Just like fashion, plastic surgery has trends too. Sure, purging your closet of skinny jeans for high-rise boot cuts is much less permanent than a face lift or liposuction, but plastic surgery is influenced by consumer demand, technology, and lifestyle.
And while you might think millennials and Gen Z are the most likely to go under the knife, Gen X and baby boomers are getting the most work done, accounting for 45 percent and 30 percent of total cosmetic procedures in 2022, respectively, according to the American Society of Plastic Surgeons (ASPS).
So what exactly are women over 45 getting done? Cue the menopause makeover.
You’ve likely heard of the ever popular ‘mommy makeover’ that consists of surgeries and treatments that help women address the physical changes wrought by pregnancy, but the menopause makeover focuses on the bodily changes that occur at another physiological watershed in a woman’s life, menopause.
Menopause is associated with hormonal changes that can affect one’s appearance, and David Feldmar, MD, double-board certified plastic and reconstructive surgeon, says he frequently receives requests from women going through menopause looking for liposuction and tummy tucks to address sagging skin, which can be caused by a drop in estrogen levels as women age.
“Hormonal fluctuations during menopause can also impact breast size and shape,” Dr. Feldmar said.” As a result, we often discuss options like breast augmentation, breast reduction, and breast lifts with our patients.”
And while the menopause makeover isn’t as popular of a request as the mommy makeover, some beauty brands, like Allure, have predicted it’s about to become the next big thing. We asked three plastic surgeons to break down the new trend and provide their best advice if you’re considering going under the knife.
How the body changes during menopause
As women age and begin to undergo perimenopause and menopause, estrogen levels in the body drop dramatically and reach near zero post-menopause, explains Robert Schwarcz, MD, double-board certified oculofacial plastic surgeon.
“Estrogen deficiency has been shown to negatively affect many physiological functions, including skin changes, resulting in wrinkles, dryness, and poor barrier function,” said Dr. Schwarcz.
With this loss of estrogen, women going through menopause may notice a wide array of changes. The body begins to use energy differently and store fat in new ways, which is why weight gain is a common side effect of menopause. Other women may find that their skin loses elasticity and their skin begins to sag or their eyelids begin to appear more hollow. While others may notice their breasts begin to change size or shape.
“I have seen an increase in patients coming to my practice specifically looking for ways to address the changes they see in their face, particularly their eyes,” said Dr. Schwarcz. “Some know that these changes can be attributed to menopause, and others are surprised to learn that menopause can cause dramatic changes in their appearance.”
Common menopause makeover procedures
While there’s no one procedure that is specific to menopause, there are a variety of concerns that occur during this stage of life. Here are what plastic surgeons say are the most frequent requests they receive.
Liposuction and tummy tucks
One of the most common hormonal and metabolic shifts that occurs during menopause is the accumulation of fat that alters the contour of areas like the upper arms, thighs, butt, and torso. To address this, doctors recommend liposuction.
“We remove the fat deposits with focused precision liposuction, while, at the same time, tightening the overlying skin with radiofrequency energy,” said Peter Lee of WAVE Plastic Surgery, MD, FACS, and Founder, CEO and Chief Surgeon of Los Angeles-based WAVE Plastic Surgery Center.
Dr. Lee adds that menopausal women can also have diastasis recti or a separation of the abdominal muscles and umbilical hernias. In this case, a tummy tuck, when excess skin and fat is removed, is recommended.
Breast surgery or implants
While radiologists will tell women that menopause causes a loss of breast tissue, and this is true, plastic surgeons know that the hormonal shifts of menopause can also cause accumulations of fat that can change the size and shape of the breast.
Dr. Lee says that during menopause loss of breast tissue can cause a decrease in the structural support inside the breast and lead to sagging or drooping breasts.
“Pregnancy and breast feeding may also have caused the areola to spread over a larger area of the breast skin,” said Dr. Lee. “These changes can be addressed by different kinds of mastopexy or breast lift procedures, sometimes performed with concomitant placement of breast implants.”
Eye and brow lifts
Mommy makeovers are usually focused on the breast and abdomen, but women who are going through menopause are usually most focused on what they see when they look in the mirror each day, said Dr. Lee.
“For this reason, we have found that it is essential in most cases that a menopause makeover includes a component of facial rejuvenation.”
For some patients, the area of concern is more focal, like drooping skin on the forehead that is crowding the eyes from above, making the patient look sleepy, and the eyes small. Other times, the neck or jawline can begin to sag or excess skin can become more noticeable. For others it can be tired looking upper eyelids or baggy lower eyelids. In this case, an endoscopic brow lift is recommended, says Dr. Lee.
Since the skin around the eyes is the thinnest on the body, it shows signs of aging the quickest, especially if women are not protecting themselves from sun exposure.
“As women age and experience perimenopause and menopause, the drop in estrogen levels in the body leads to poor skin barrier function,” said. Dr. Schwarcz. “This decrease in skin barrier function makes skin more susceptible to environmental stressors like temperature, humidity, and pollution, which can lead to an increase in wrinkles, dry skin or crepey skin.”
Collagen production in the skin also slows dramatically in perimenopause and menopause, which leads to the skin around the eyes appearing more hollow, which ages the face.
Because of this surgeons recommend eye filler or fat grafting,or a blepharoplasty, a surgery that removes excess skin from the upper and lower eyelids. In fact, according to the ASPS this surgery is currently the top facial cosmetic surgery in the U.S.
“It is a common cosmetic procedure, but it can also be medically necessary in some cases if the skin is preventing proper vision,” added Dr. Schwarcz. “ I specialize in blepharoplasty in my practice in New York City and they are the most common surgery I perform.”
Considering a menopause makeover? Here’s what to know
When considering plastic surgery to address the effects of hormonal changes during menopause, the first and foremost step is to do thorough research and find a plastic surgeon you can trust, advises Dr. Feldmar. “Trust is paramount in any medical journey,” he says.
Start by scheduling an in-depth consultation with a board-certified plastic surgeon who takes the time to listen to your concerns and truly understands your medical history. During this consultation, the surgeon should be willing to discuss potential treatment options tailored to your specific needs and goals. This dialogue is essential to ensure that the chosen procedures align with your expectations, and that you’re aware of any potential risks or side effects.
“I always emphasize the importance of maintaining realistic expectations,” said Dr. Feldmar. “Plastic surgery can be transformative, but it’s not a magic solution. Comprehensive rejuvenation often involves a combination of surgical and non-surgical treatments. For example, combining a facelift with skin resurfacing treatments can effectively address both sagging skin and surface imperfections, resulting in a more youthful and refreshed appearance.”
It’s also crucial for individuals to recognize that surgery is just one part of the equation. Lifestyle factors play a significant role in overall well-being and the longevity of results. This includes maintaining quality nutrition, a healthy skincare routine, and exercising regularly.
“The journey toward addressing hormonal changes through plastic surgery should begin with research, trust, and a comprehensive consultation,” said Dr. Feldmar. “Realistic expectations, a combination of treatments, and a focus on overall wellness are essential components of a successful and fulfilling transformation.”