Is Plastic Surgery Permanent?

Episode summary

Is plastic surgery permanent? The answer depends on the procedure and what you mean by permanent. A treatment can make a lasting anatomical change while aging, weight changes and tissue changes continue. Darren M. Smith, MD, a board-certified plastic surgeon in New York City, compares facial procedures, injectables, liposuction and breast surgery through that distinction.

Originally published August 23, 2020. Longevity estimates in the recording are historical examples, not guarantees or fixed replacement schedules.

Key takeaways

🗓️ Aging and facial change

Facial rejuvenation can reposition tissues or restore volume, but it does not stop future aging.

⏳ Injectable duration

Botox and fillers have temporary effects. Dr. Smith discusses how the product and treatment location can influence duration.

⚖️ Weight and body contour

Liposuction removes fat from a treated area, but later weight changes can still change its contour. The episode emphasizes maintaining results over time.

🔎 Breast implants and change

Breast appearance can change after augmentation, and implants can develop complications such as rupture or capsular contracture.

⏳ Breast lift over time

Breast lift results are also influenced by tissue quality and ongoing changes; a lifted breast does not become immune to future sagging.

Questions this episode answers

Does a facelift stop aging?

No. Dr. Smith uses the idea of resetting a clock to explain a change in appearance while time continues to pass. The number of years of visible benefit varies and cannot be promised from a general discussion.

Can weight gain change liposuction results?

Yes. The recording explains that fat remains after liposuction and that subsequent weight gain can alter treated and untreated areas. A lasting reduction of fat in an area does not mean its size and shape will never change.

Are breast implants lifetime devices?

No. Current FDA guidance on breast implant risks states that implants are not lifetime devices and that complications may lead to additional surgery. This current context supplements the recording; the life of an individual implant cannot be predicted from a single year estimate.

🔗 Related information

Read current information about liposuction, breast augmentation, and breast lift surgery, or schedule a consultation to discuss expected longevity and follow-up for your chosen procedure.

Educational information, not individualized medical advice. Recovery, risks and results vary. Show notes updated September 30, 2026.

Original show notes

Plastic surgery can require a significant investment of time and money. How long will it last? Board certified NYC plastic surgeon Dr. Darren Smith dives in.

[00:08] I'm board certified New York City plastic surgeon, Dr. Darren Smith, and this is plastic surgery before and after. Your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine, and candid sessions with industry insiders. We hope you enjoy today's episode. Is plastic surgery permanent? The answer to this is it depends, and it's really a very good question. plastic surgery procedures can be a significant investment of time and money. So it's only natural to want to know how long your investment is going to last. So let's go through several kinds of plastic surgery procedures and discuss how long they're likely to last and which of them are in fact permanent. First, let's talk about anti-aging procedures like facelifts and neck lifts and blepharoplasty or eye lifts.

[01:03] And the first thing to do here is to really consider exactly what these procedures are doing. Over time... most facial aging is essentially due to the loss of volume and the descent of tissues and These are caused by gravity and its effects on tissue over time and also changes in the soft tissue over time Such as the loss of elasticity. It becomes less springy. It's less likely to Retain its shape over time. So what we're doing with most facial rejuvenation procedures like facelifts and brow lifts and eye lifts is we are volumizing areas that have lost volume and resuspending the soft tissues in cases in which they have descended. So after these procedures are performed unfortunately we do not yet have the ability to stop time as plastic surgeons although believe me we're working on it.

[02:05] time does continue on and even though we have achieved significant success in restoring the structure and volume of the face, it still will be subject to gravity and the passage of time after the procedure. So the best way to think about the longevity of facial rejuvenation procedures is that they essentially set back the clock and it More or less holds true that the more invasive a procedure is, the further it will set the clock back. So for example, a good facelift, and there's of course variability here, will often set the aging clock back by a good seven to 12 years. In contrast, some of these non-invasive approaches, and I really like face-tight for rejuvenation of the neck, for example, they'll often give us a nice three or four years back of aging. So while the results of both of these procedures can be quite impressive, you will continue to age after you have them, but you will have reset things by a number of years depending on the nature of the procedure that you've had.

[03:14] So moving into less invasive facial anti-aging procedures, let's address injectables. And as we've discussed in earlier episodes of the podcast, there are two main kinds of injectables, and those are fillers. and Botox. By way of review, Botox is a neurotoxin or neuromodulator that works by selectively, in a very controlled way, weakening muscles of facial expression in the area of interest so that those muscles are essentially slowed down and can't effectively contract and wrinkle overlying skin. Botox treatments tend to last on average from three to six months. So while Botox is really geared towards these dynamic facial lines, those lines that come when your face is moving, fillers are targeted at static facial lines, those lines that are present when your face is at rest. And the longevity of fillers is really quite variable based on the composition of the filler and also the location of the filler.

