Between the increasing variety of aesthetic procedures and the growing acceptance of surgically enhancing your appearance, it’s not surprising that more people are choosing aesthetic surgery than ever before. But as we learned when we recently queried top docs across the country about what’s trending in their offices, some procedures are more popular—or becoming more requested—than others. Here’s what a host of discerning dermatologists and plastic surgeons predicts will be the hottest things in aesthetics in the upcoming year.
A deflation in breast size
“For surgery, I predict breasts are going to continue to trend smaller—whether you have really large breasts and want a breast reduction or have small breasts and want an augmentation. Either end of the spectrum seems to have the common goal of wanting a more athletic look—think full B, sporty C. And there will be more current breast implant patients who desire a downsize or removal. Big breasts often don’t look youthful, so menopausal women frequently present for removal or downsize with a breast lift.
Neurotoxins on the rise
“In the nonsurgical realm, I predict an uptick in neurotoxin use across the board. The addition of Daxi [aka Daxxify, a recently FDA-approved, long-lasting neurotoxin] to the market is going to bring more focus to all neurotoxins and show even more people—men and younger women—that the judicious use of neurotoxins is an amazing way to refresh our looks, slow aging, and even prevent some age-related changes.”
Dr. Melinda Haws, a board-certified plastic surgeon in Nashville and president-elect of The Aesthetic Society
Microchanneling anti-aging cocktails directly into the skin
“Aquagold is a glass vial with tiny gold, hollow needles that stamp a cocktail under the surface of the skin for a ‘glow on the go’ appearance. The cocktail can be customized but usually contains hyaluronic acid, Micro Botox, vitamin C, and hydroquinone. With this combo, skin appears hydrated and pore size is decreased. Aquagold can be a stand-alone treatment, or it can be done after almost any procedure.
Smaller-scale fat grafting
“We do facial fat grafting to use natural tissue for facial improvements and filling. However, the microfat can be further processed into nanofat. This fat is chock full of regenerative stem cells and elements that can be stamped into the skin with Aquagold or injected with a very fine cannula—including under the eyes, to help with darkness.
Maintenance plans to ensure success
“Patients want to know a schematic plan for the year. For example, Botox every three months, IPL four times a year, Hydrafacials monthly, the timing of lasers, microneedling, and microneedling with RF [Secret RF]. The annual plan allows staff and patients to create comprehensive improvement with goals. This strategic planning can be done for younger people and even after a facelift to protect the investment of surgery.”
Dr. Elisa Burgess, a board-certified plastic surgeon in Portland, Oregon
A call for more-chiseled cheeks
“Requests for buccal fat pad excision have risen exponentially this year, and I expect continued growth into 2023. Patients are looking for more structured and defined cheeks. Removal of the buccal fat pad in the mid to lower cheek helps contour the face, adding definition to the cheeks while making the patient look thinner. The procedure can be performed under local or IV anesthesia. The best part is that the incision is on the inside of the mouth, so there are no telltale signs of surgery and patients are generally back to normal activities within a few days.
A new injectable jaw implant
“Volux, the newest of the FDA-approved hyaluronic acid fillers, is the first hyaluronic acid [HA] filler approved for jawline augmentation. The thickest of all the HA fillers, it’s essentially an injectable jaw implant, customizable based on the location of injection and the number of syringes. I’ve had early access to the filler, and the results are dramatic and real. Allergan is launching Volux in early 2023, so expect increased interest in jawline definition.
A growth in penis augmentation
“Since I introduced the SWAG [short for Shafer Width and Girth] procedure five years ago, the demand for penis augmentation has been tremendous. Like the rise of breast augmentation in the ’80s and ’90s, I expect the SWAG procedure to continue to rise in popularity in 2023. The procedure is performed most commonly with Voluma XC but also with Bellafill and even the new Volux for sustained results.
More RF skin rejuvenation
“While laser still has a place, there is more and more interest in fractionated radiofrequency technology for skin tightening and rejuvenation. With the expanded scope of skin types that can be treated compared to laser devices, technology such as the Genius by Lutronic is helping with skin texture, tightening, and even acne scarring in as little as one treatment.
A game-changing anti-acne laser
“Aviclear is a transformation laser for acne treatment. With results comparable to [those of] Accutane but with fewer side effects, faster results, and much less risk, Aviclear has become one of the most popular laser treatments in my practice. Aviclear laser technology is not just helping current acne breakouts but transforming the skin to prevent future acne. Adult acne is a real concern for many people, and now there is a viable treatment with real results.
