How Gen Z, Millennials, & Gen X Really Feel About Plastic Surgery

The differences may surprise you.

by Garrett Munce
TZR/ Getty

Plastic surgery is always a hot topic. There are new procedures and aesthetics popping up at what seems like every moment (buccal fat removal, anyone?) and they seem like all anyone can talk about — at least for a while. But there’s one trend in the plastic surgery world that just keeps bubbling up: Gen Z’s seeming obsession with going under the knife. According to the American Academy of Facial Plastic and Reconstructive Surgery, 75% of plastic surgeons reported seeing an uptick in patients under the age of 30 — though exactly how much of an “uptick” is not disclosed.

People love to attribute reasons to why this rise might be happening — selfie obsessions, front-facing cameras, Zoom, the general narcissism of a generation raised on the internet, and the list goes on. And while it’s hard to argue with statistics and even harder to argue with hashtags like #plasticsurgery (over 21 billion views on TikTok) and #plasticsurgerytiktok (over 242 million views), we were curious. Is Gen Z really as hyperfixed on plastic surgery as we might be led to believe? And, for the record, are their ideas around getting work done really that different from the other generations? We set out to interview women across the spectrum – Gen Z, millennials, and Gen X — to see where their attitudes and opinions lie about plastic surgery. This is what they had to say. The differences, or lack thereof, may surprise you.

On Plastic Surgery Aesthetics They Consider ‘Beautiful’

I can't lie, I am a bit influenced by the people that we see on TV and social media in terms of beauty standards, but I think we've also started moving into embracing natural features and features that are unexpectedly beautiful. Those stand out to me. Maybe it's the spacing between a person's eye or a mole or little nuanced, natural looking features that I find most beautiful. -Dee, 19, New York, New York

I'm really into little beauty nuances that make you enhance your natural beauty. It’s more like microblading your eyebrows to make them look bushier or something in that vein that I find beautiful. And I love a sporty physique. So on women, I am definitely more drawn to somebody that looks more athletic than somebody that looks like they've had a lot of work done. I like toned arms and strong legs more than super big butts or boobs. So, if you don't look like you've had work done, that's more beautiful. -Hannah, 33, Charlotte, North Carolina

The biggest thing for me is that they [women] still look like themselves, but like better versions of themselves. I can sometimes tell when people have had some work, but it’s when people start looking like a facsimile of who they used to be that I don’t love. I just prefer something that looks more natural. I've had this discussion lately with my girlfriends, and we're not trying to not look our age. I'm not trying to look like I'm 20. That ship has sailed. But I think it's just looking like the best version of yourself, where your eyes are brighter. Maybe you've done a little bit of pulling or filling and Botoxing, but you still look like you in an awake kind of way. For me, the key is not looking artificial. -Kat, 48, Brooklyn, New York

On Why People Get Work Done

I think it probably stems from some sort of insecurity or wanting to change a specific thing. The way I see it is if I were to get work done, it would be because I want to look a certain way. There's also the pressure of society thinking a different shaped nose is more beautiful or a fuller chest is more beautiful, so you can get more attention. But I truly think that for whatever reason someone gets work done, it doesn't matter what it is, it's valid no matter what. If you have the resources, if you want to go through a literal surgery to do something that you think is going to make you feel better about yourself, then absolutely do it.

There’s also the social media aspect. Living in the age of influencers like Alix Earle, for example, she's really big with my generation, and she had a chest enhancement. She's had a nose job, and she owns it, she talks about it. But it's also a world where there are celebrities like the Kardashians who are morphing their bodies to be completely unrealistic and denying that they had plastic surgery that sets such terrible expectations for girls who don't have the resources and who don't look like that naturally because no one looks like that naturally. -Leah, 24, Chicago, Illinois

Social media definitely plays a huge part. Also, speaking from my perspective and my friends who've had tummy tucks, there's a lot of pressure after you have a kid to bounce back to your former body and maintain your youth, —which becomes increasingly harder when you're getting older, and it's harder to take the weight off. I feel like in my general community, the main things happening are boob jobs and tummy tucks to maintain a certain standard of a pre-motherhood body. I remember being at birthday parties soon after having my second child and other moms sizing me up. At least in my mind, I felt like they were. I felt so insecure about myself at that point. -Hannah, 33

I think people get work done for a variety of reasons. In one sense, I think it begins by wanting to look like the best version of yourself: rested, hydrated, healthy. But I think it quickly slips into something else even beyond maintenance, such as fear of aging, a mark of social status, cultural relevance, and addiction. Also, I've noticed people mention fillers and Botox appointments as an indication of luxury or indulgence. -Lauren, 42, Weston, Connecticut

I mean there are basically two reasons, right? Because they want to look younger/better or because of societal pressures. These two things cannot be separated, but I do think it has a lot to do with people getting plastic surgery at a younger age. I grew up in New York, so the 55+ facelift was not shocking. But there is a difference between chasing youth and changing an actual look. The trends where younger people are having surgery to chase a similar aesthetic is a little disturbing. That aesthetic can change in 10 years, and then what happens? -Molly, 45, Brooklyn, New York

On Thinking About Getting Work Done & The Procedures They’d Choose

Sometimes you go out with friends and you're like, "Oh yeah, I would like to get this and this done." But I think for me, since I'm still young, I don't want to make any life-altering decisions until after my brain is fully formed.

