The "Glow-Up" Facelift Is Real

It’s a concept that resonates across generations, whetting appetites and driving demand. “There’s so much more excitement around the facelift than there was even five years ago,” says David Rosenberg, MD, a double board-certified facial plastic surgeon in New York City. “The popularity of the operation has exploded.” Helping to boost its image is “a subset of surgeons who are taking patients to new aesthetic heights,” he says. “Their work is being posted—people are seeing it and sharing it—and the facelift, which was once a very private act, is now being celebrated.” Circulating with similar fervor is “this idea that I can go and get a facelift and be prettier than I ever was,” says Dr. Rosenberg. “It’s a total turning point.”

Since “beautification facelift” isn’t exactly a textbook term, every surgeon has a different take on it. And the line between rejuvenation and beautification can be a bit blurry, given that the former often contributes to the latter. But Ariel Rad, MD, PhD, a board-certified plastic surgeon in Washington, DC, sees a clear-cut distinction: “A traditional facelift aims to restore what has faded through time while a beautification facelift builds what may have never been there to begin with: sharper angles, better proportions, more facial harmony,” he says. “It isn’t strictly about age—it’s about anatomy and intent.”

“The facelift, which was once a very private act, is now being celebrated.”

That said, the beautification lift is not a preventative procedure. Nor is it a euphemism for the earlier-than-ever facelift. While it is true that people are seeking facelifts at younger ages—roughly one third of facelift patients are between 35 and 55, according to a recent report from the American Academy of Facial Plastic and Reconstructive Surgery—responsible surgeons don’t perform facelifts prophylactically. To get your face in the door, so to speak, you must have something to treat—even if it’s just early laxity, a hint of a jowl, burgeoning neck bands, bothersome nasolabial folds, or a genetically blunted jawline.

But this type of lift is ultimately not about turning back the clock–it’s about slowing it down. Beverly Hills board-certified plastic surgeon Kameron Rezzadeh, MD, links the rise of the beautification facelift to “patients seeing their friends’ results,” he says, and realizing a facelift “can surgically optimize someone to age better.” While there isn’t an age limit on this kind of lift, “in my mind, it pertains to a patient who is usually in their 40s and has early or more advanced signs of aging.” By interrupting the cascade, he says, “we can really impact the architecture of the face and fundamentally alter the way they age for the better.”

Anecdotally, surgeons find that patients who have facelifts earlier in life, when their tissues are robust, often enjoy better, more durable results and a faster recovery than their older counterparts. They seem to age at a slower rate, too (though they might wind up getting another facelift in the future). “But with every patient, we have to be able to say, with tremendous certainty, that we will improve them and make them look natural,” Dr. Rezzadeh says. “We don’t want to be in a situation where they don’t look better, they have permanent scars [usually, hidden around their ears and in their hairline], and they’re living with the results for several decades longer.” In other words: “We can’t just be signing up everyone who comes through the door.”

Dr. Elizabeth Chance's patient before (left) and after an extended deep plane facelift, deep structural neck lift, lateral brow lift, upper eyelid blepharoplasty, lower eyelid skin pinch, and facial fat transfer. Courtesy of Elizabeth Chance, MD

Dr. Chance's patient before (left) and after an extended deep plane facelift, lateral brow lift, deep structural neck lift, and facial fat transfer. Courtesy of Elizabeth Chance, MD

The beautification facelift, defined

Let’s start with the basics: A facelift classically takes aim at the lower face and neck to deliver, above all, a crisp jawline and smooth, contoured neck while removing excess skin through incisions around the ears. Modern facelift surgeons lift in a mostly vertical direction to counteract the effects of gravity and time. Addressing the upper face requires a separate procedure, a brow lift, which is commonly done alongside a facelift, in order to avoid an aesthetic mismatch. “The brows really complete the full face and neck lift,” explains Mike Roskies, MD, a double board-certified facial plastic surgeon in Toronto, Canada. “Excessive bunching from a well-done face and neck lift is removed by addressing the temple and brow.” Push up on the skin in front of your ears and you’ll see what he means by “bunching.” The brow lift not only resets the upper face, it smooths any facelift-induced rippling at the border between the cheeks and temples.

