The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) has unveiled its 2023 member survey results, revealing a resurgence in demand for facial plastic surgery and noninvasive treatments as life returns to pre-pandemic levels of activity. Facelifts are making a comeback, and advancements in technology have made “tweakments” highly popular due to their accessibility and appeal to all age groups.

The survey, conducted by ACUPOLL Precision Research, Inc. in December 2023, involved a select group of 2,200 AAFPRS members through an online survey.

Fresh-Faced Facelifts

Modern techniques like subcutaneous and deep plane facelifts are breathing new life into this age-old enhancement and drawing a younger crowd to the procedure. Since 2019, a whopping 90% or more of AAFPRS surgeons have performed facelifts each year. On average, members performed 48 facelifts or partial facelifts in 2023, demonstrating a 60% increase since 2017. Over the past seven years, the number of facelifts performed has steadily increased year over year. The survey also noted a directional increase among patients ages 35-55, suggesting that facelift patients are getting younger.

“At some point in the aging process and with a certain degree of laxity and sagging, you will get diminishing returns on your noninvasive procedures,” says AAFPRS President Sherard A. Tatum, MD. “At this point, it’s best to opt for a facelift or partial facelift to get the desired effect. Facelifts also soared in popularity this year due to the ‘Ozempic Effect’ where patients lost a large amount of weight in a condensed period of time, resulting in sagging skin.”

For females, facelifts (performed by 86% of surgeons) were the most requested procedure last year by a wide margin. The next most popular for women were rhinoplasties, at 79%, and eye lifts, or blepharoplasties, at 73%, respectively. Consistent with years past, the top three surgical procedures were rhinoplasty (performed by 83% of surgeons), blepharoplasties (49%), facelifts and partial facelifts (48%) across all genders. 

Gen Z Has Entered the Chat

From the ‘Sephora Tween’ phenomenon to TikTok’s wildly popular ‘Get Ready with Me’ videos, Gen Z (now ages 11-26) is coming into their own purchasing power and prioritizing aesthetics. This year’s survey supports this, showing that 77% of AAFPRS members believe there will be a greater emphasis on earlier maintenance and prevention starting in the 20s and 30s to forestall signs of aging. 

“This generation is growing up with a greater awareness of what is possible when it comes to aesthetic treatments thanks to the normalization online,” says Tatum. “Rapid advances in non-invasive treatments and technologies allow younger patients entry into aesthetics with very little pain and downtime, making it more attractive to a larger patient pool.”

The new data points to this, with 83% of the total number of procedures performed in 2023 being minimally invasive. The remaining 17% were surgical. Of minimally invasive procedures, the three most common treatments were neurotoxins, fillers, and topical treatments (micro-needling and chemical peels). Rhinoplasty remains the single most requested surgery among patients under 34 years old.

MANual Enhancements 

It is still no surprise that women continue to reign when it comes to undergoing facial plastic surgery. However, this year’s results reveal that 44% of AAFPRS surgeons expect more men to have treatments and surgeries in the coming years (up 5% from 2022). AAFPRS members also noted that they are seeing more young men under age 35 seeking surgical and non-surgical enhancements. 

“As minimally invasive technology continues to advance, this opens the door for more men to get discreet, quick-to-heal cosmetic treatments,” says Tatum. “From noninvasive neck lifts to needle-free enhancements, there are more options than ever for men to keep looking as vital and youthful as they feel. The rise of minimally invasive options seems to be slowly closing the gender gap when it comes to facial plastic surgery.”

For men, rhinoplasty, blepharoplasty, and facelifts, in that order, followed by revision surgery and forehead lifts were the most-requested surgical procedures. 

Looking Ahead 

“Our field is growing at such a fast pace. It’s an exciting time to be in facial plastic and reconstructive surgery,” says Tatum. “Over the next year, we will certainly see the rise of AI in aesthetic medicine as surgeons integrate this technology to better analyze facial features, guide both their cosmetic and reconstructive surgery work, and predict outcomes of interventions over time. Things like 3D imaging allow us to simulate potential outcomes for more precise treatment planning, injectable placement, and more. Custom computer-generated implants are available to better enhance or reconstruct facial contour problems.” 

“We may also see a reduction in the demand for injectables since a top concern for patients is appearing ‘overdone,’” adds Tatum. According to 24% of survey respondents, looking unnatural is their patients’ biggest fear when considering a facial procedure. “I predict we’ll see a greater focus on more natural outcomes and graceful aging,” Tatum says. “Some outward appearance of maturity can be taken as a sign of experience and wisdom. Although I am speaking as a boomer.” 

Informed Patients

Revision surgery saw its first decline since 2019, which points to better educated consumers investing time and money in qualified surgeons. However, 54 % of facial plastic surgeons believe there will be an increase in nonmedical staff doing procedures, potentially resulting in poor results or increased need for corrective procedures. This is a 13% increase from 2022, making it the highest jump among trends in this year’s survey. As such, it’s imperative to remind patients that AAFPRS members are the most qualified and skilled for procedures in the face and neck, association officials say. And, according to our survey, 25% agree that finding the right doctor is a patient’s top concern when deciding to undergo facial plastic surgery in 2023.

Whether patients are considering surgery or a noninvasive tweak, choosing a qualified surgeon should be the priority, says Steve Jurich, CEO and executive vice president of the AAFPRS. “Always select a surgeon specifically trained in procedures of the face, head, and neck and make sure the physician is qualified, experienced and board-certified in the procedure you want,” he advises patients.