Ever wonder how a woman decides she’s ready for a facelift? Let’s follow the story of Margaret, 59, a dynamic Baby Boomer who says she’s “reinventing herself.”

For several years, Margaret has been happy with her results from non-surgical facial enhancements. Botox treatments have relaxed the lines in her forehead and glabella (the area between the eyebrows) and minimized her crow's feet.

Dr. Parungao has also treated Margaret with Juvéderm to smooth out her nasolabial folds (the lines from the nose to the corners of the mouth) and the “marionette lines” from the corners of the mouth to the chin.

As she nears her 60th birthday, Margaret is realizing she may need more than injectable fillers to maintain her youthful look. “A few months ago, I noticed my cheeks were starting to drop from the eye socket area,” she says. “It was really bugging me. And even worse, I’m developing my mother’s turkey neck.

“Recently when I went for a Botox treatment, Dr. P said to me, ‘You know, you might benefit more from a facelift than from fillers.’”

“From a medical standpoint, I look at the degree of sagging, loose skin, jowling, the depth of the wrinkles and nasolabial folds and crow's feet,” Dr. Parungao explains. “Then I decide whether a nonsurgical approach can give the patient what she's looking for—or at least get started in the right direction.

“I certainly want to find out about the patient's goals and her social situation. Does she have the time for surgery? Does she have someone to help her around the house while she’s recovering?

“In Margaret's case, we've gone down that path. She's very pleased with what I've done so far with the appearance of her face and now she's ready,” Dr. Parungao explains. “She's got the time and the courage to take the next step and have surgery.”

You’re invited to share Margaret’s journey as she prepares for her facelift. On July 6, we will launch an online forum where you can read comments from Margaret and Dr. Parungao—and join in on the conversation. Watch your e-mail for details on how to join the forum.

During the consultation, Dr. Parungao explains
to Margaret how a facelift or rhytidectomy will rejuvenate her face by tightening the underlying muscles and redraping the skin of her face and neck. “I’m doing this for me,” she says.

In Margaret’s case, the biggest factor is the degree of sagging in the neck region and around her cheeks; these might be better served by making the longer, more extensive incision of a full facelift. In a full facelift, I will free more of the facial skin from its underlying tissues and lift it to a greater degree than in a mini-facelift.