Dr. Anil Shah has performed over 7,000 rhinoplasties and 4,000 face and neck lifts, but it’s how he’s doing them that has the industry watching. In this episode, he joins me to break down his game-changing 5D rhinoplasty and Five Layer Neck Lift, two techniques redefining facial plastic surgery by going deeper, smarter, and more natural.
From deprojecting the nose without distortion to sculpting the neck in a way no filler can replicate, Dr. Shah reveals how true surgical artistry lies in mastering anatomy, not chasing trends. He also shares how AI, 3D imaging, and surgical data are speeding up recovery and improving precision, and why more men and younger patients are opting for advanced facial procedures in 2025.
If you think you know plastic surgery, you don’t. Not until you hear this.
This episode is sponsored by: NewBeauty 💄
🎧Listen Now on Apple: https://dub.sh/3Vkx3eV
📱 Listen and Watch here on Spotify: https://spti.fi/Y7892uv
Episode FAQ
What are the latest approaches in rhinoplasty, neck lifts, and facial plastic surgery?
On The Dr. Randi Show, Dr. Anil Shah, a facial plastic surgeon who practices in Chicago and New York, shared insights from performing more than 7,000 rhinoplasties and more than 4,000 face and neck lifts. He discussed his 5D rhinoplasty approach for making the nose smaller in several dimensions at once, his 5-Layer Neck Lift aimed at improving the position of the hyoid bone, and growing demand for low downtime facelifts with discreet scars. He also shared his views on filler, AI and 3D imaging, social media, and in office treatments that he believes can support healing. This reflects Dr. Shah’s professional experience and is not medical advice.
What is a 5D rhinoplasty, and how can a nose be made smaller in multiple directions?
On The Dr. Randi Show, Dr. Anil Shah described his 5D rhinoplasty as a technique he developed to deliver what many patients ask for: a nose that is smaller overall, rather than a compromise between changes. He explained that the goal is to reduce projection, shorten the length, refine the tip, and reduce the bump while straightening the nose, all at the same time. He said that when he measures results on a 3D program, the change can be as much as seven to eight cc of volume, which he compared to the familiar one cc syringe of filler. He noted this is what many, though not all, patients want. This reflects Dr. Shah’s professional experience and is not medical advice.
What is a 5-Layer Neck Lift, and can surgery improve the position of the hyoid bone?
On The Dr. Randi Show, Dr. Anil Shah explained that the hyoid, a small floating bone deep in the neck where muscles from above and below connect, is one of the most challenging areas to change in neck surgery. He said people born with a favorable hyoid position tend to have a naturally defined neck and jawline, while many others are not, and that traditional approaches remove fat in front of and around the hyoid without changing its position. His 5-Layer Neck Lift works in a deeper layer with the goal of improving that position, and he mentioned a forthcoming study that he said shows this change can be achieved with a neck lift alone, without a facelift. This reflects Dr. Shah’s professional experience and is not medical advice.
Why are defined jawlines and necks so popular, and can neck muscle strength help?
On The Dr. Randi Show, Dr. Anil Shah said jawlines and necks are currently the most requested facial features, and that neck procedures and rhinoplasty are roughly tied among his most common requests. He referenced research by author Nancy Etcoff, whose work across cultures suggested that a strong jawline and neck are seen as universally attractive in both men and women. He noted that age is not always the deciding factor, since some younger patients were never born with the neck contour they want. He also shared his observation that patients who maintain muscle tend to hold onto their neck results better, which is why he does not favor Botox in the neck, and said that while he does not love facial exercises, he does not mind neck strengthening. This reflects Dr. Shah’s professional experience and is not medical advice.
Do you need to dissolve filler before a facelift, and does filler still have a role?
On The Dr. Randi Show, Dr. Anil Shah said the filler backlash grew from patients who were overfilled and looked different rather than better, which he partly connected to profit driven settings, while noting that not all med spas operate that way. He disagreed with the idea that anyone with filler cannot have a facelift, explaining that in his experience a surgeon working in the appropriate deeper plane can operate on someone who has had filler, Sculptra, or radiofrequency treatments. He said he does not ask patients to dissolve everything, though certain areas may be dissolved depending on the procedure. His view was that filler still plays an important role when used in the right amount, since too much filler and too much surgery are both problems. This reflects Dr. Shah’s professional experience and is not medical advice.
What is a no scar facelift, and at what age do people get their first facelift?
On The Dr. Randi Show, Dr. Anil Shah said the hottest trend he sees is a shift from filler toward low downtime surgery, particularly facelifts designed to avoid a visible scar with about a week of recovery. He said this is drawing a younger group, from the late thirties to the early fifties, although most first facelifts still happen around ages 52 to 55, and he personally named 46 or 47 as an ideal age for a first facelift. He cautioned that some popular no scar techniques can leave a scar along the back of the hairline that shows when the hair is worn up, so he modified his approach to keep the incision in the crease behind the ear rather than along the back of the hairline. As he put it, a scar is a scar. This reflects Dr. Shah’s professional experience and is not medical advice.
Can AI images and 3D imaging help plan cosmetic surgery, and how does social media affect expectations?
On The Dr. Randi Show, Dr. Anil Shah, who described himself as an AI enthusiast, said an AI generated image can be a useful way for patients to start a conversation about what they want, such as higher cheekbones, a smaller nose, or a stronger jawline. He cautioned that AI is often wrong, so he uses 3D imaging to review what is and is not realistically possible. He said patients arrive better informed today and make fewer outrageous requests than they did a decade ago. He called social media a double edged sword: it offers helpful education and patient reviews, but it can also fuel comparison, unrealistic images, and judgment. This reflects Dr. Shah’s professional experience and is not medical advice.
What in office treatments can support recovery after facial plastic surgery?
On The Dr. Randi Show, Dr. Anil Shah described in office devices as a complementary part of how patients heal. He said having technology on site that he feels can shorten bruising from a couple of months to a few days is valuable, along with hyperbaric therapy, CoolSculpting for noninvasive body treatment, and hair transplantation, which he noted can be paired with a hairline lowering procedure to refine or further lower the hairline. He also shared his belief that patients who take protein and powdered greens probably heal faster, while acknowledging the data is not yet definitive, and said he hopes AI that connects medical databases will someday help shorten recovery from about a week to three or four days. This reflects Dr. Shah’s professional experience and is not medical advice.
What is a Pain-Free Rhinoplasty, and how long does rhinoplasty recovery take?
On The Dr. Randi Show, Dr. Anil Shah shared that he presents his Pain-Free Rhinoplasty technique at medical meetings so more surgeons can use it, with the goal of helping patients have less pain and use fewer narcotics after surgery. He said other doctors have told him the technique has helped their patients, which he sees as a greater good. When asked about recovery, he estimated about 10 days before a rhinoplasty patient is back to their usual routine, while noting that complete recovery takes longer. He also named septal perforation repair, often during revision rhinoplasty, as one of the most challenging procedures he performs. This reflects Dr. Shah’s professional experience and is not medical advice.
Are injectable nose jobs, preventative Botox, and microneedling worth it?
In the speed round on The Dr. Randi Show, Dr. Anil Shah shared quick personal takes on several popular treatments. He called injectable nose jobs overhyped, said he is not into preventative Botox, and said he would not choose microneedling by itself. He said he loves laser treatments, named under eye filler as the most popular nonsurgical procedure at his practice, and said the one skincare step patients should never skip is using retinol every day. When choosing between filler and fat grafting, he said it depends on the area, though he might lean toward filler. These are Dr. Shah’s personal opinions and are not medical advice.
