September 22, 2026 | Facelift, Facial Rejuvenation
“I don’t think this is surgical. It is quite clear that she’s had surgery in the past, but not in this recent transition. A facelift will change the position of the tissues, and what we’re seeing on her is a change in the volume or amount of tissue.”
I sent that to the Daily Mail about Adriana Lima. It is also the first thing I work out at every facelift consult in El Paso. Did the tissue move, or did the tissue shrink? The full read is on drworldwide.com. This is the surgical half. I have not treated her.
Position or volume
“Around 2023 and 2024, her midface was much fuller and rounder, but she still looked youthful. Her cheeks sat lower and wider, and her lower face was much heavier, but there was no visible jowling.”
Heavy lower face, no jowls. Age gives you jowls. Weight gives you fullness.
“So really the difference is not that any volume was added, but rather that it has been taken off, and her structures are now showing better.”
A facelift puts the jowl back on the jawline and the cheek back where it sat at thirty. It does not turn a round cheek into a hollow one.
How little it takes
“What could explain it from a surgical perspective? I think the main difference here is her weight. She’s been pretty open about gaining weight after her pregnancies, and as surgeons we know that 10 or 15 pounds makes a huge difference in the face, whether you gain it or lose it.”
Nobody believes that number until they see it on themselves.
Where a surgeon fits, and where not
“I do think she may have used radiofrequency for skin tightening in this transition. She doesn’t have the temporal wasting we usually see in weight loss, so she may have had some biostimulators or fillers added to the temples. Botox to the masseters can help create that hollow appearance below the cheekbones. If anything a buccal fat pad removal can accentuate it even further.”
Buccal fat removal is the one operation on my list, and it is possible, not required. I remove buccal fat for the patient whose cheeks stay round at a stable weight. Different patient.
“In conclusion, from the photos, it just doesn’t look like a face that has had surgery, but a face that has lost the excessive volume and allowed the deeper structures to show through.”
Who does need the lift
The patient whose weight has been stable for years and whose tissue has moved. Jowls below the jawline. A neck that lost its angle. A cheek that slid rather than shrank. For that patient the deep plane lift repositions the whole unit from underneath and the skin is laid back down with no tension.
The patient whose face changed because their weight changed does not need that operation. I will say so.
Why they ask me
Mayo Clinic fellowship. Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Deep plane facelifts every week. Castle Connolly Top Doctor thirteen consecutive years.
Ready to talk?
Bring the two photos. If it is weight, I will say so. If it is position, I will show you what moved. Call (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
The full read, filler and skin tightening included, is on drworldwide.com.
