Millennials are self-expressive, confident, open to change and are estimated to become the most educated generation in American history. But these attributes don’t just apply to their access to Google search and their willingness to roll with the latest Instagram update. This also applies to their desire to undergo plastic surgery. The rise of social media and the developing transparency and acceptance within the cosmetic industry has caused popularity of plastic surgery among Millennials to grow. According to the American Society for Aesthetic Plastic Surgery (ASAPS), Millennials in 2015 made up 26.8 percent of surgical procedures and 15.9 percent of non-surgical procedures—making up 17.5 percent of the total procedures performed. The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) reported that 64 percent of member facial plastic surgeons saw an increase in cosmetic surgery or injectable treatments in patients under age 30.
Of course Millennials don’t look at plastic surgery the same way as Gen-Xers or Baby Boomers. Some of the most popular procedures among this 18-35 group are common among previous generations, but Millennials come into it with a better idea of what they’re looking for and a more complete understanding of each procedure, having researched and weighed their options beforehand. Among this group the most popular surgical procedures are breast augmentations, rhinoplasty and liposuction, with botox, injectables and non-invasive sculpting procedures topping the non-surgical list. It should be noted that “mommy makeovers” are also on the rise for the 30-35 set, which includes procedures like tummy tucks, breast enhancements, stretch mark removal and vaginal rejuvenation. Considering 90% of all new mothers were Millennials in 2014, this doesn’t come as a surprise. “While some reports have called this generation ‘narcissistic and self-obsessed,’ it’s more likely that they adapted to the world they live in. It is impossible to separate the personality of the Millennial generation from their relationship with technology,” Dr. Ashley Gordon, a board-certified plastic surgeon based in Austin, explained to JustLuxe. “They grew up with MySpace and Facebook and now have Instagram and Snapchat. They use online services for dating. Their desire to look and feel their best isn’t going away.”
Whether it’s due to the “Kardashian Effect” or the rise in social media, it’s apparent that influencers and celebrities are compelling Millennials to go under the knife. According to the AAFPRS, 82 percent of surgeons surveyed last year reported that stars were a “major influence” in their patient’s decision to have surgery. But what most doctors are finding is that instead of wanting to replicate Kylie’s lips or Kim’s butt, they’re using social media platforms to better understand their choices and educate themselves on what transformations are possible. “Social media created a much greater awareness for enhancements in general. The way celebrities put everything out there regarding the work they've had done has caused the procedures to become much more mainstream. This doesn't necessarily mean that my patients want to look like them, it just means that it’s helped make them aware of what options are out there,” Dr. Edwin Williams III, President of AAFPRS told us. “I've had more patients come in and say that they do not want to look like so and so celebrity. Celebrities have motivated patients to some degree, but I find it’s more of them over-analyzing their own image, rather than wanting to look like specific stars. They'll reference celebs, but want a more natural look.”
Dr. Gordon agrees, adding that the girls that come to see her for breast augmentation are more concerned with the final look instead of the size of their breasts. “With the growth of social media, Millennials have a very clear picture of what they want and how they want to look in their clothing and in swimsuits. They bring in Instagram photos of girls in bikinis to convey their breast augmentation wishes. They are well read on the procedure, so the focus has shifted from solely on size and cc’s to the ‘look’ they want,” she explained. “The ‘look’ refers to how much upper pole fullness they desire when naked, in a swimsuit and in a bra. Some want the ‘augmented’ look, while others desire a more natural size and shape.” Millennials made up almost half, 47.9 percent, of breast augmentations last year and 27.3 percent of breast reductions for women. “In the past, women would typically wait until they were done having children to have this surgery, but Millennials want to look and feel great today. Many of these young women aren’t even sure if they are going to have children, so why wait?” she said, noting that many of these surgeries can be performed as an outpatient procedure with only several days of downtime, perfect for the busy Millennial lifestyle.
Breast enhancements aren’t the only surgical procedure Millennials favor. Liposuction and non-invasive sculpting techniques are some of the most popular services, especially in the warmer months. “We have always seen seasonal trends. In the spring we see a lot more breast augmentation procedures and liposuction as people get ready for the summer,” explained Dr. Daniel Mills, President of ASAPS. “Yearly trends we have seen a much bigger trend towards nonsurgical, but it’s stayed relevantly consistent between liposuction and breast augmentation as the biggest number of procedures performed.” Millennials make up 27.9 percent of liposuction patients, but many are starting to opt for non-surgical procedures due to their ability to permanently reduce 20 to 25 percent of fat in the waistline with mild side effects and no downtime. Deciding on which procedure is best depends on what you’re looking to improve and to what degree. “If a patient can improve their aesthetic concerns by maybe 40-50%, non-surgically, and be happy with that, then there is no reason to pursue surgical option. On the other hand, if someone is seeking a faster and more dramatic outcome, then surgery will likely be best option,” added Dr. Paul Nassif, a board-certified plastic surgeon and RealSelf advisor. “We like to make sure our patients are well educated about all of their options (both surgical and nonsurgical) prior to undergoing a procedure.”