Honestly, I don't really feel pressured. I think now everyone is having the mentality, "Oh, you do you, girl.” So it really isn't like you have to get something done to feel pretty. But I wouldn’t close the door completely because I genuinely don't know who I'll be in 10 years. I think if I were to ever consider plastic surgery, it would be very subtle, either to enhance something of mine or to help quality of life. But I don't want to fundamentally change anything about me. -Dee, 19

As a 22-year-old, I don’t think I have genuinely considered plastic surgery. The topic of the BBL is huge in the Black community, so I’ll see certain Instagram photos or celebrities who have undergone the procedure, and think, “Wow she looks so good” or “That is such a good BBL,” but I haven’t really considered it myself. I’m not at all against plastic surgery or anything like that, but I think plastic surgery is a huge decision and financial burden and, again, at my age, I’m not in the mental or financial headspace to really think about that. I’m just focused on graduating college and post-grad life. I’m definitely not going to say that I will never get it or never consider it. My opinions might change as I get older and grow as a person. -Jordan, 22, New York, New York

I have had a breast reduction as well as a septum surgery and Lasek eye surgery as a teen — so I have had what is considered corrective surgery. I consider corrective surgery as surgery for better function in the body and not necessarily for cosmetic or appearance reasons. In my 20s I really wanted a reduction but my family discouraged it. But after I knew I was done having kids, I finally went to a doctor and I’m so happy I had it. I’m hesitant to go farther than that only because recovery is difficult. Right now, there aren't any areas I would want or consider having surgery done on. However, I am considering fillers and/or Botox for the areas around my eyes. -Corynne, 41, Chicago, Illinois

Definitely. This is an age thing — the upper eyelid. I'd consider doing thread lift. I haven't really thought of filler yet, but I'm also keeping an eye on my neck right now. I saw Erin Parsons, the makeup artist, do an eyebrow transplant a couple years ago. It looks spicy, but I'm one of those people who in the '90s tweezed my eyebrows into a pencil slit, and they've just never grown back. Kudos to Erin, she's super open about it, showed the before, showed the healing, and showed the after. That’s another thing I’d consider.

Liposuction is probably down the line. There are members of my family who've had lipo and tummy tucks, including my mom. It's nothing to sneeze at, especially a tummy tuck. She was in so much pain after, and I was helping her take a shower and everything, and she was like, "I regret this." And the doctor said, "Everyone regrets it the first few days, but come back to me in a month and let me know." And sure enough, once it all healed, it gave her back so much confidence and clothes fit her better. So I'm definitely open at one point to getting lipo. I think with all kinds of new technologies too, there's going to be different options that help melt fat away. -Kat, 48

On The Age It’s Acceptable To Get Work Done

I think once you reach adulthood, I suppose that means at 18, then you can really start thinking about getting a procedure done. I don’t think you should rush into anything as a teenager. Give yourself some time to think. Women should have the right to choose to get plastic surgery without worry of judgment, but I also don’t think that while growing up you should have this idea that if you are struggling with confidence that you should fix your perceived issue right away. It is so hard being a woman because no matter our age or what we look like we are always heavily scrutinized and expected to keep up with every new beauty standard or trend. You’re judged if you choose to get something fixed, but you’re also judged for just existing as your natural self. -Jordan, 22

I think mid-30s when you are established. I feel like if you're in your 20s, your body and your identity is still taking shape. So early 30s to mid-30s I think is a good time to start making more permanent changes because you are more sure of yourself and you wouldn't regret it later. At 35, if you're still considering it and you've been considering it for 10 years, then it's not a rash decision at that point. -Hannah, 33

I think the pre-college nose job is fine but generally I think human brains are not fully developed until 25. Decisions about permanently changing your body should not be made before then. There were girls in my high school who got chin jobs and cheek jobs at 16 and I find that terrifying. -Molly, 45

On The Price They’d Pay For Plastic Surgery

If I am getting something small done, I don't know, maybe a few thousand dollars, but if it's something that's so going to change my life and how I feel or how I perceive myself, I don't think I would put a dollar amount on how much I'm willing to spend, so long as it's reasonable to my income and I can afford it. -Leah, 24

I would do it for like $10,000. It would be a much larger conversation when you're getting closer to $20,000. I'd be willing to spend that amount of money to make myself happy, but it's a sizable amount so you're talking about something that's an investment in your future and hopefully something you don't have to do again. -Hannah, 33

It really depends on how much I feel it is necessary to feel good about myself. But I would say I am not spending more than $40,000. -Molly, 45

You have to look at it like an investment. It's your physical self, something that really improves your day-to-day life, I’d charge that shit. For me personally, I could probably go up to $20,000 at this particular time, but again, it would have to be pretty significant. I mean, I see a lot of these mommy makeovers, which I'm probably a good candidate for. It's the kind of thing where it could be a steep price, but I wear glasses and I don't spare a dime because I wear them every day. So it's worth it, right? It's like, I have to look at myself every day. -Kat, 48

On Transparency Surrounding Plastic Surgery

I would definitely be honest with friends and family, but I’m not going to lie, I would be hesitant to share it because of how brutal people are online. -Jordan, 22

I have a lot of friends that have had a tummy tuck and are not OK with people knowing about it, but I would be totally fine with anybody knowing that I did it. I’m pretty open in general. I feel like it's normal. I wouldn't post about it on social media though. I just don't think I would ever share that kind of info on social. -Hannah, 33

I would not hide it at all. I don't think I would post about it online, but that is because I don't really post much of anything online anymore. But I would tell anyone who had the ability to hear it. -Lauren, 42

It's weird because I'm so open about so much, and I'll tell any of my friends. Would I put it on social? I actually think I would. I think if you're proud of yourself, why not? It's like, "Hey, look, this is what I looked like before and this is what I look like now, and I'm really happy." I just don't think I've done anything that significant to really post something like that yet. I haven't lost enough weight or done enough to my face, but I think I would because I don't want to kind of contribute to the taboo-ization of it. -Kat, 48

Studies referenced:

The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) 2022 Member Survey.