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Pre-juvenation Continues to Dominate Cosmetic Trends

Pre-juvenation Continues to Dominate Cosmetic Trends

Dr Langsdon

Each year, the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) conducts a survey of its members to get insight into patient demographics, and to identify popular procedures and trends in the cosmetic specialty. This year’s results indicate that millennials (aged 22-37 years) will be driving the demand for cosmetic procedures. Seventy-two percent of facial plastic surgeons saw patients younger than 30 years seeking cosmetic surgery or injectables,1 a significant increase from the previous year when that figure was 56%.2

“There are 2 aspects impacting the growing interest in the 20 to 30 age group,” said Phillip R. Langsdon, MD, FACS, president of the AAFPRS and a board-certified facial plastic surgeon with a practice in Germantown, TN. “First, availability of information makes it easier for patients to learn about and understand what treatments are available. Second, the ‘era of selfies’ is causing many young people to be more appearance conscious, and unfortunately some are overly and unrealistically self-conscious.” Dr Langsdon spoke more about how selfies are influencing procedures, and other themes from the survey results.


The biggest patient motivators reported in the AAFPRS survey were the desire to look better in selfies and dissatisfaction with their profile, such as complaints about the nose, chin, and/or neck.1 Reports on the influence of selfies among cosmetic patients led to the coining of the term “snapchat dysmorphia” in early 2018, which is commonly attributed to Matthew Schulman, MD, a board-certified plastic surgeon in New York, NY.3

“The age of selfies has exponentially increased unrealistic expectations,” said Dr Langsdon. “Worse, many people with a cell phone now feel they know more than expert providers.” He recommends providers be aware and cautious when dealing with unrealistic patients.

Although the survey does not report on trends in patients with body dysmorphia disorder (BDD), Dr Langsdon noted that he was seeing more patients who potentially had BDD in his office due to enhanced social media tools. 

Concerns for BDD among patients seeking cosmetic enhancements has been reported both in the media4-6 and journals, including a recent letter published in JAMA Facial Plastic Surgery.7 (The Dermatologist published a cover story on the subject in December 2018.)

Social media also has normalized cosmetic treatments and self-care that involves preventive measures to reduce or delay the signs of aging, often referred to as pre-juvenation.

While celebrities are still considered a major influence on cosmetic procedures by 97% of AAFPRS members, overly enhanced looks, like Kylie Jenner’s pout, are becoming less popular.1 The focus is more on a “natural look,” with 41% of patients reporting a fear of looking unnatural as a top concern when considering cosmetic surgery. 

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