Not a lot of loose skin, but surgery is not an option so what do you do to look refreshed at 60?

Facial rejuvenation: There are a lot of nonsurgical options for facial rejuvenation. You can look more refreshed with some Botox (or dysport) to smooth wrinkles around the eyes and forehead. Fillers (juvederm, restylane, (dermal fillers) radiesse, etc) are great for smile lines and thin lips. Sculptra is great for facial hollows (hollow cheeks, temples, etc). See a board-certified plastic surgeon who offers a full range of options.

Sculptra/Ultherapy: If surgery is not an option then stimulation of your own collagen with ultherapy which is ultrasound focused energy will help to lift and tightened your face and neck. Sculptra is an injections which also stimulates collagen production. This helps with volumizing the entire face: upper middle and lower in a natural way. Botox/dysport can also be utilized to shape and lift the brows and reduce line.

Yes: Non surgical rejuvenation include injections of neurotoxins, fillers, and use of combination of laser and skin tightening devices such as ultherapy. The concept of volumizing and contouring with neurotox and fillers and them tightening and lifting with ultherapy and laser resurfacing can provide a "lift" affect. Keep in mind it is not a facelift and can be just as expensive. But its an option!

Ultherapy : If surgery is not an option, then consider ultherapy as a noninvasive facial skin tightening procedure.