[04:17] Hyaluronic acid fillers, which are the majority of fillers that we use in our practice, can last anywhere from three months to two years, depending on exactly what that filler is and how it's formulated. And this is something you can discuss in depth with your injector at the time of your treatment. Aside from the composition of the filler, the location of the filler comes into play because the more mobile the area of the face that is injected, the faster that filler will dissolve, so the more quickly it will go away. And the reason for that is simply that the more an area of the face is moving, there's more physical disturbance of the filler, so it is apt to be dissolved by your system more rapidly.

[04:59] Another very popular facial aesthetic procedure is rhinoplasty or nose job. And in a rhinoplasty or nose job, we are performing a series of maneuvers to rearrange the structures of the nose, the bone and the cartilage in such a way that we achieve a more aesthetically pleasing shape. And since we are performing osteotomies or bone cuts and suturing structures together and placing cartilage grafts, rhinoplasty does tend to have very long lasting, if not permanent, results. Now let's move into some body procedures. Is liposuction permanent? Well, as we discussed on an earlier episode about liposuction, When we perform a liposuction procedure, we are permanently removing fat cells. And we know from recent studies on fat biology that while the body, after you've reached adulthood, is constantly making and destroying fat cells, the number of fat cells you have actually remains relatively constant. So when you gain weight, your existing fat cells increase in size, and when you lose weight, your existing fat cells shrink. You're not creating more fat cells to store more fat or losing fat cells to get rid of fat. So it stands to reason that if you have a liposuction procedure on your stomach, for example, and we remove say 75% of the fat cells in your stomach, and then you gain a significant amount of weight after your procedure, you are not going to produce more fat cells in your stomach or abdominal region to account for this weight gain. Instead, all of your existing fat cells are going to increase in size, including the fat cells that are remaining in the area that was treated with liposuction. Because when we perform liposuction, we never remove all of the fat in the treatment area because that wouldn't look natural. We usually remove, we say, about 75% of the fat in the treatment area and leave about 25% of the fat behind. So when you gain a lot of weight after liposuction, you'll kind of gain weight more or less evenly distributed throughout your body or consistently with however you usually distribute your weight. And you'll also gain weight in the area that was treated with liposuction, but to a much lesser degree because there are fewer fat cells left there to expand with weight gain. So as far as liposuction goes, if you maintain your diet and exercise after liposuction, the results should last a very long time.

[07:36] And now let's consider some breast surgery procedures. Is breast augmentation permanent? Well, breast augmentation is a very powerful and very popular procedure that we can perform usually in about an hour with instant results and about a two-day recovery time. And while breast augmentation is very long-lasting, there are two things preventing it in most cases from being permanent. The first is our old friend gravity. So when we perform a breast augmentation and we're using either silicone or saline implants in most cases, that adds weight to the breasts. So they will descend over time. And this can lead to an appearance that will lead to a patient either wanting to exchange their implants or have a breast lift or mastopexy over time.

[08:25] On the other hand, if smaller implants are used or in folks with stronger connective tissue, gravity may not play such a role and the position of the implants can remain relatively constant over time. The other thing working against breast implants being permanent is the fact that, since they are essentially foreign bodies, they are subject to problems over time, such as breaking or rupture or capsular contracture, which is when the scar capsule around a breast implant shrinks and that can become painful or even change the position of the implant. So while breast implants last a very long time in general, and in some cases can last for someone's entire life, we usually say that about 10 years is a reasonable expectation in terms of longevity of breast implants. What about a mastopexy? Is a breast lift permanent?

[09:19] Well, a breast lift, just like a lot of these other procedures that we were talking about, is also susceptible to gravity. So if someone has droopy breasts or tautic breasts and we perform a breast lift or mastopexy to rearrange the tissues of the breast in such a way as to improve the appearance of the breast and to move the substance of the breast up on the chest wall, that improved breast structure will be subject to gravity and will gradually descend over time. So while not permanent, the results of a breast lift, when well executed, will last a very long time. And this will also vary according to the individual's soft tissue quality. For someone with weaker soft tissues with more laxity and less elasticity, a breast lift will not last as long as for someone with very good quality soft tissue.

[10:12] For individuals that have more skin laxity and lack elasticity, and this sometimes isn't someone that's lost a lot of weight or a patient that's come in for a breast lift after childbearing or breastfeeding, we'll sometimes use a product like Galliflex, which is a dissolvable scaffolding, which essentially functions as an internal bra to help hold the position of the breasts against gravity for an extended period of time. So is plastic surgery permanent? It depends, and that's why it's very important to have an in-depth conversation with your board-certified plastic surgeon to make sure that the procedure that you're planning is going to meet your needs. Thanks for listening, and don't forget to subscribe, share the show, and head over to darrensmithmd.com for more real-world plastic surgery talk.

Original Captivate episode. Original release date: 2020-08-23. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.

• liposuction
• breast augmentation
• breast lift surgery
• schedule a consultation
• Related episode: Who is the Best Plastic Surgeon in New York City?
• Related episode: When is Plastic Surgery a Bad Idea?
• Dr. Smith’s background and training