works If You’re Not Ready for Surgery
The overwhelming majority of midlife women are not looking for a facelift. They want to know what genuinely helps — and what is a complete waste of money.
Dr. Yoon was refreshingly direct here. There is no non-surgical treatment that can replicate what a facelift does for loose, hanging skin. That gap exists, and no amount of marketing language changes it. However, there is one non-surgical treatment he considers the current gold standard: radiofrequency microneedling, with Morpheus 8 being the most well-known brand.
The science behind it is straightforward. When collagen is heated to a specific temperature, it becomes damaged in a controlled way. As it heals, it tightens. Radiofrequency microneedling achieves this by delivering heat deep into the skin through tiny needles. The result is real but modest — where a facelift might remove a centimeter or more of skin, non-surgical tightening might produce a couple of millimeters of change. Not nothing, but expectations need to be calibrated accordingly.
Dr. Yoon does this treatment on himself every four to six months on his neck and lower face. He’s also seen it delay the need for facelifts in some of his patients. But he’s clear that results vary significantly from person to person, because it’s your body’s healing response doing the work, not a predictable surgical outcome.
Red light therapy also gets his endorsement. He recommends consistent use of a red light mask to stimulate collagen production, with the reminder not to overdo it. And collagen supplements — something he uses himself daily and formulated his own version of — are backed by genuine studies showing improvement in skin hydration, collagen content, and even collagen precursors in the bloodstream after about two months of consistent use.
The Truth About Botox and Fillers
This is where a lot of women have questions, and Dr. Yoon gave some of the most honest answers I’ve heard from a plastic surgeon.
On Botox: after 21 years and tens of thousands of patients, he has not had a single major complication. He considers it generally very safe. That said, he acknowledges a small percentage of people do seem to react poorly — headaches, feeling unwell — even when studies can’t confirm why. Bio-individuality is real, and some people simply don’t do well with it.
His most important practical tip on Botox? If you’ve never had it before, leave the forehead alone. Start with the glabella (the frown lines between the brows) and the crow’s feet. Injecting the forehead affects the muscles that lift your eyebrows, and if those muscles are weakened, your brows can drop and your eyes can look heavy. Depending on your natural brow shape, it can also create an exaggerated arch that looks unnatural. His advice: learn how your face responds in those safer areas first before introducing forehead Botox.
On fillers: the problem isn’t filler itself, it’s that plastic surgeons tend to go too far. Faces do lose volume as we age — fat, muscle, and even bone volume all decrease, which is why aging is truly three-dimensional and not just about sagging. A conservative amount of filler to restore some of that lost volume can be genuinely beautiful. The pillow-face effect that has made so many women swear off fillers entirely comes from excess, not from the treatment itself.
The more serious concern with filler is safety. Accidentally injecting filler into a blood vessel can have devastating consequences, including blindness or tissue death. Dr. Yoon’s guidance is firm: use the minimum amount necessary, and only allow experienced practitioners — dermatologists or plastic surgeons — to administer it.
Your Daily Skincare Non-Negotiables
When it comes to skincare, Dr. Yoon approaches it like building a house. The foundation is diet. The first floor is what you actually put on your skin.
He keeps his morning routine simple: vitamin C serum, every single day. Vitamin C does two critical things — it fights free radical damage (one of the primary drivers of aging) and it is essential for collagen production. There is no substitute for it in your morning routine.
At night, the most proven anti-aging ingredient is a retinoid. Prescription-strength tretinoin is more powerful, but for midlife women experiencing the skin-thinning and sensitivity that comes with declining estrogen, over-the-counter retinol or gentler plant-based alternatives like Bakuchiol may be a better fit. Peptides are another excellent option — short protein chains that signal your skin to produce more collagen without the irritation of retinoids.
For the dark spots and hyperpigmentation that become more common after menopause, niacinamide is a gentle and effective brightener. It’s not the most aggressive option, but it’s accessible, mild, and can work well as part of a consistent routine. IPL (Intense Pulsed Light) treatments are his top recommendation for addressing existing spots more aggressively, with no significant downtime.
He advises against using hydroquinone casually — it’s the most potent skin brightener available, but it carries risks including potential cancer links in high-dose animal studies and a condition called ochronosis in darker skin tones. He reserves it for specific clinical situations under careful supervision.
On topical estrogen for the face: there is evidence that estrogen applied to facial skin can help counteract collagen loss that accelerates after menopause — women lose about 30% of their skin’s collagen thickness in the first five years after menopause, then about 2% per year after that. Hormone replacement therapy can slow and even partially reverse this. However, topical estrogen applied to the face can trigger melasma in some women, so it warrants caution and ideally the involvement of a dermatologist.
Gua Sha, Derma Rolling, and the Tools You’re Using
If you’re doing gua sha every morning: it’s not moving facial structures, but it is a genuinely useful lymphatic massage. It can reduce puffiness, help with fluid retention from a salty dinner the night before, and feels good. Keep doing it with realistic expectations.
Derma rolling gets a more complicated review. The concept — creating controlled micro-trauma that triggers the skin to heal and tighten — is sound. The delivery mechanism is the problem. A roller forces needles into the skin at an angle, which creates small tears rather than clean punctures. Dr. Yoon’s recommendation is to switch to dermal stamping instead, which delivers the needles straight in and straight out, producing the beneficial micro-trauma without the tearing. Once or twice a week is sufficient, and it can be paired with serums for enhanced absorption. He uses it on his own scalp to address thinning hair.
The One Thing Every Midlife Woman Should Be Doing Right Now
When asked what single takeaway he’d want every woman listening to walk away with, Dr. Yoon came back to two things: retinol at night and a collagen supplement. Both are accessible, both are backed by evidence, and both are things almost anyone can incorporate.
For sensitive skin — especially common in midlife as estrogen declines — he swaps retinol for peptides and Bakuchiol, which he uses on his own skin every night.
But he also offered something that had nothing to do with skincare, and it stuck with me. He said beauty is health. The most powerful anti-aging strategy available is taking care of your overall health — the things Natalie talks about regularly: nutrition, hormones, sleep, movement, reducing inflammation. What shows up on your skin is a direct reflection of what’s happening inside your body.
And finally, he offered the advice he gives at the end of every podcast: find something that gives you meaning and gives back to the world. For him, it’s rescue dogs. For you, it might be something entirely different. But the research on longevity and vitality consistently points back to purpose. Midlife, he believes, is often when people finally figure out what that is.
The contents of the Midlife Conversations podcast is for educational and informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider. Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links mentioned on this podcast.
