Just the mention of a facelift used to evoke images of tightly pulled skin and a permanently shocked expression.
These days, though, the increasing number of celebrities looking like they have been drinking from the fountain of youth indicate that techniques have evolved to give an undetectable, but “refreshed” look.
That, combined with the explosion of weight loss drugs on the market, has led to a spike in demand for the surgery despite the eye-watering cost, which can run from tens of thousands of dollars up to hundreds of thousands for top surgeons on both coasts — some of whom have trademarked their techniques. Think: Ponytail Facelift, the signature procedure of L.A. plastic surgeon Dr. Chia Chi Ka.
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“Cost is pretty variable and depends on several things including where you are geographically,” says Dr. Prem Tripathi, a facial plastic surgeon in the San Francisco Bay Area. “I’ve seen facelifts as low as $15,000 and as high as $300,000, depending on the location.”
According to the American Society for Aesthetic Plastic Surgery’s most recent data, the number of facelifts increased 8 percent year-over-year in 2023, outpacing the previous 8 percent growth rate that took place over a three-year timeframe from 2019 to 2022.
“We are in a ‘quiet’ facelift era, where patients are opting for deep-plane face and neck lifts earlier and temporarily stepping out of the spotlight for one to two months,” says facial plastic surgeon Dr. Akshay Sanan, who operates in the Boston area. “Advances in deep-plane facelift and neck lift techniques have enhanced precision and reduced recovery time. The focus is now on creating subtle yet meaningful, natural results.”
At the same time, while some celebrities have kept shtum on what procedures they’ve had, others (Catt Sadler, Marc Jacobs and Caroline Stanbury among them) have started to be more open about having facelifts.
“More people are seeking out facelifts because it’s become a more socially accepted procedure than it used to be,” notes Dr. Rukmini Rednam, a plastic surgeon operating in Houston. “Some celebrities have been more open about it while others haven’t. The average person notices those in the public eye looking younger, with the obvious reason being facial rejuvenation.”
From the early 2000s to just before the COVID-19 lockdown, Botox and filler were the go-to treatments in cosmetics. But during the pandemic more people started going under the knife, driven in part by constantly looking at themselves in Zoom meetings (coupled with the fact that patients could keep their recoveries private during lockdown).
The trend has only intensified despite society opening back up.
“There was a bit of a pendulum where it went very far over to non-surgical solutions and everybody was looking to avoid surgery, and the Joan Rivers of the world kind of gave facelifts a bad name,” says Dr. Cory Goldberg, a Toronto-based plastic surgeon. “The past five years has seen a shift in that mentality as the sort of really overdone, overfilled look has played out, and people recognize that the non-surgical solution isn’t really giving them what they want. Through the pandemic, there was a shift of people interested in facelifts, neck lifts and facial rejuvenation surgery and that’s increased even more since the end of the pandemic.”
As for the weight loss factor, Dr. Daniel Gould, a plastic surgeon in Beverly Hills, tells WWD Weekend that around 30 to 40 percent of his patients take GLP-1s.
“Patients undergo not just deflation, but also skin quality changes and other structural changes with the use of these medications. It’s really fueling face surgery, because if you lose even 30 to 40 pounds on these medications, it makes a significant difference,” he said.
“These patients need a multipronged approach. It’s not just a face lift. We’re adding fat back in. I’m using topical medications with vitamin A, but we’re also rejuvenating the skin in other ways, with CO2 lasers, radio frequency and micro-needling.”
TikTok, which was shuttered in the U.S. last month only to reappear 12 hours later, also played a part in demand, especially in terms of trends.
Dr. Jason B. Diamond, a Beverly Hills celebrity facial plastic surgeon with his own skin care brand Metacine, has been performing deep-plane facelifts since the ’90s and over the past few years has seen a surge in patients asking for this surgery.
“In this world in particular, there’s a lot of buzzwords that go viral and gain popularity, and they pop up and they go down, and they pop and they heat up and they die down,” he says. “From 2000 into probably 2010 every single facelift consult I did, I spent that entire hour talking about the deep-plane facelift, why I thought it was best, what the differences are. Then after several years of developing my reputation, eventually people just came in and said, ‘Doc, I don’t even care. Just do what you think is best.’ In 2021 I’d say, I started hearing the term pop up. I think some people marketed on social media made the term go viral. Now every single person says, ‘can we do the deep-plane facelift?’”
His version involves a skin elevation and dissection of the underlying facial tissue and muscle. “Once the muscle layer is mobilized or freed from its surrounding structures, it is then re-suspended upward towards the top of the ear. This addresses the deeper structures of the face, tightening and lifting the SMAS layer, without pulling only the skin. This allows a more comprehensive lift via all structures, so that the skin does not look too pulled. I want a comprehensive, natural result for my patients. The excess skin is then re-draped and trimmed, and the incision is closed.”
But he cautions that just because people ask for a certain type of procedure, it doesn’t mean it’s appropriate. “There’s no one solution for everybody. There’s no one magic way to do it. It’s an artistic endeavor. It’s a matter of doing what’s best for that person. It’s not a recipe like you’re cooking chicken parmesan; it’s the same every time. It’s not like that. And so there’s a million modifications, and we continue to hone our techniques, and we continue to modify based on what we’re seeing over long periods of time, to make these procedures perfect.”
As for the age range of people seeking a facelift, New York-based plastic surgeon Dr. Adam Kolker is seeing more patients in their early 50s and some begin the conversation in their mid-to-late 40s.
Still, despite speculation on social media that celebrities as young as in their 20s are getting facelifts, he says this is rare.
“You have to be really thoughtful about the benefits and the risks of any procedure, as there is no treatment that is completely risk-free. Even nonsurgical treatments, including injectable fillers, have potential drawbacks, and in certain scenarios surgery may be both more effective and safer,” he says.
“The early signs of facial aging may become manifest in the 30s and 40s, but the collective decision between patient and surgeon to do a facelift is not necessarily related to how severe the problem is, but rather how the individual perceives it.”
For those not wanting surgery, Gabby Garritano, founder and chief executive officer of medical spa Ject, offers a multiple-pronged approach to give clients a non-surgical lifted look.
“It’s not just how do we lift the skin and tighten the skin, but it’s really looking at the face and even the neck as well, and treating it holistically. It’s usually done with a combination of wrinkle reducers or Botox injections. With Botox, when you’re treating the lower face, we have muscles that are acting as depressors, like the platysma muscle, the mentalis, the DAO muscles, so those muscles are pulling down on the face and when we inject Botox into those areas, we get kind of the reverse effect, where we see a lift in the mid-face. That’s a really nice starting place for people,” she says.
“One thing about surgery is you really can’t go back from surgery. For patients that are like, ‘I’m just going to jump in and get a facelift,’ and they haven’t even tried injectables or even some of the modalities that we have with our lasers and micro-needling, with radio frequencies, CO2 lasers, things like that, why don’t you just spend a year and try some of the non-surgical techniques?”
Dr. Saami Khalifian, a cosmetic dermatologist and surgeon based in San Diego, also stresses that a facelift doesn’t necessarily mean that you won’t still need additional non-surgical procedures.
“When people get facelifts, the idea that they will no longer do Botox or filler or laser is inaccurate. Like, if you spent $100,000 on a facelift, the notion that you’re not going to protect that investment with like medical grade skin care, with Botox, with simulators, with laser, is just not correct. And so that’s one of the things that I often will tell patients is the chances of you needing to do additional things after the facelift are pretty high.”
