The era of subtlety in plastic surgery

There has been a noticeable shift in what plastic surgery patients are looking for during the last few years, moving away from the "bigger is better" concepts of oversized breast implants, dramatic Brazilian butt lifts and noticeable facelifts to the more understated "less is more" approach. In other words, the specialty has reached a new moment – the era of subtlety.

Patients are seeking out subtle nips and tucks to improve their appearances without their inner circles noticing, rather than wanting noticeable changes. It's all about less recovery time, small tweaks and a "natural" youthful glow rather than an "in-your-face" change or blown-out proportions.

To learn more about this shift in plastic surgery, we reached out to ASPS Member Surgeons Kristy Hamilton, MD, and John Burns, MD.

From dramatic transformation to minimalist intervention

There's no denying that a change has occurred in recent years, a shift towards a more subtle approach in the world of plastic surgery. But what is causing it?

"This is driven by a number of factors," said Dr. Hamilton. "One is patients coming in younger and younger. It used to be very typical to see patients in their younger 20s coming in for breast augmentation, but now they're coming in asking how to maintain themselves and enhance their beauty with little tweaks. They've come in to have a comprehensive plan, and it's part of their wellness and lifestyle."

People are becoming increasingly knowledgeable about the options available to them at all stages of life as plastic surgery becomes more mainstream.

"I think that younger people are more aware, in a good way," said Dr. Burns. "In the past, having a facelift may have been a status symbol, but for younger people, it is not like that. They are not trying to one-up each other, from my experience. It is more of an 'I am doing this for myself' type of goal."

Patients are also being proactive in slowing the aging process.

"As we get older, we're talking more about rejuvenation and facial aging," said Dr. Hamilton. "Patients are pursuing surgical intervention earlier, before they have dramatic signs of aging. That's how they can have the so-called undetectable look. It's about slowing the passage of time, maintaining beautiful skin and doing these things earlier so that you can't tell that anything happened in the first place."

Another factor in the boom of subtlety is undeniably the prevalence of social media.

"Social media is another driver of this trend," said Dr. Burns. "Meaning that I think that people want to look good for their social media. People derive a lot of their income from social media now. Having something that is not quite so obvious helps in that regard."

The prevalence of before and after photos on social media is leading more people to understand what is possible with plastic surgery.

"No question social media offers a big contribution," said Dr. Hamilton. "When you see these before and afters popping up everywhere, it gives patients so much more confidence that this is something that they want to pursue and have the expectation that they are going to look good after."

Procedures that play into subtlety

Several already popular procedures are seeing a boost as part of the "less is more" trend.

"Upper blepharoplasty is a big one; you're getting your upper eyelids done," said Dr. Burns. "This is becoming a common thing at a younger age. Brow lifts are also coming back, with a focus on a gentle lift that is not noticeable. Rhinoplasty is also a big one, where you delicately shape the nose without being so obvious about it."

However, subtlety goes beyond facial procedures

"Everything's bigger in Texas, but not when it comes to breast implants anymore," said Dr. Hamilton, who is based in Houston. "The vast majority of my patients are those coming in for structure and shape over volume. How are we going to get the shape and the look that we want, rather than how many ccs we can stuff into the breast."

A crucial consideration is how surgeons strike a balance between noticeable improvements to appearance and a natural, understated look. Find the best balance for your face and body by consulting with a board-certified plastic surgeon.

"That comes down to discussions with the patient," said Dr. Hamilton. "I show them and demonstrate either by redraping tissues in real life or through AI-powered imaging to give them an idea of reasonable expectations, like what they could closely look like after. That is very helpful to help them visualize and see it. Before and afters from other patients are really helpful too. It helps me get in the mind of the patient in terms of what they want to look like."

How subtlety is changing plastic surgery's future

Subtle interventions are likely to continue being refined in the future.

"I think that because we can now create natural results, it is here to stay," said Dr. Hamilton. "There is always going to be a little bit of both, but natural is what looks best long term, and I think it speaks to the accelerated results and improvement in surgical techniques that we have recently had."

Yet trends, including plastic surgery trends, come and go.

"What goes up must come down," said Dr. Burns. "I think that I have seen the pendulum swing back and forth. Unfortunately, I do think that the pendulum will swing again, and over the top things will be popular. That pendulum always swings back."

Over-the-top procedures and noticeable changes have reigned king in plastic surgery, but there has been a noticeable shift in recent years towards more subtle, understated interventions. Younger patients are focused on small tweaks and minimalist changes, so the preferred aesthetic is quickly evolving to be "less is more" rather than "bigger is better." As technologies advance and perspectives change, it will be fascinating to see whether plastic surgery stays in this era of subtlety or evolves once more into something entirely different.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.