No red-carpet moment, social media scroll or glossy magazine cover escapes the watchful eyes of aesthetic enthusiasts, and, inevitably, their critics. While bold cosmetic enhancements have long made headlines, a quieter movement is taking center stage. Enter the makeunder trend: a shift toward subtle, natural-looking cosmetic treatment results, whether to fine-tune past work or embrace a less-is-more approach.
What’s driving the shift?
For some people, it’s about reconnecting with their natural features. For others, it’s about avoiding the unmistakable signs of looking “overdone.” From quick tweaks like dissolving filler to complex revision surgeries, the makeunder movement spans the spectrum. But, the goal is universal. “Patients are pushing for the most natural-looking results possible,” says Boston facial plastic surgeon Akshay Sanan, MD. “They want to look remarkable for their age without looking ‘done.’” And right now, there’s no better time to strike that balance.
The Rise of the Redo
Sometimes, the road to a makeunder is paved with lessons learned. “The COVID pandemic plastic surgery boom led many people to seek revision rhinoplasty after being unsatisfied with their results,” says Stanford, CA facial plastic surgeon Sam P. Most, MD. Social media played no small role. “Patients saw ‘pixie’ or ‘Whoville’ noses on Instagram [recognized for their dramatically upturned, small and pixie-like shape] and thought it might look good on them.” However, Dr. Most says that instead, they found it looked “very unnatural, and in many cases, they could no longer breathe.”
This is when Dr. Most helps restore balance. “Most revision patients have lived with the trauma of their decision, which may have been made without careful deliberation,” he says. “In preparation for revision, they often have done more research and have greater confidence about what can be done and how their nose can be made to look beautiful yet fit their face.”
The same reset is happening with fillers. “I’m seeing a huge number of patients coming in who have been overfilled, especially in the upper cheek and under-eye area,” says Woodbury, NY oculoplastic surgeon David Schlessinger, MD. That’s precisely why, at his practice, filler dissolving is skyrocketing. “Every week, I see two or three patients dissolving their filler,” he adds.
Refining Results
The makeunder isn’t just about undoing treatments; it’s about refinement, too. Inspired by celebrities embracing a more toned-down, natural aesthetic, patients are seeking similar changes. Atlanta plastic surgeon Stanley Okoro, MD highlights this growing trend: “I’d call it more of a classic look instead of an overdone one. Over the past 10 years, some celebrities and influencers—Kim Kardashian, for example—have shifted toward a leaner, more natural look. That whole trend is changing again.”
Lips are a prime example. “I see fewer patients trying to overfill their lips,” adds Dr. Schlessinger. “Most people I see who want their lips done tell me, ‘I just want it natural,’ or ‘I want you to even it out’ because they have uneven lips or just want subtle enhancement.”
The makeunder mindset isn’t limited to faces; it’s also reshaping breast aesthetics. “A big part of my practice over the last few years has been patients who have had implants for at least five years, but usually 10 to 15 or more, who feel like they were too top-heavy and overdone,” says Grand Rapids, MI plastic surgeon David Alfonso, MD. He credits the rise of the yoga breast: a shift from oversized implants to a lighter, more natural shape. Some people choose to solely remove their implants; others combine their removal with a breast lift for perkier, more balanced results. The “yoga breast” name says it all: freedom to move comfortably, from downward dog to child’s pose.
The same applies to Brazilian Butt Lifts (BBLs). “The most common procedure we do at my practice right now is actually BBL reversal,” explains Dr. Okoro. “People want a nice shape without exaggeration. We use a combination of liposuction to restore balance and remove excess fat, paired with Quantum RF or BodyTite and Morpheus to tighten and shrink wrap.” This brings us to the heart of the makeunder movement: ultra-customized care that’s all about getting it just right.
A Smarter Approach to Treatments
Today’s aesthetic treatments are less about “more” and all about “better.” “We’re doing more things like collagen stimulation with Sculptra, versus using hyaluronic acid fillers,” says Dr. Schlessinger. He calls it a “back to the future” moment, reviving treatments like Sculptra, which was first introduced 25 years ago. Unlike instant fillers, it works gradually, stimulating collagen to deliver soft, natural volume. As a bonus, it also enhances skin tone, making it a top pick for the less-is-more approach.
The secret to success might just be combining treatments. “Our faces age as a result of many factors, including skin and muscle looseness, volume loss, and skin texture and quality,” says Dr. Sanan. Addressing it all requires a mix of tools, including, as Dr. Sanan recommends, biostimulators like Sculptra, lasers to improve texture, and radio-frequency microneedling to tighten. The layered approach lends itself to impactful results without looking overdone.
Small tweaks around the eyes, like upper blepharoplasties and baby browlifts, are popular options for patients looking for a subtle refresh. An alternative gaining traction is Upneeq, a prescription eye drop that temporarily improves droopy eyelids, or ptosis, without surgical intervention. “Upneeq works very well on a certain type of patient whose eyelid is closing a little bit, or patients with ptosis,” says Dr. Schlessinger. He often recommends it as a “test drive” for patients considering eyelid surgery, though it also stands on its own as a temporary fix.
The Future of Less-Is-More
The makeunder marks a turning point in aesthetics—one where subtlety leads the way. As Alamo, CA facial plastic surgeon Prem Tripathi, MD puts it, today’s approach is far more thoughtful. “It used to be that patients would say, ‘I want lip filler,’ they’d get it, and that would be the end. Luckily, the trend is moving toward a comprehensive consultation that discusses skin, contour and balance.”
Customization is the cornerstone of this shift. “The consultation is more important than ever,” Dr. Schlessinger adds. “We have so many options now, and it’s about finding the best plan for the individual.” Because, in the end, the makeunder isn’t about doing less; it’s about doing what’s right—proving that sometimes, the quietest tweaks make the loudest impact.
Dr. Schlessinger gave this 38-year-old patient a subtle lift with an upper blepharoplasty and brow contouring.
