Susan Goldfarb, the executive director of an area learning center and a long-time yoga teacher, says that in her 40s she pooh-poohed the notion of plastic surgery. “Why not just grow older gracefully, letting the beauty from within shine through the well-earned wrinkles?” she thought.

Yeah, right.

When she hit her 50s, Goldfarb says, all that changed. She would look in the mirror and feel dispirited. “My reflection didn’t show the healthy, high-spirited me,” she explains. “My upper eyelids had extra skin that made them look less open, and my lower lids were puffy, giving me an overall tired look. My jowls were starting to sag a little and I had developed a deep line between my eyes. I looked like I was frowning, sad or mad at somebody. People told me I looked tired all the time.”

Goldfarb spent the next two years and thousands of dollars experimenting with non-surgical options, including an acupuncture facelift, Botox and Restylane treatments, and anti-aging creams. In the end, she says, she wanted a more permanent solution.

She did her research and found two highly recommended board-certified plastic surgeons. “I didn’t feel comfortable going to someone who wasn’t an expert in his field,” she says. “After all, I’ve only got one face.” After these consultations, Goldfarb decided to go ahead with upper and lower eyelid surgery and a lower facelift, commonly referred to as a “mini-lift.”

She says she chose her surgeon, Dr. Leikensohn, for two reasons. First, she had seen “his triumphs” on a few of her friends. Second, his before-and-after photos “didn’t look stretched and unnatural. I wanted a subtle outcome, not the wind-tunnel effect.”

Leikensoh says that he avoids working with anyone who has unrealistic expectations.

“My patients do look younger after surgery,” he says, “but we’re not talking 20 years younger. At most, people turn back the clock back 10 years. Our goal is to emphasize the natural contours of your face and body.”

Dr. Mobley seconds this. “It shouldn’t look like a face lift,” he says. “We strive to achieve a natural look—to reveal your natural bone structure and give you back the features that have been worn down by the aging process. After treatment, our patients look like themselves, only more fresh and youthful. They look better, not different.”

In other words, if you think you’re going to look like your high school yearbook picture—or like Jennifer Aniston—forget it. If you’re 55, you’re never going to look 35 again. And any reputable doctor worth his salt is not going to recommend surgery for people who are addicted to the process itself.

Dr. Leikensohn is all about the reality principle. You’re thinking about going under the knife, after all. This is not the time for denial—or obsession.

“I always advise my patients to weigh both the risks and the benefits,” he says. “Surgery is not without its risks.”

So, is plastic surgery right for you?

Ask yourself if the aging process is eating into your self-image enough to justify it. Make sure that your goals and expectations are realistic. Check that you’re doing this to boost your self-esteem and not to please someone else or dissolve depression or emotional turmoil. (Although, according to a recent ASPS study, the effect of cosmetic surgery has shown to be a factor in weaning patients off antidepressant medications.) If the insults of time are incidental and you’re still in your 30s or 40s, consider non-invasive treatments to hold you over for a few years.

Money, of course, is another factor. A traditional face lift averages between $5,000 and $10,000. A series of Botox injections costs around $200 to $400 per prick, with the results lasting last three to four months. Hyaluronic acid wrinkle filler treatments such as Restylane cost up to $600 per treatment area, with results lasting up to seven months.

Two years after her surgery, Goldfarb says she is still thrilled with the benefits and the results.

“I put my money into preserving my looks because I look like someone who still belongs in the workforce and not out to pasture. All I wanted to do was buy back a few years and look less dragged down by gravity and age. I got that. I guess you can say I came out of my middle-aged closet ready to tackle the world. I still look like a middle-aged woman—but a healthy and vital one!”