Introduction

As a plastic surgeon with over two decades of experience, I’ve witnessed aesthetic preferences rise and fall like fashion seasons. From the ultra-thin brows of the 90s to the contoured cheeks popularized by social media influencers, and, most recently, the so called “bird’s lip” trend in Southeast Asia, the pursuit of beauty often mirrors societal trends. While innovation in aesthetics is something I welcome, it’s important to distinguish between what I call trend based aesthetic surgery and classic aesthetic surgery. The difference between the two isn't just semantic; it has long term consequences for patients.

Let me walk you through these two approaches and what they mean for anyone considering a cosmetic procedure.

Defining the Terms

Trend Based Aesthetic Surgery refers to procedures driven by current fashion, celebrity culture, or social media influence. Think of the "Instagram face," which includes a combination of plumped lips, high cheekbones, and fox like eyes. These features may not naturally occur together, yet they have become emblematic of the pursuit of a certain vision of beauty in the digital age. Procedures like the BBL (Brazilian Butt Lift), buccal fat removal, or “cat eye” surgery have surged in popularity based on fleeting beauty ideals.

Classic Aesthetic Surgery, on the other hand, is rooted in proportion, symmetry, and harmony. It draws on principles that have stood the test of time and are influenced by artistic canons from ancient Greece to the Renaissance. Surgeries under this category, such as rhinoplasty, facelift, breast reduction (and, to a certain extent, augmentation) are performed not to chase a trend but to enhance or restore balance in a way that looks natural and ages gracefully.

Motivations Behind the Procedures

One of the starkest contrasts between trend based and classic surgery lies in patient motivation.

Patients seeking trend based surgeries often arrive with a photo in hand, usually a filtered selfie or a celebrity image. Their goal is to look like someone else, not necessarily a better version of themselves. These patients are sometimes younger and more impressionable, swayed by social media algorithms that reward certain facial aesthetics. Chasing those little dopamine hits by way of “likes” and “follows” is not, in my view, a good reason to pursue life changing surgery.

By contrast, those interested in classic aesthetic surgery typically want to address a longstanding concern such as a nose that feels out of balance with their face, signs of aging, or a post pregnancy body they no longer recognise. Their motivations are usually personal, less about fitting in with what’s fashionable and more about feeling confident in their own skin.

Longevity and Aging Gracefully

Perhaps the most important distinction, from a surgeon’s point of view, is how these surgeries age.

Classic aesthetic procedures are designed with time in mind. A well executed facelift, for example, will continue to look natural as a patient ages. It will not expire or go out of style. It enhances your own facial features rather than masking them. This kind of work is often invisible to the untrained eye, which is the goal. How long does a facelift last? Well, it resets the clock so (from that point of view) it lasts a lifetime because you will always look more refreshed than you would at the same age without having had the facelift.

Trend based surgeries, however, can age poorly. This happens not just physically, but culturally. Just as we now cringe at the overly plumped lips and overdrawn brows of the early 2000s, today's popular enhancements may look dated in a decade. In the case of buttock enhancement, it already does (BBL reversal is now big business among some of my colleagues). Worse, the anatomical changes they involve, such as fat removal or bone shaving, are not always reversible. That means patients may need revisions or corrective procedures when tastes inevitably change.

Psychological Considerations

I always spend time evaluating the psychological readiness of my patients, and here too, the contrast between these two approaches is sharp.

Patients pursuing trend based surgery are sometimes chasing an identity or social validation, which may lead to dissatisfaction even after technically successful procedures. Social media reinforces this cycle by bombarding users with filtered perfection, which can distort body image and expectations.

Conversely, classic aesthetic patients often arrive after much contemplation. They’re usually more grounded in their self image and have realistic expectations. These patients are not chasing perfection, but harmony. Their satisfaction rates tend to be higher, not because the surgeries are easier, but because the motivations are healthier.

Surgeon Responsibility

As surgeons, we are not just technicians. We are gatekeepers of patient safety, long term satisfaction, and ethical standards. When I consult with a patient requesting a highly specific, trendy procedure, I ask: “Will this still look good on you in ten years?”,  “Are you doing this for yourself, or for an audience?”,  “Does this align with your natural anatomy?”. Finally, I ask “Am I comfortable doing this?” If the answer is no, then sorry but I’m not the surgeon for you.

I believe strongly in educating patients about the implications of their choices. Sometimes that means gently advising against a popular procedure that doesn’t suit the patient’s face or body. It means favouring subtle enhancements over dramatic changes. It means prioritising the patient’s future self over immediate gratification.

Aesthetic Evolution: Is There a Middle Ground?

Absolutely. Not all trends are inherently bad. Some innovations in technique, such as non or minimally invasive treatments and fat transfers have revolutionised the field for the better. Likewise, patient preferences evolve, and so must our practices. The key is discernment.

It’s possible to incorporate elements of what’s trending while staying grounded in timeless principles. For example, subtle lip enhancement or lift done with restraint can be both trendy and classic. A deep understanding of facial anatomy allows us to blend art with science, trend with tradition.

Final Thoughts

If you’re considering aesthetic surgery, I encourage you to ask yourself: Am I doing this because it’s currently popular, or because it genuinely aligns with how I want to look and feel long term?

As a surgeon, my goal is not to create the “perfect” face, but your face. It should be enhanced, refreshed, and unmistakably you. Beauty is not a template to be copied. It is a personal expression to be celebrated.

Trend based aesthetic surgery may offer short term excitement, provide clickbait for Ticktockers and create attention and even notoriety but classic aesthetic surgery offers enduring satisfaction. One is about fitting in. The other is about standing tall in your own skin. And in my experience, the latter always wins in the long run.