She’s one of the most respected plastic surgeons in the country. She broke barriers as the first woman to serve as President of The Aesthetic Society. And she has a front-row seat to where aesthetic surgery is heading next.
This week on The Dr. Randi Show, I sit down with Dr. Jennifer Walden for an unfiltered conversation about the evolution of aesthetics; from the era of overfilling to the resurgence of surgical gold standards.
Inside the episode, we explore:
🔵Why facelifts are making a major comeback
🔵The real impact of GLP-1 weight loss on facial aging
🔵The rise of minimally invasive technology that bridges the gap between devices and surgery
🔵How social media is reshaping patient expectations
🔵What defines the next era of aesthetics: longevity, peptides, hormones, and a return to natural results
If you want to understand where aesthetics is going next, and what’s worth paying attention to, this is a conversation you don’t want to miss.
Sponsored by NewBeauty💄
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Episode FAQ
What are the biggest shifts happening in aesthetics right now?
On The Dr. Randi Show, plastic surgeon Dr. Jennifer Walden, the first woman to serve as president of the Aesthetic Society, shared her view of where aesthetics is heading. She described a broad growth in aesthetic providers over the past few years that she feels is now beginning to calm down and self-regulate through legislation and oversight, with a stronger focus on training, education, and patient safety. Dr. Walden also pointed to a resurgence of surgical procedures such as the facelift after several years of heavy emphasis on non-invasive treatments, along with growing interest in minimally invasive devices, longevity medicine, and more natural looking results. This reflects Dr. Walden’s professional experience and is not medical advice.
How are GLP-1 weight loss medications changing who seeks aesthetic surgery?
During this episode of The Dr. Randi Show, Dr. Walden explained that GLP-1 weight loss medications are bringing younger patients into her practice. She shared that as patients lose weight they often develop looser, saggier skin on the face and neck, which leads more of them to consider procedures such as facelifting, tummy tuck, and breast lift at a younger age than before. In her experience this has contributed to a noticeable rise in patients seeking surgery. This reflects Dr. Walden’s clinical experience and is not medical advice.
Why is the facelift making a comeback as the gold standard for facial aging?
On The Dr. Randi Show, Dr. Walden described a clear resurgence of the facelift after several years when much of the focus was on fillers and non-surgical options. She explained that she considers the facelift the gold standard for facial aging because it is the only way to lift the underlying foundation of the face, something fillers cannot do. In her experience there is only so much that facial fillers can accomplish, and she has seen patients who spent heavily on filler over many years still end up needing surgery. This reflects Dr. Walden’s clinical experience and is not medical advice.
When should a non-surgical provider refer a patient for surgery instead of more injectables?
On The Dr. Randi Show, Dr. Walden said that knowing when to refer a patient to a plastic surgeon is one of the smartest and most important skills for an injector, nurse, or nurse practitioner to develop. She shared that providers who have worked alongside a plastic surgeon often recognize the point where continued fillers or non-invasive treatments will no longer satisfy a patient, and that referring at the right time for a procedure such as blepharoplasty, facelift, or neck lift helps avoid disappointment. In her view, recognizing that limit protects the patient. This reflects Dr. Walden’s clinical experience and is not medical advice.
What is the difference between a deep plane and a high SMAS facelift?
On The Dr. Randi Show, Dr. Walden discussed how patients now arrive already familiar with facelift terminology they have seen on social media, such as the SMAS layer (the superficial musculoaponeurotic system, a layer of muscular connective tissue under the skin) and whether a facelift is deep plane or high SMAS. She explained that both techniques have existed for decades and that good results depend more on the skill and technique of the surgeon than on the specific label. She cautioned that a patient may become fixed on wanting a deep plane facelift after reading a social media caption when a high SMAS approach could deliver an excellent result without the added risk. This reflects Dr. Walden’s clinical experience and is not medical advice.
What is the minimally invasive laser that bridges the gap between non-surgical treatments and a facelift?
On The Dr. Randi Show, Dr. Walden described a minimally invasive dual wavelength subdermal laser that she uses to bridge the gap between non-invasive skin tightening and a full facelift. She explained that the device uses two diode wavelengths, around 980 and 1470 nanometers, inserted under the skin through a fiber about the diameter of a hair, with no incisions or stitches. In her experience it can help melt fat while also tightening the skin, getting as close to surgical results as she has seen from a minimally invasive device, with continued improvement over the following three to six months. Dr. Walden noted that the device is made by ONYXA Medical, and that she serves as the company’s chief medical officer. This reflects Dr. Walden’s clinical experience and is not medical advice.
What is the recovery and downtime like for the minimally invasive subdermal laser?
On The Dr. Randi Show, Dr. Walden said the downtime for the minimally invasive subdermal laser is usually about three to five days, with some mild swelling and bruising. She explained that patients wear a compression garment for the first couple of days and then at night about every 30 days to help retrain the skin as it heals. In her experience patients also see improvement in overall skin quality, since the dual wavelength design can target vascularity and pigment as well as fat. This reflects Dr. Walden’s clinical experience and is not medical advice.
Are regenerative aesthetic treatments like exosomes and growth factors safe?
On The Dr. Randi Show, Dr. Walden urged caution around the term regenerative aesthetics, which she considers vague. She noted that a group of plastic surgeons recently co-signed a paper in a plastic surgery journal warning that the phrase can be misleading, because treatments that inject exosomes, PDGF growth factors, or PLLA under the skin have not been studied enough to know their long term effects. In her view there is a place for regenerative approaches, but they need to be evidence based and backed by scientific literature rather than adopted before they are well understood. This reflects Dr. Walden’s clinical experience and is not medical advice.
With so many options available, how should patients prioritize which treatments to do?
On The Dr. Randi Show, Dr. Walden acknowledged that the number of treatments and the terminology can feel overwhelming for the average person. She recommended starting with a physician led practice, ideally a core physician, plastic surgeon, or facial plastic surgeon, and building a personalized treatment plan based on the patient’s goals, stage of aging, budget, and available downtime. She explained that treatments are often stacked over time rather than done all at once, for example a laser now and filler or a chemical peel later, and that the current focus is on natural looking results rather than heavy filler. This reflects Dr. Walden’s clinical experience and is not medical advice.
What helps patients get the best results from aesthetic treatments?
On The Dr. Randi Show, Dr. Walden shared that the patients who do best tend to have realistic expectations and have done their own research before the consultation, so they can focus on what is right for them rather than starting from a blank slate. She also emphasized that following postoperative instructions closely is one of the biggest contributors to a smooth recovery, noting that patients who heal the best tend to be the happiest the quickest. This reflects Dr. Walden’s clinical experience and is not medical advice.
