Three Big Lessons From 2025 in Facial Aesthetics
Every year in my practice, a few patterns stand out so clearly that they’re worth sitting down and writing about.
Here are my top three observations from the past year.
1. Younger Facelift Consults Are Way Up
Over the past year, I’ve seen a noticeable rise in facelift consults from patients in their 30s and early 40s. That trend, in my opinion, is being driven by two main forces:
GLP-1 Weight Loss and Skin Laxity
I'm seeing more patients who’ve lost a significant amount of weight on GLP-1 medications. They feel better, they’re healthier, but their face and neck often tell a different story:
Deflated cheeks
Loose neck skin
Early jowling
Here’s the blunt truth based on what I see every week:
When there is true skin laxity after major weight loss, surgery is the only reliable way to tighten that skin on the face and neck.
Radiofrequency (RF) devices, lasers, and similar gadgets are often marketed as if they can “shrink-wrap” loose skin. In my experience, they cannot reverse significant laxity. Patients come to me after:
Months of treatments
Thousands of dollars spent
Minimal to no visible change
If you have substantial skin laxity after major weight loss, I don’t want you wasting your money chasing miracles from these devices. You’ll be frustrated, and I’ll be the one meeting you later when you’re disappointed.
Younger Patients Want Subtle, Not Extreme, Change
My younger facelift patients aren’t usually asking for a “dramatic transformation.” They don’t want to look like a different person; they just want to:
Sharpen their jawline
Clean up early jowls
Smooth out a lax neck
When I perform an extended deep plane face and neck lift in someone in their 30s or 40s, the before-and-after photos aren’t as shocking as a 65-year-old with advanced aging—and that’s a good thing. It looks:
Fresher
Tighter
More defined
But still very natural.
A few important points here:
I do not do “mini lifts.”
Mini lifts, in my opinion, are usually a waste of your time, my time, and your money. If you’re going to undergo a facelift, my goal is always to do it properly, so it looks natural and lasts as long as possible.
Doing it earlier doesn’t mean I’m doing “less of a facelift.”
The technique is the same; you simply start from a better baseline, so the change is more refined than extreme.
One big advantage of operating earlier:
You get to enjoy the results longer. Instead of chasing aging with temporary fixes for a decade, you lock in a strong foundation that ages gracefully with you.
2. Filler Fatigue Is Real
Another big trend this year: a lot of people are backing off fillers. Industry numbers suggest there’s been a notable drop in filler usage year over year, and I see that reflected in my own practice.
Why Are People Pulling Back?
The “overfilled” look is finally being called out.
We’ve all seen it: pillow faces, distorted lips, blunted features. The public has gotten smarter. Many people now specifically say, “I don’t want to look overdone,” and they’re actively avoiding that look. I completely agree with that goal.
Fillers aren’t “bad,” but they’ve been overused.
When I say this, I’m referring to hyaluronic acid fillers. They can still be fantastic tools when used:
In the right areas
In the right amounts
For the right reasons
A little filler can be very helpful for:
Smoothing a line or crease
Softening a small contour irregularity
Subtle volume restoration
The problem isn’t the material itself - it’s too much of it, in the wrong places, for too long.
Why I Often Prefer Fat Over Filler in the Face
For global facial rejuvenation, especially in combination with a facelift, fat grafting is usually my preferred approach (with one major exception: the lips).
Why I like fat in most other facial areas:
It’s your own tissue.
You’re not introducing a foreign substance, which reduces the risk of chronic inflammatory reactions.
What survives, stays.
Fat that survives becomes living tissue. It doesn’t simply “wear off” like filler.
It can improve skin quality.
Fat is yellow, and placing it under the skin can give a subtle internal “glow.” In addition, there’s evidence that fat grafting (and the stem cells that come with it) can improve the quality of the overlying skin and dermis over time. Think of it as "fertilizer for the skin".
Downsides of fat:
It requires a small procedure to harvest it (usually from the abdomen, thighs, or flanks).
A small subset of patients may have less-than-ideal take, but in my practice this is the exception, not the rule. I'll write a blog post on the misconceptions about fat transfer survival rates in 2026. Stay tuned.
Where filler still wins:
Lips. Fat in the lips is notoriously unpredictable. It can have poor “take” and be less consistent. For lip augmentation, hyaluronic acid filler is still king, and a surgical lip lift is another very powerful option in the right patient.
The bottom line:
I'm seeing a shift away from chasing every line with more filler and toward structural solutions - fat grafting, lip lift, and facelift - especially in patients who feel like their face has been distorted or “filled to death” over the years.
3. Devices Are Finally Being Seen for What They Really Are
The third big shift this year involves energy-based devices, especially radiofrequency (RF) microneedling devices marketed for “non-surgical tightening.”
The RF Reality Check
There is now an FDA black box warning for certain RF microneedling devices, and that alone should give everyone pause. But beyond that, my own experience has been consistent for years:
I routinely see patients who were told that treatments like “Morpheus8” would tighten their neck or jawline.
They spend months in treatment and thousands of dollars.
They end up in my office still bothered by the exact same loose neck skin, now frustrated and feeling misled.
This is not theoretical.
I own these devices. I have personally used them on patients. I’ve given them a genuinely fair shot. On the face and neck, I’ve been consistently underwhelmed by their ability to meaningfully tighten skin laxity.
RF Devices Melting Facial Fat Is Real
One of the more concerning issues: When RF energy goes deeper than the dermis, it can damage or melt the underlying facial fat. I’ve seen this multiple times this year.
Signs can include:
Unintended hollowing
Contour irregularities
A “wasted” or gaunt look in areas that were supposed to be “tightened”
I have to correct this with facial fat grafting - essentially putting fat back where the device helped remove it.
So when I talk about being cautious with these treatments, it’s not from a place of fear-mongering or jealousy of non-surgical options. It’s from direct experience and treating the aftermath.
Bringing It All Together
If I had to summarize this year in three lines, it would be:
Younger patients are turning to surgery earlier, especially after major weight loss, to get clean, natural results instead of chasing marginal gains from devices that can’t actually tighten loose skin.
Filler fatigue is real, and we’re moving away from the overfilled look toward more structural, longer-lasting solutions like fat grafting, lip lift, and well-planned deep plane facelifts.
Devices are finally being questioned, and the gap between what’s marketed and what they actually deliver on the face and neck is becoming too big to ignore.
I’m not anti-filler. I’m not anti-technology. I’m anti-wasted time, money, and disappointment.
My promise - whether you’re a patient, a follower, or just someone trying to navigate the aesthetic world - is the same as always: truth and transparency. No sponsorships. No paid opinions. Just what I see, day in and day out, in real faces, with real outcomes.
As we close out 2025, I just want to say thank you. Whether you’re a patient who trusted me with your face, a follower who shares these posts, or someone simply trying to make sense of a very noisy aesthetic world - I’m grateful you’re here. I hope you and your family have a wonderful holiday season, and I’m genuinely excited for what 2026 will bring: smarter technology, better techniques, more refined outcomes, and continued advances that let us deliver natural results with even more precision and predictability. Here’s to a healthy, happy New Year - and to raising the standard in facial aesthetics even higher.