Last year, on December 21, Stacy Simons was expecting 150 people at her Colorado home for a Christmas party. It was an ambitious affair, given that a mere eight weeks earlier, she had traveled to San Diego to undergo a full face and neck lift, including blepharoplasty (eyelid lift), a lip lift and fat grafting. By the time she was decking the halls and dusting off her eggnog cups, she was more than ready to celebrate — the holidays and her newly lifted face. “My husband said, ‘It’s crazy. There’s no way anyone would know you just had surgery,’” she says.
Simons, 55, a former pharmacist, decided to go under the knife when she realized that the fillers and Botox injections she had started getting in her forties were no longer working for her as well as they once did. After consulting with several doctors across the country, she decided on Amir Karam, MD, a San Diego–based facelift specialist with a massive social media following. Simons’ surgery didn’t come cheap — she paid over $100,000 for it — but now she doesn’t have “dimples and wrinkles” and feels like she looks 10 years younger. “People think I look better, and they don’t know why. That’s the best compliment,” she says.
Forget what you think you know about facelifts. Today’s nip and tuck is a vastly different venture than it once was. Now, it involves a lot less bruising, pain and downtime. And — in the hands of a skilled surgeon — it can yield longer-lasting, hypernatural results that make you look like yourself, just much younger. Think Demi Moore and Brad Pitt, neither of whom have copped to having had “work” done but whose youthful appearance defies the laws of time and gravity. In a way, their rumored surgeries make them just like the rest of us: Celebrities age, and they don’t like it, either.
Artwork by Agata Rek
“The desire to look as young as you feel is the whole motivation for every single patient,” says Karam. “What they don’t want is … to look like somebody else. They’re not saying, ‘Hey, I want to exchange my jowls and come out looking like a different person.’ [They’re saying,] ‘I want to look like I used to, and that’s it.’ As a surgeon, that’s been a difficult thing to achieve for a long time.” Karam is known for his trademarked Vertical Restore facelift — a variation on the so-called deep-plane facelift — which lifts the face at a particular angle or, in doctorspeak, “vector” that Karam says provides superior results.
It’s thanks in part to modern advances — such as the extended deep-plane technique, which allows surgeons to leave the skin attached to the underlying layers while working on the ligaments of the midface — that facelifts are quickly rising in popularity. The American Academy of Facial Plastic and Reconstructive Surgery reported a 60% increase in facelift procedures between 2017 and 2023, attributing the growth to a significant jump in younger patients between the ages of 35 and 55. Patrick Byrne, MD, president-elect of AAFPRS and chief of Cleveland Clinic’s Integrated Surgical Institute, linked this jump to improved results (thanks to the “leap forward” of the extended deep-plane lift) and the rise of social media. “Despite the gamesmanship of the before and afters a lot of practitioners do, social media, which skews younger, obviously helps with exposure,” says Byrne, a facial plastic and reconstructive surgeon.
Besides the new deep-plane technique, there have been plenty of other innovations. For example, Kenneth Kim, MD, a plastic surgeon who is an assistant clinical professor at the David Geffen School of Medicine at the University of California, Los Angeles, performs “awake” and “bloodless” facelifts in his operating suite. The benefits of forgoing general anesthesia include less potential for brain injury and faster recovery; his “precision surgery” method, which bypasses (and thus avoids hitting) blood vessels, allows him better visibility during surgery. “It’s like driving,” says Kim. “If you’re driving in fog or through an area in which there’s a blizzard, it’s dangerous to drive because you can’t see, so your coordination is off. Surgery is the same when there’s a lot of bleeding.”
Nathan Newman, MD, a dermatologist, cosmetic surgeon and regenerative medicine pioneer in Beverly Hills, California, emphasizes the importance of maintaining skin and tissue integrity but takes it one step further: He doesn’t cut into patients at all. Newman says he used to perform traditional facelifts but realized that one of the major problems was that cutting into the face ultimately, in the long term, caused trauma by damaging nerves and blood vessels. Five years later, he says, patients “look older, not better; tighter, but older.” His Stem Cell Lift procedure, which costs $35,000 to $65,000, involves zero cutting, only the transfer of stem cell-rich adipose cells to areas of the face. “Stem cell [facelifts] are great for anyone who has lost volume if they’ve got jowling or loss of fullness around their eyes.” He adds that he sometimes will do a little liposuction under the neck if warranted.
Chia Chi Kao, MD, a plastic surgeon in Santa Monica, California, is pioneering a scarless facelift technique. His patients fly in from all over the world — often on their private jets — and pay more than $200,000 for the procedure. He recently published a peer-reviewed paper in The Aesthetic Surgery Journal on his endoscopic “Ponytail Facelift,” a deep-plane procedure that includes a cheek lift as well as brow “fashioning” (versus simply lifting, a subtle but key difference), nano fat transfers and his signature “Neck Corset,” a procedure that involves individually sculpting each layer of the neck to give patients more natural and longer-lasting results. “It’s an art project,” he says.
For Oren Tepper, MD, a plastic surgeon in New York City, facelifts are a photography project. He uses 3D imaging to show his patients how they’ve aged more than five or 10 years. Unlike 2D photos, these photos will indicate that “you have lost volume by this much, your skin has descended in this vector,” says Tepper, who also uses artificial intelligence to predict the number of years he can take off a patient’s face by, say, performing a lip lift.
Finally, facelifts are notorious for their difficult recovery periods. David Shafer, MD, a plastic surgeon and founder of Shafer Clinic Fifth Avenue in New York City, has added vitamin and NAD (nicotinamide adenine dinucleotide) intravenous therapies to his pre- and post-op facelift protocols to help speed recovery. The two-hour NAD IV drips are given two days before surgery to promote cellular activity and energy, and the vitamin drip is given right after the procedure and sometimes again seven days later (at $300 a pop). “Our patients come back in a week, and we’ve noticed that their incisions look much better,” says Shafer.
He adds: “The pandemic was terrible for plastic surgery. It closed us down for six months, but then there was the whole Zoom phenomenon. Now, people can work remotely, get procedures done and recovery is faster. Two days later they’re working from home.”
And maybe eight weeks later, they’ll throw a holiday party.
