How Facelifts Are Changing in Washington

Before her hybrid deep-plane facelift surgery, M.K. (who requested to go by her initials) would look at pictures of herself and think, Is that really me? She felt ten years younger than the face staring back at her. So the 63-year-old grandmother of four in North Bethesda had her brows, eyes, and face lifted to reflect the age she felt. After a short recovery, M.K. says, friends told her she looked as if she’d spent a month at a spa.

More sophisticated surgical techniques mean patients can now avoid the dreaded “windswept” look that has long been associated with facelifts. Even the decades-old deep-plane facelift, which contours the area under the skin rather than just the skin itself, has gotten much better—and more popular—especially when it comes to targeting the procedure to each patient. “Every facelift is custom-designed. It matches face, age, ethnic background, desire,” says Fairfax plastic surgeon George Bitar. The result is a more natural look.

Ten or 15 years ago, mini-facelifts, which address sagging of the lower face and mild signs of aging, had a moment. But the results can last as little as a few weeks, says DC plastic surgeon Christopher Chang, and “people are more accepting of having a bigger procedure for the results.” Deep-plane facelifts are often that “bigger” procedure. The surgery manipulates the space between facial muscles and deeper tissues, allowing the surgeon to reposition the face as a whole rather than merely pulling the skin tighter. It’s performed under general anesthesia, and surgeons work near delicate facial nerves. Hybrid deep-plane facelifts (such as M.K.’s) are similar but also include the tightening of more superficial layers. Both types of facelifts are sometimes followed by supplementary procedures such as fat grafting, in which fat is taken from another part of the body and used to restore volume in the face. Combined with the latest recovery regimens—lymphatic-drainage massages, laser treatments—results can last ten to 15 years or longer.

“I used to think facelifts were extreme and just didn’t look very good back in the day,” says Bethesda resident Christina, 61, who had a facelift when she was 59. “More and more women, at least at my age, are open to getting more done quietly, with the hopes that no one will notice and be able to say, ‘That was work.’ You just look better.”

Even though a natural, less obvious result is the goal of today’s facelifts, this shift is partially attributed to online chatter. Previously, people might have been intimidated by getting facelift surgery or wouldn’t have known anyone who’d had it. “Social media has demystified the facelift journey,” says Chang. “There is a new norm of being open and sharing on social media—think about Kris Jenner or Denise Richards—and it becomes a talking point.”

The ubiquity can be beneficial for combatting an outdated stigma, but it also has drawbacks for those feeling pressure to conform to unrealistic beauty standards. “People used to look at magazines a couple of times a week,” says Trevor Dunn, a psychologist in DC who specializes in body-image concerns. “Social media is nonstop. If you linger on beauty products or looksmaxxing, the algorithm will keep pushing and exaggerating that. That reinforces someone’s insecurities.” Even if a facelift is financially and logistically feasible, it’s a good idea to consider if and when it will be enough. As M.K. puts it, “We live a long time. Are you going to do this twice?”

The question of whether people are going to undergo multiple facelifts is even more relevant as patients trend younger. Bitar has been practicing for more than 25 years. “Twenty-five years ago, the average age of my patients was 65,” he says. “Now the average is 47.”

Chang echoes this sentiment. “I see patients as young as mid-thirties or even early thirties,” he says. “DC is still a conservative town for facelift style and exploration. But I see more patients under 50 than I ever thought I would.”

Last fall, Bitar and his team hosted a “Deep Plane Facelift Fashion Show.” Patients from their forties to their eighties walked the runway to show off their fresh faces to an audience of family, friends, and aspiring patients. For Bitar, a father of two young adults, it was especially important to offer something real. “Here we showed everything very raw,” he says. “We let the patients speak for themselves.”

For many, the main goal of modern facelift procedures is not to freeze time but to reinvigorate natural features. “I wanted a refresh, not a forehead that didn’t move or eyes that didn’t crinkle,” M.K. says. “I knew I wasn’t going from 63 to 43. I was going to go from 63 to how I feel.”