Ozempic injections for weight loss
“‘Metabolic aesthetics’ is a term I coined when I opened my practice three years ago. The concept is treating patients at the metabolic level to improve their appearance. We customize everything from hormone balancing, peptide supplements, and antioxidant infusion treatments to each patient. The newest component, Ozempic, a diabetes medication found to help with weight loss in nondiabetic patients, will see substantial interest in 2023. As opposed to other medical weight-loss treatments that rely on increasing metabolism with stimulants, Ozempic works directly on the GI system to slow down gastric emptying so patients feel full after just a few bites. As a result, patients lose interest in fattening foods and foods they would normally crave. While there are currently worries of shortages with increased demand, production will hopefully increase as more and more patients seek Ozempic to maximize their weight loss in combination with exercise and nutrition.”
Dr. David Shafer, a double board-certified plastic surgeon in New York City
Less is more
“Based on conversations and some movement we’ve already started to see, I think patient goals will shift from ‘bigger’ to ‘smaller’ in the next year. When it comes to filler, we’ll see fewer lips and more jawline. I think people will be focusing on creating a nice and defined jawline and going more for a subtle plump look with their lips.
“We can also expect to see a focus on smaller buttocks. The Miami BBL is going to be [in the past], and people are going to be looking for a smaller, more athletic, and shapelier behind, with modest hip augmentation.
“When it comes to breast implants, we might start going in the other direction, with more patients taking out their implants or just opting for a lift alone. We’re going to see a lot more of that, specifically because we’re learning more about BII [breast implant illness]. It is rare but also becoming a bigger social media topic.
A switch to Daxxify
“The ideal candidate for the recently FDA-approved Daxxify is a long-term Botox user who already knows they like it and gets it regularly. I think some patients will transition over to Daxxify simply because they have to get it less frequently, which is great for convenience. Who wouldn’t want the added convenience if you know you already like the results?
“But I think that new Botox [neuromodulator] users—or someone who is trying Botox in a new area—will go for the shorter-acting option to make sure they like it first. They will try it a couple of times and get the prescription just right—where to put it, how much to use, etc. Then they will choose whether they like those results and transition to Daxxify.”
Dr. Michelle Sieffert, a board-certified plastic surgeon in Columbus, Ohio
Scar-free skin tightening
“Ellacor is the most exciting device in years, and it’s being released in 2023 in a large way. Every device manufacturer has been searching for the answer to the age-old problem of tightening skin without a scar. I believe Ellacor has developed a very simple but ingenious solution! Instead of promises of skin tightening through laser or heat energy, Ellacor works through micro-coring, the removal of hundreds of very small amounts of skin, which adds up to a significant amount—well over a postage stamp size—without a scar. There are no ifs, ands, or buts—skin is being removed. And if skin is removed, the remaining skin is tightened, as it pulls those micro holes shut to heal itself. Simple, safe, and quite honestly, amazing. We are starting to apply this technology to all areas of the body that develop laxity as we age—the face/jawline, supra umbilical [the area above the belly button], above the knees, and even with little mini breast lifts, to elevate nipple position. This will be the hot trend in 2023.
A move toward mini butt lifts
“The evolution of the BBL procedure is another prediction for 2023. The BBL procedure has gotten a bad rap: women associate BBL surgery with giant, oversized rears. In my practice, BBL procedures are more about restoring a woman’s rear end as opposed to increasing the size. As women age, they lose volume—in their cheeks, lips, breasts, and butt. We have fillers for the face and implants for breasts, but revolumizing the rear as we age has been ignored for years. Women are starting to realize that a fat transfer to the rear in a fortysomething-plus lady is more about restoring what was there in her 20s and 30s than creating a large rear end. A conservative BBL procedure in a woman who’s lost volume in her rear end as she ages can make her Pilates teacher green with envy.”
Dr. Jonathan Weiler, a board-certified plastic surgeon in Baton Rouge, Louisiana
An explosion in exosome therapy
“Forget about PRP—exosome therapy is the hottest tool in regenerative medicine, especially for hair restoration and wound healing. Exosomes, which are secreted by stem cells, contain hundreds more growth factors than PRP, and with more anti-inflammatory properties. They can be applied topically after microneedling or lasering, and there are ongoing studies for injectable use. Clinical studies have shown 180% increased elastin production, 300% fibroblast proliferation, six times more collagen production, and a significant reduction in downtime. I see more hair growth in a single treatment of exosomes than in three rounds of PRP.