While liposuction and breast augmentation are intended to improve the overall look of the body, the doctors we spoke to made note that most of the rhinoplasty, or nose jobs performed are corrective in nature, meant to smooth out bumps, shorten extended bridges and fix humps. “A simple hump reduction and tip refinement can soften and balance a face tremendously” explained Dr. Justin Yovino, one Beverly Hills’ most sought-after plastic surgeons. “In other words, the nasal tip and bridge exhibit power over the entire face and cosmetic fan or not, just about everyone agrees. Major holiday breaks and summers between semesters see a spike in nose reshaping. The procedure requires a bit longer general anesthetic, but is still well within the safe limits. While the discomfort is notoriously less than anticipated, the bruising and swelling cannot be hidden for up to two weeks.” Nose jobs were notoriously popular from the ‘90s and into the early aughts, but it seems they’re still a favorite among the younger generation; Millennials made up for 46.5 percent of all the nose surgeries performed in 2015.
The most popular non-surgical procedures include fillers like Juvederm, Botox and Restylane, with the consulting surgeons almost unanimously naming lip injections the preferred procedure of choice. “The most common request for non-surgical treatment still continues to be lip augmentation. Whether we like it or not, social media has popularized the Jenner lips and the growing attachment to these media outlets will continue to drive the lip filler market in the years to come,” said Dr. Behrooz A. Torkian, a dual-board certified facial plastic and reconstructive surgeon and member of the AAFPRS. “As a specialist in facial surgery, I also get a high rate of requests for facial fillers, Botox and non-surgical treatments. Among these procedures, the trend to maintain and prevent has led them to treatments such as Botox in the upper face as early as in the early twenties! Similarly, this group is highly likely to ask for treatment of aging in the lower eyelid area such as Restylane filler in the tear trough.”
It seems in an attempt to stave off aging (and look more like a Jenner), Millennials are opting for these fillers and injections as a preventative measure, or in some cases to stop wrinkles from even forming. Unlike previously noted procedures that are an attempt to correct or improve a persistent problem, these non-surgical injections are being performed before any issue has developed. “There are a lot of Millennials age 30-35 that are using Botox to prevent wrinkles. If you aren't wrinkling that area, you're essentially preventing the facial expressions that cause those wrinkles to form and become more pronounced over time,” explained Dr. Williams. But there is a big difference between selecting a hyaluronic acid injection, something like Juvedurn or Restylane, and a botulinum toxin, like Botox or Dysport. “I'm not concerned about the safety as far as drawbacks. However, the age between 18-22 can be a funny time developmentally and I have to question—is it really necessary at this young of an age? A drawback to a 25 year old getting Botox is that starting at such a young age, you need to maintain that indefinitely. The benefit of injectables is that they are not permanent, so the effects will wear off if you change your mind about it later on,” he added.
Whether they’re hoping to get a small tuck or are looking to remain ageless forever, one thing all of our surgeons agreed upon was the Millennial desire to look like a better, but natural version of themselves. “What is unique to the group appears to be the basic desire of looking natural and fit. For example, rhinoplasty procedures, which are the most common surgical procedure in the group in my practice, are now requested to be a better version of my own nose, or not a dramatic change,” explained Dr. Torkian. “Taste in this group is notably different as fewer desire excessively small or scooped noses. Body procedures appear to have a focus on the appearance of fitness such as abdominal definition, gluteal definition, and the like.” As with anything else there are exceptions to the rule, but for the most part it seems they are looking for small improvement and upgrades without completely transforming their individual look. “Patients will come in with a certain celebrity photo and ask to achieve a similar feature, which is different than if a person would say ‘I want to look exactly like this.’ That would be unrealistic and raise red flags,” added Dr. Mills.
Working on young men and women, even for seemingly simple changes, comes with its own set of challenges. “The overall benefit of all these procedures is to enhance self-confidence. I think every face has beauty in it, and as an artist and surgeon my job is to bring that beauty out,” explained Dr. Marc Mani, a Beverly Hills plastic surgeon to stars and socialites. “Some girls do want to mimic certain body parts of celebrities. If they're already close to that ideal, it's reasonable, but if they're looking for a total identity change, that's clearly not my style of practice. Nor, in my opinion, is it healthy. I generally discourage more dramatic undertakings for younger patients…. I'm not about completely changing someone's face, just gently tweaking it or restoring its beauty.”
When consulting with the younger end of Millennials, there are generally a series of steps in place to better understand their motivation, expectations and state of mind. “Sometimes, the onslaught of social media pressure can lead to body dysmorphic disorder (BDD), so if this is suspected, the procedure should not be performed, and the patient should be referred to someone who specializes in BDD,” explained Dr. Grodon. “It is the responsibility of board-certified plastic surgeons to educate this generation and guide them toward the right choices and steer them away from treatments they will likely regret. Younger patients should be cautioned to not go overboard, as overtreatment can actually age them way beyond their years. We must spend time during their consultation figuring out exactly what their desires are and determining if those desires are realistic.” But the numbers are growing and it seems the majority of millennials rushing in for quick lip injection or scheduling breast augmentations aren’t suffering from anything quite so serious, just a major case of Kylie Jenner lip envy.