The new year’s plastic surgery trends are also an extension of injectable trends, to some extent. Patients who are used to tweaking their face with Botox or filler may be looking for more long-lasting or aesthetically different results. “Right now, the biggest fear that most people have about doing cosmetic treatments, whether it’s surgical or nonsurgical, is looking unnatural,” says Julius Few, MD, a board-certified plastic surgeon in Chicago and Los Angeles. So the procedures that are rising to the top will likely be ones that create small but impactful changes to the face. “That’s number one. Also, if you can do something in a way that minimizes recovery downtime, that is the way to go,” says Dr. Few.
Here, the three trends — and five procedures — set to drive the plastic surgery business in 2023:
Facelifts in your ’40s will be a thing — only they’re more like facelifts lite.
“I have people come in all the time in their mid to late 40s debating, ‘do I do a facelift?,'” says Dr. Few. “That’s become a much more common discussion, compared to even two years ago.” The facelift they’re mulling over is “not your mother’s facelift that was this super-pulled Saran Wrap kind of result,” says Dr. Few. Excess skin is still removed but, at a younger age, there’s not much sagging, so there’s typically not a ton of skin to cut off. The muscles underneath the jawline and neck are tightened, “but there’s not that much [to do there]. It makes the process a bit faster, a bit more predictable,” says Dr. Few, who typically injects cheeks with a patient’s own fat at the same time to “balance where the lifting is happening, so that you don’t look too tightly pulled. It’s much more three-dimensional now than it ever has been.” That’s a big deal in the plastic surgery world: “Evolutions in fat injections play a big role in [making facelifts more natural],” says Dr. Teitelbaum.
But to some extent, a facelift is a facelift is a facelift — and by that we mean, it’s still surgery and not a walk in the park (an incision is made in the folds of your ear and a surgeon lifts the inner layer of your face and neck muscles). But with less lifting to do, the recovery time is shorter. Instead of two weeks of swelling and bruising, “I can often get somebody back in the public eye in a week,” says Dr. Few. A little bit of laxity typically comes back after five to 10 years, which is less than the 10-year window of a traditional lift that involves more pulling and tightening.
And there’s more at play with these early facelift adopters: A facelift in a patient’s 40s or 50s is typically just one part of a whole future program, observes Dr. Few: “It’s similar to scheduled maintenance for a car.” The goal of getting a facelift earlier is to have less of that maintenance — and less expense — in the long run. “The attitude is, ‘I want to limit my use of fillers and so I want to get a lift,’” says Dr. Few. “It allows them to create a plan, know what is financially involved, and plan accordingly. I’m seeing that kind of long-term planning more than I ever have in my career, going on close to a quarter of a century.” The facelift is the anchor and then in-office procedures like Botox and filler may support the results.
But, all trends aside, finding a good surgeon is always (always, always) key and that means staying miles away from anyone shilling dishonest before/afters (where the lighting and angles are blatantly different) on Instagram. “A facelift is the least-standardized procedure between physicians — each surgeon tailors individual aspects of it to each patient and the surgeon’s own aesthetic — so it really matters who you go to,” says Dr. Teitelbaum. “There are some people who try more aggressively to restore or create a younger look at the price of looking ‘done.’ Others set a more conservative expectation, with the advantage of the patient not having those telltale signs of surgery and just looking a lot better.”
Following filler fatigue, more people will get blepharoplasty and brow lifts.
“We’ve always done blepharoplasty [conventionally called eyelid lifts] and brow lifts, and the numbers are slowly growing. But what you see more and more is people who have become used to going in for injections recognizing the limitations of those injections,” says Dr. Teitelbaum. “They’re realizing celebrities with a ton of filler look bizarre.” Or they want to eliminate horizontal forehead lines while still having full motion in the area. “Being able to raise your brows creates levity and makes you look more approachable and gentler, and you get a natural movement of the forehead with brow lifts,” says Dr. Teitelbaum. “So we’re doing more surgeries based upon these people already sort of being involved with [treating the forehead and brows with injectables], but not being satisfied with the results that they’re getting.”
In theory, it’s the surgical extension of making small tweaks to your face, for patients who want something longer-lasting or aesthetically different from injectables. And blepharoplasty and brow lifts are two ways plastic surgeons can create a natural-looking facial rejuvenation, says Dr. Teitelbaum. “Patients talk about hooding of their lids or horizontal lines on their brows giving them a stern expression, rather than the lighter, happier look you get with an arched brow.” But just like with the facelift — even a “lite” one — blepharoplasty and brow lifts are very much surgeries. In an upper lid blepharoplasty, for example, a surgeon targets the excess skin or fat causing hooding, crinkly skin, or puffiness. “The main part is removing a pinch of that skin in the upper eyelids or you remove some of that fat,” says Dr. Teitelbaum. “With the lower eyelids, it’s more an issue of the fat, and sometimes you remove the fat and sometimes you reposition it.” The downtime usually involves swelling, redness, and bruising for about a week. A brow lift, which entails raising the soft tissue and skin of the forehead and brow, has a similar recovery time.
Dr. Teitelbaum notes that most patients coming in for blepharoplasty and brow lifts are in their late 30s to late 40s (respectively) and beyond. He thinks the willingness to undergo surgery is also a reaction to the growing number of so-called tightening lasers at medi-spas around the country. “People are tired of spending money on these therapies which promise a lot and the best result anyone ever gets is, ‘Yeah maybe it’s a little bit better,'” says Dr. Teitelbaum. “It’s a return to the knife.
As money gets tighter, breasts might get bigger and waistlines smaller.
Okay, that’s a bit of hyperbole. But Steven Williams, MD, a board-certified plastic and reconstructive surgeon in Dublin, California, and president-elect of the American Society of Plastic Surgeons predicts that the economy will influence surgical trends more than usual this year. “Breast augmentation and liposuction will be incredibly popular, partly because they are relatively long-lasting procedures [an implant typically lasts for 10 years, while liposuction’s contouring is usually permanent], but also because they are gateway procedures in some ways,” he says. Williams explains that breast augmentation, especially, is typically the plastic surgery procedure people have been thinking about getting for 10 years or so before actually moving forward. “When these patients think about their big life events, it’s often getting a car, getting a place of their own, and then getting this procedure,” he says. “When someone has been planning and saving for the last decade, they’re going to find a way to make it work out.”