Some surgeons are now modifying these standard procedures in the name of beautification. On Instagram, Daniel J. Gould, MD, PhD, a board-certified plastic surgeon in Beverly Hills, promotes his Weekend Lift as “a surgery for people in their 40s and even younger, who have heaviness in their neck, heaviness in their brow, and want an early intervention to kind of tweak the way they look,” he says. Since the operation provides “better-looking shape, better-looking definition, a better-looking jawline,” but allows for very little skin removal, “it's facial beautification, not really facial anti-aging,” he notes. Dr. Rosenberg offers his youngest patients (most in their late 30s and early 40s) a mini deep plane facelift, which combines an endoscopic brow lift with a vertical midface lift. (Endoscopic procedures are guided by illuminated cameras, which allow for tiny incisions, usually hidden in the hairline; vertical midface lifts hoist fallen cheeks.) Dr. Rosenberg’s mini lift improves the upper face, the cheeks, and the jowls, but doesn’t fully address the neck, he tells me. In patients with minimal skin laxity aiming for beautification, Dr. Rad will routinely use endoscopic methods to minimize scars.”

“We can surgically optimize someone to age better.”

By adjusting the brow, face, and neck at once, surgeons can “resuspend the muscle and skin in a very natural way,” Dr. Roskies says. But to make someone look not just younger, but more striking, surgeons typically tack on procedures that refine other features during a lift, with every aspect negotiable, customizable. This idea of a beautification bundle, for lack of a better term, may conjure another plastics catchall: the “mommy makeover” with its customary spate of surgeries. And in a similar vein, it probably seems like a lot—and trivial, it is not—but Dr. Roskies assures me that these are not “witness-protection facelifts.” Ideally, patients emerge looking like the most beautiful versions of themselves, not someone else entirely.

Among the individualized add-ons that may come with a beautification lift are an upper and lower blepharoplasty (eyelid lift), which remove slivers of skin from the top lids and bulging fat pads from below to make the eyes look more open and alert. A lateral canthopexy can tilt the outer corners of downturned eyes up slightly. Sometimes “symmetrizing” the eyebrows can be the sort of millimeter-level tweak that makes someone “just look so good,” says Elizabeth Chance, MD, a double board-certified facial plastic surgeon in Charlottesville.

In the interest of balancing a face, surgeons may also raise or lower a hairline (39-year-old Chrissy Teigen recently had hers lowered), or finesse the proportions of other features. If a patient has a long philtrum (that groove below the nose), a conservative lip lift can shorten the space, making a mouth look pert and pretty in an uninjected way. In Dr. Rosenberg’s practice, delicate chin implants (to augment weak or recessed chins) and mini rhinoplasties (which lift droopy nasal tips) are often integral parts of a beautification lift.

So too is judicious fat transfer: By carefully distributing miniscule amounts of fat throughout the face, surgeons can replace lost volume, obscure temple and under-eye hollows, and soften transitions—between the lower lids and the cheeks, say, or the chin and the jawline—lending a more seamless finish to the face. Fat can also provide subtle shape, creating “a robust but not overdone cheek,” says Dr. Rosenberg, that gives someone “a cheek highlight they’ve never had.”

Some surgeons take beautification a step further by altering patients’ bone structure to bolster the contours of the midface, so they better support the overlying soft tissues. As Dr. Rad explains, “A facelift done on an unsupported frame is like a heavy ball gown hung on a thin hanger—it’s destined to slide off,” he says. In select cases, he’ll use implants made of a biocompatible, bone-like material called high-density porous polyethylene to improve the prominence of the lower eye sockets and outer cheekbones. “Better bone structure generally translates to more graceful aging,” he notes. In other instances, he may surgically slim or reshape the chin and jawline—carving out more feminine curves in women or a more chiseled angularity in men—before doing a facelift to tailor the soft tissues so they snugly fit their new framework.

