Facial surgery trends

From the rise of preservation techniques to the growing popularity of hybrid approaches, the surgical field is shifting. Contributing reporter Ellen Cummings explores what this means for both practitioners and patients

In recent years, facial aesthetic surgery has undergone a significant shift, with surgeons adopting advanced techniques to achieve more natural, long-lasting results. To explore these trends, we spoke with two experts: Mr Metin Nizamoglu, specialist plastic surgeon, and Mr Shehab Jabir, consultant facial plastic surgeon at Centre for Surgery in London.

THE MOST IN-DEMAND PROCEDURES

Facial aesthetic procedures remain a cornerstone of cosmetic surgery, with demand for certain treatments increasing in recent years. According to Mr Nizamoglu, blepharoplasty – particularly upper eyelid blepharoplasty – is currently the most sought-after facial surgery.

“After that, I’m seeing things like brow lifts, face and neck lifts, and, interestingly, a lot of patients coming in for chin liposuction and neck liposuction,” he explains. Mr Jabir echoes this, adding that rhinoplasty, otoplasty and lip reductions are also highly requested procedures.

“There’s also a need for lots of people wanting this fox eye surgery, which is actually a brow lift combined with a retinacular suspension,” he notes. Additionally, both surgeons have seen an increase in demand for ultrasonic and preservation rhinoplasty, as well as fat transfer for facial rejuvenation.

THE CHANGING DEMOGRAPHICS OF FACIAL SURGERY

One notable shift in recent years has been a growing interest in facial surgery among younger patients.

“I’m actually seeing a younger cohort of patients presenting,” says Mr Nizamoglu. “Many younger patients are now asking for neck liposuction, neck lifts or even facelifts – whereas before, that was usually reserved for older patients.”

Mr Jabir has observed a similar trend: “There are patients now even in their early 30s who’ve noticed some cheek droop and want a cheek lift. Endoscopic facelifts are also becoming more popular with younger patients because they’re more conscious of having a scar.”

This growing demand among younger patients is largely driven by the influence of social media and digital filters, which have heightened self-awareness and altered perceptions of beauty.

“Social media, video conferencing and the use of filters have made people more self-conscious,” says Mr Nizamoglu. “You’re always seeing an ideal of perfection, and some of these images may be edited. People want to emulate that appearance.”

Mr Jabir adds that wide-angle lenses used in smartphone cameras can distort facial proportions, particularly making noses appear larger. “Unfortunately, when you continuously take selfies with the same phone, you develop this perception distortion, which can lead to a desire for unnecessary surgery.”

A SHIFT IN APPROACH

In response to evolving patient preferences, surgeons are refining their techniques to achieve subtle, long-lasting results with less invasive methods. One of the biggest advancements in recent years has been the shift toward preservation techniques in both rhinoplasty and facelifts.

“Facelifts and rhinoplasty have undergone a change where surgeons are trying to manipulate tissues less but still get a better and longer-lasting outcome,” says Dr Jabir.

For rhinoplasty, the concept of preservation means maintaining as much of the natural nasal structures as possible. “You don’t manipulate the nasal bones as much, and you preserve as much of the cartilage as you can,” he explains. “Instead of taking a big chunk of tip cartilage out, which can collapse over time, you take a smaller trim and use sutures to provide support.”

Similarly, the approach to facelifts is shifting. “Instead of having huge skin dissections over the SMAS, the dissection is now limited. There’s a focus on deep-plane facelifts while preserving skin attachment, which not only reduces the risk of bleeding but also provides a more natural result,” he adds.

Mr Nizamoglu highlights another innovation: the hemostatic net. “It’s being adopted by more surgeons now when performing face and neck lifts or brow lifts. Although it’s an older concept, it’s now becoming more widely used.”

COMBINING SURGERY AND NON-SURGICAL TREATMENTS

Another significant trend is the combination of surgical and nonsurgical treatments for optimal results.

“Hybrid approaches include combining face and neck lifts with fat grafting, TCA peels, laser treatments and non-surgical aesthetics,” says Mr Jabir. “We’re also seeing treatments like polynucleotides and exosomes being trialled, which could significantly improve facelift outcomes.”

Energy-based skin tightening technologies and regenerative medicine are also playing a role in post-surgical care. “Hyperbaric oxygen therapy is something I’d love to see more widely available,” he adds. “It can significantly improve healing before and after surgery.”

PATIENT EXPECTATIONS AND THE RISE IN REVISION SURGERY

With increasing exposure to edited images on social media, managing patient expectations has become a crucial part of the consultation process.

“I spend a lot of time managing expectations,” says Mr Jabir. “I always make it clear that asymmetry will always be there – it exists before and after surgery. Some patients expect perfection, and it’s important to burst that bubble with realism.”

Mr Nizamoglu also emphasises the uniqueness of each patient’s anatomy. “Everyone is different. Even if they bring in a celebrity photo, it’s only a vague guide. The results are always dependent on the individual’s anatomy.”

This misalignment of expectations is contributing to an increase in revision surgeries. “We see a lot of patients coming from overseas, particularly Turkey,” says Mr Jabir. “The surgery itself might have gone well, but the surgeon didn’t fully understand what the patient wanted. This is something that’s not widely discussed.”

Additionally, prior non-surgical treatments can complicate future surgeries. “Patients who’ve had extensive fillers or biostimulators may develop subcutaneous scarring, which distorts anatomical planes and makes surgery more difficult down the line,” warns Mr Nizamoglu.

THE FUTURE OF SURGERY

Looking ahead, both experts agree that the industry is moving towards a more holistic, minimally invasive approach.

“I think preservation concepts will dominate,” says Mr Jabir. “We’ll also see more interplay between surgery, energy-based devices and non-surgical aesthetics.”

Mr Nizamoglu adds that advancements in regenerative medicine could play a key role in future treatments. “Techniques like fat grafting, nanofat, PRP and stem cell-enriched grafts are exciting developments. We just need more standardised methods to integrate them effectively.”

MR METIN NIZAMOGLU

Mr Metin Nizamoglu is a plastic, reconstructive and aesthetic surgery consultant at Centre for Surgery, and is highly experienced with over 15 years of expertise. He holds dual fellowships with the Royal College of Surgeons (FRCS Plast) and the European Board of Plastic, Reconstructive, and Aesthetic Surgery (EBOPRAS). Mr Nizamoglu has authored over 38 peer-reviewed publications and is a fellow of the Higher Education Authority.

MR SHEHAB JABIR

Mr Shehab Jabir is a consultant facial plastic surgeon at Centre for Surgery, and a quintuple fellowship and board-certified plastic and reconstructive surgeon with expertise in facial plastic surgery. He holds certifications from UK, European and international boards and has trained at renowned institutions, including St. George’s University and St. Thomas’ Hospital.