Plastic surgery is obviously a very personal, deliberate journey, one that should be taken with very serious thought and care (as is the case with anything from Botox to lasers to even peels). But if you’re perhaps interested in hearing more, or just want to know what’s popular and trending right now, we chatted with one of the best (and most discreet) in the biz: Dr. Melissa Doft. The board-certified surgeon is also a clinical assistant professor of surgery at Weill Cornell Medical College, and is the owner of Doft Plastic Surgery on the Upper East Side of New York City. Here, she answers every question we had about plastics.
Can you be a feminist and be interested in getting plastic surgery?
I think the best part of plastic surgery is about feeling confident with yourself. And I think the best part about being a feminist is feeling confident about being a woman. So I actually think they parallel each other.
It’s probably a little bit different being a female plastic surgeon then a male plastic surgeon. But the patients who are coming to me are not interested in, “How do I look to a man? Do I look voluptuous? Do I look sexy? Am I going to attract this husband who’s been cheating on me?” Those patients will go to a male surgeon. They’re not coming to me. They want the male opinion, and they want to look beautiful.
One of my male colleagues one time told me that one time as a patient was going to sleep, she said, “Make me look how you would want your girlfriend to look.” Nobody says that to me. Most women who come to me, they say, “I’m not feeling great about this one or two aspects, and I want to look how I used to look.” Or, “I’ve never liked my nose,” or, “I’m starting to see these aging signs that I never saw before and I’m not feeling like me.”
That’s the biggest comment in regards to aging: “When I look in the mirror, I don’t feel like me.” Most of my patients are choosing plastic surgery to either restore something or to feel better about something. I don’t think that goes against feminism.
What’s the most popular treatments by age range?
I do a lot of breast reductions for girls, teenagers, and young women in their 20s. And a lot of otoplasty, which is pinning up the ear. It’s a really big transition for a lot of these kids. Maybe they’ve been teased, they maybe feel uncomfortable, and this is a transition that they’re going to college, they’re going to graduate school, they’re switching schools, whatever—it’s a really good time to do it.
In the 20s, breast augmentation starts becoming more popular. You shouldn’t be considering this until you’re in your 20s anyway because even if you look at some of the FDA approvals for breast reduction in regards to the silicone, you’re supposed to be 22 to even place it.
You should also be fully developed. You should come in this having really thought about it; it shouldn’t be just a quick thing of, “I’m not big enough and I’m just going to do this because everyone else is going to do this.” Or, “I think it looks sexier to a boy.” It has to be a more mature decision.
The next most common treatment would be rhinoplasty, then liposuction. In your 20s, your metabolism is fast, but you’re working a little bit more, don’t have a much time to exercise, maybe you’re not eating as properly, maybe gained some weight during college or graduate school.
In their early 30s, people are starting to think about skincare more. They’re starting to think about vitamin C, maybe dabble in a retinol, maybe they do micro-needling, maybe they do facials, but they’re thinking, “I want to prevent what I see happening to my mother who is in her 50s.” For the first time, your mother is looking a little bit older to you, and you’re starting to think about it. And for a lot of people, 30 is a big age. It’s that “I have to take things into control; I can’t just do everything that I was doing, drinking and partying, and staying up late in my 20s” age.
Many women are also starting to think about having a family or they’ve already started a family. By the late 30s, many women have had kids. The term “mommy makeover” is used, but I hate that term as a mom. But it’s this idea of restoring your body to a pre-pregnancy body. Maybe it’s a breast lift, or a little breast implant with a lift because your breasts have become deflated. Maybe it’s doing a little tummy tuck or a little lipo. It’s often right before 40. The children are old enough that you’re looking around and you’re thinking, “You know what? I need to concentrate a little bit on me.”
As it gets towards the 40s, I see more Botox, more fillers, and lasers because now you have some pigmentation changes. And the eyes start becoming top of mind. Some people are born with puffy eyes and a lot of skin on their upper eyelids. The eyes are a super easy thing to fix, and it makes a huge difference.
Fixing the eyes is like buying a dress that’s maybe a little bit big on you, and then taking it to a very good tailor and having it fit you perfectly. You look just great in it—that’s kind of like doing your eyes.
If it’s puffy underneath the eyes, I usually just pluck out a little bit of the fat that’s creating this puffiness, from a small incision on the inside the eye so there’s no scar. For the upper eyelid, it’s just taking out a little bit of skin. You have a few stitches, and you heal in about a week. It’s a really easy thing—it’s not very painful, and I can do the upper eyelids the office.
50s, 60s, and 70s
Anything after the 40s, people are still thinking about their eyes, but also face and neck lifts.
What’s the difference between men vs. women when it comes to plastic surgery?
For men, when they’re younger, they get the liposuction, gynecomastia of the male breasts reduction, nose jobs, chin implants, and then as they get to late 50s and 60s, they’re starting with the face.
When a woman comes in, I almost feel like we’re dating. They kind of want to get to know me, they want to know about my children, they want to know about what procedures I have done. They notice what I wear, they notice my shoes—kind of like you would if you were meeting another mother at nursery school or in a group. But there’s a back and forth. They often go to multiple doctors; they want to see who they feel the best with, and they look at your before-and-afters. Sometimes it’s almost just to make sure you know how to do the operation.
But for the men that come in, they know exactly what they want. They want to know the nuts and bolts, they want to know the cost, and they want to know how long they have to be away from work. And that you’re proficient at it. But it’s not as much of, “Does she like me? Does she not like me?”
Botox: Do you think it’s better to start early, on the preventative side, or get it later in life?
If you’re really going at it to prevent, you should never stop, but I’m not a huge preventative Botox person. I think you get pretty good results from starting when you already see the lines. If you’re 70 and the lines are really etched in when you’re starting to do Botox, I can’t always get out the lines. But maybe I could lessen them.
In general, I would say wait until you start seeing lines at rest. Everyone makes lines when they’re moving. Even my 9-year-old son makes lines when he’s moving his face. There’s a misconception of “I can raise my forehead, I need Botox.” I don’t think that’s true.
Sometimes I will do it in the crows feet for people who just have heavy eyelids to just opens up their eye a little bit. And there are other reasons to do it, like for sweating over the summer. Hyperhidrosis is the term. I’ve written a few papers on it. I have some patients who just do it electively to not sweat at all.
What’s the normal price range for Botox?
We charge by areas: $600 for the first area (glabella [forehead between the eyebrows], forehead, or crow’s feet), $350 for an additional area. It is a bit more for hyperhidrosis (excessive sweating) or the masseter muscles (a thinner jawline) as they require larger doses.
Your skin and face are so incredibly lovely and natural. What’s your regime?
My secret is still a little bit of a secret. I have been working on formulating my own skincare line for the past three years, and I use all of the products on myself. The products are still in development/testing but hopefully will be out in the next year. I also dabble in Botox but I am never a very consistent user as my husband does not know. My other trick is microneedling, which I try to do at least seasonally if not more often. It gives me a little more radiance.
As with any serious procedure or treatment, make sure you see a board-certified surgeon or their office.