Glowing skin is another hallmark of beautification. “We can create beautiful contours on a face, but if there’s this dull, gray, ashen appearance to the skin, it won’t exude beauty,” says Dr. Roskies. Surgeons routinely incorporate lasers and peels into facelifts to treat sun damage and restore luminosity for a time. As a finishing touch, some swear by nanofat—fat that’s been processed to remove intact fat cells but retain stem cells and growth factors—to improve the quality of the skin (its thickness, texture, luster) and help speed recovery.

Dr. Chance's patient before (left) and after an extended deep plane facelift, deep structural neck lift, endoscopic brow lift, upper eyelid lift, transconjunctival lower eyelid blepharoplasty, buccal fat pad repositioning, fat transfer to face, and fractionated Co2 laser. Courtesy of Elizabeth Chance, MD

Dr. Rosenberg's patient before (left) and after a deep plane facelift, endoscopic brow lift, upper and lower blepharoplasty, and laser resurfacing. Courtesy of David Rosenberg, MD

Behind the rise of the beautification lift

Surgical advancements have, no doubt, contributed to the facelift’s rebrand by creating the supernatural, next-level results we see in Hollywood and on social media. And this helps to normalize the facelift, fueling greater interest across age groups.

But there’s another influential force at work here: Over the past few years, surgeons have witnessed GLP-1 medications, like Ozempic, Zepbound, and Wegovy, “unlock thinness for people who’ve always been heavy and have never felt comfortable in their skin, never felt beautiful,” says Dr. Chance, who operates only on women. Once they achieve a body they’ve never had, they want a face to match. Unlike facelift patients who dream of looking like they did decades ago, those seeking surgery on the heels of dramatic weight loss are decidedly less wistful. They’re aiming for an upgrade—unprecedented appeal. The yearning is especially strong in cases of “Ozempic face,” where rapid weight loss makes the face look older than its years. “We’ve had multiple people in their late 30s, who’ve lost 100 pounds, coming in for facelifts,” Dr. Rosenberg says. “I even did a 28-year-old facelift [for this reason] and she [says she] looks prettier than she ever has in her life.”

“In my heart of hearts, I just don't want to be the surgeon who alters young women’s faces.”

But let's be clear: The vast majority of "beautification lift" patients are still over 40. Dr. Roskies tells me that any time he posts a result of a younger facelift patient, his office is bombarded with calls from 30- to 35-year-olds, who think a facelift is the answer to whatever’s troubling them. In the under-40 set, however, he turns away 90% of facelift seekers. As for the few who wind up in his OR, “most are in the context of massive weight loss or connective tissue disorders,” he says, which can lead to premature aging.

Dr. Chance can count on one hand the number of 30-somethings she’s lifted in the past five years. (There were three, all with genetically large necks and indiscernible jawlines.) Her patients range in age from 45 to 70, she says, with most in their early 50s. “I wouldn’t feel socially responsible operating on someone who doesn’t have some modicum of aging, like a jowl or drooping of the midface—which we can see as early as the 30s in people who have collagen disorders or massive weight loss,” she says, echoing Dr. Roskie’s point. “But in my heart of hearts, I just don't want to be the surgeon who alters young women’s faces.”

Criticism and controversy

Ethical doctors say, No, when a treatment isn’t warranted—or if a patient has health issues, unrealistic expectations, or shows signs of body dysmorphia. “If they’re seeing things that I’m not seeing, or if I can’t give them what they want, I’m not going to operate,” says Dr. Rosenberg. Generally speaking, for a surgeon to perform a facelift (irrespective of goals), there has to be evidence of laxity. It may not be obvious to scrollers on social media, but it should be detectable in an exam. “A great litmus test,” says Dr. Rezzadeh, “is to have patients flex their necks by looking down—that really gives a sense of the true laxity in the neck.” (At 48, I’d recommend avoiding this move at all costs.) When assessing facelift potential, Dr. Rosenberg reviews old photos of patients to see how they’ve changed and he feels their faces, looking for looseness. If the face is taut and does not move, he’ll send them away, with an invite to return in the future.

