The “Glow-Up” Facelift Is Real

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.”

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.

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.”