Booster shots for skin rejuvenation
“Skin boosters deliver instant gratification as well as long-lasting benefits. Also known as mesotherapy, skin boosters deliver active ingredients through the skin with tiny needles. The possibilities are endless, but my favorite cocktail is Micro Botox, hyaluronic acid, nucleotides, and polylactic acid. This delivers smooth skin and the disappearance of pores from the Micro Botox, instant glow and plumping from the hyaluronic acid, and long-term collagen stimulation from the nucleotides and polylactic acid.
Make way for CBG skincare
“CBG is cannabigerol, which is a precursor to CBD [cannabidiol] and THC [tetrahydrocannabinol, the chemical in the cannabis plant that causes the high]. It has no psychoactive effects, but CBG has antioxidant and anti-inflammatory properties and outperforms CBD—a super-popular beauty ingredient—for stimulating collagen, elastin, and hydration. I like to have my patients apply Omni Bioceutical Innovations Revitalizing CBG Moisturizer after filler injections and threadlift procedures.”
Dr. Jessie Cheung, a board-certified dermatologist in Chicago and New York City
Jawline beautification and masculinization
“Juvéderm Volux XC, the first FDA-approved hyaluronic acid filler for jawline enhancement, will be available in the U.S. market in the first quarter of 2023. This newly approved filler will revolutionize the injectable market, since it will allow practitioners to sculpt both women’s and men’s jawlines, making for a more defined and beautiful jawline in women and a more masculine jawline in men. Injections with Volux XC, which usually take just a few minutes, will be able to achieve a more defined jawline that lasts up to one year.
Chiseled facial sculpting with buccal fat removal
“In 2022, more and more people realized they could achieve a celebrity-like, super-chiseled look with the removal of buccal fat, a pocket of fat that causes the face to look more rounded. 2023 will be the year when this cosmetic plastic surgery procedure becomes mainstream, mainly due to social media. People nowadays want to look in real life as if they have a permanent beauty filter or FaceTune filter, and with buccal fat removal, they’ve realized that this could be achieved easily and permanently.
Snatched chin and jawline, with extended chin liposuction
“Extended chin liposuction, performed by removing the excess fat under the jawline and jaw angle, will become the new standard of double-chin correction in 2023. Since the pandemic, everybody has become more aware of their double chins due to self-images reflected on Zoom calls or other types of video calls. Although chin liposuction demand has increased since then, people want a more defined jawline in addition to getting their double chin corrected. Along with removing the double-chin fat, extended chin liposuction will deliver the snatched chin and jawline that everybody now wants.”
Dr. John Mesa, a board-certified plastic surgeon in New York City; Livingston, New Jersey; and Miami
Cutting the connective bands that cause cellulite
“I think Avéli will continue to be an important part of our toolbox to treat one component of cellulite—namely, dimples and depressions. For this, Avéli is the answer, period. By precisely identifying and releasing the fibrous septa bands that pull down on the skin, allowing fat cells to push up and create dimpling and depressions, I can treat the root cause of cellulite on the thighs and buttocks with Avéli. In the meantime, we are all working on safe and reliable ways to treat skin laxity, which can surround the cellulite dimple, making it very difficult to completely treat the area where we see depressions. The great news is, I can successfully treat cellulite dimples with Avéli.”
Dr. Laurie Casas, a board-certified plastic surgeon in Glenview, Illinois
Transplanting beard and body hair to the scalp
“The area of growing interest in hair restoration relates to the use of body hair—in particular, beard hair, which tends to be a bit thicker than scalp hair and provides good density—in restoring scalp hair. This is particularly desired by patients who’ve had prior work done in which the donor area was overharvested. This is something we see particularly in those patients going out of the country, where they are receiving 4,000-plus grafts in a single procedure. These cases of 3,500 or more grafts in a single procedure in most patients are designed more to maximize clinic revenue than patient outcomes. Another area of ever-growing interest is hairline lowering/forehead reduction surgery, which is capable of lowering an overly high hairline instantaneously. One surgery is the equivalent of 9,000 or more hairs.”
Dr. Jeffrey Epstein, a board-certified hair restoration surgeon in Miami