“The margin for error is narrower. We must approach these cases with heightened restraint and artistic precision.”

Surgeons who perform facelifts on patients at unconventional ages, regardless of the circumstances, are often taken to task online, you may have noticed. Dr. Rad has some experience with this. His beautification results for patients in their 30s—which frequently involve multiple invasive procedures, including skeletal changes (nose jobs, midface implants, jawline slimming) as well as deep plane facelifts—inspire both praise and scrutiny. Social-media critics question why people so young would ever need such extensive work. As Dr. Rad explains, younger patients, even those without significant drooping, are increasingly seeking procedures that enhance contours and proportions, without adding the artificial volume of fillers. “They’re seeing that subtle, well-planned surgical refinement, done early, can look more natural than years of overfilling or chasing trends,” he says. In such cases, the facelift is more a tool for sculpting than lifting. But when the goal is “subtle elevation [of one’s appearance] rather than restoration,” he adds, “the margin for error is narrower and we must approach these cases with heightened restraint and artistic precision.”

In April, Dr. Rosenberg received backlash on a before-and-after montage he posted of a fresh-faced facelift patient. “How old is she? She looked perfect before,” one commenter wrote. Another suggested that the “doctor must have needed another Mercedes.” Others used the words “criminal” and “malpractice.” Dr. Rosenberg says the facelift was, indeed, indicated and that this woman is one of his happiest patients. “If there’s a 42-year-old who, objectively, is already beautiful, but wants a subtle jowl improvement, why wouldn’t I do it, if it’s going to make her happier and [the procedure] is safe and proven to be effective?” As for the outrage? He likens the scenario to a wealthy person striving to get richer: “It can make someone who has less feel uncomfortable or have negative thoughts about it,” he explains.

It’s disconcerting, this notion of hoarding beauty in an almost avaricious way. The inequity of it all.

Of course, in the age of the six-figure facelift, money and beauty are inextricably linked—which calls to mind the meme: You’re not ugly, you’re just poor—and this can intensify the discomfort for some. In a 2023 study published in Evolutionary Human Sciences, the authors write, “Until recently, the privileges afforded to attractive women were only made available to those lucky enough to be born beautiful. With the rise of cosmetic surgery, however, beauty is slowly becoming more attainable; for those who can afford it, beauty is now a purchasable commodity.” In analyzing data on beauty bias and popular attitudes towards women who choose to have cosmetic surgery, the researchers suggest that “beauty (and its associated privileges) is inherently something that can be ‘stolen’—as one woman undergoes cosmetic surgery to become more beautiful, another becomes less beautiful by comparison.”

It’s disconcerting (and, oof, objectifying), this notion of hoarding beauty in an almost avaricious way. The inequity of it all. But Dr. Rosenberg doesn’t judge patients or their motivations. “My job is pretty simple,” he says. “It’s to help people feel more beautiful. And that gives great joy.”

The bottom line

Beautification by facelift: Revolutionary or not, this phenomenon is giving the centenarian operation new life. While some argue that beauty is akin to rejuvenation, others maintain that beauty is distinct from youth, and that achieving it often requires more than putting fallen tissues back where they belong. It means adding color and brightness to the canvas of the face, in Dr. Roskies’ words, without rendering any part exaggerated or unrecognizable, in order to cultivate a harmonious outcome. Of course, it takes a skilled surgeon, with a keen eye, to literally create beauty by performing a curated assortment of procedures, centered around a facelift. And every doctor has a different concept of beauty, shaped by their culture, upbringing, and taste. For a look that’s true to them, patients must find a surgeon whose vision aligns with their own.

Photographer: Huy Luong

Stylist: Roberto Johnson

Hair: Jerome Cultrera

Makeup: Nolan Eakin

Manicure: Leanne Woodley

• Kris Jenner’s New Face Is a Great Case for Keeping Plastic Surgery Old School
• The Newest Changes to the Facelift Procedure
• 13 People Get Real About Their Facelifts