Modern Wedding Prep: Pre-Nuptial Cosmetic Treatment Trends in 2023

It is no secret that weddings are a focal point for one’s appearance-related concerns. Common themes under this umbrella have long included generalized weight loss and a desire to improve skin tone and quality. In addition to seeing a general increase in the volume of these cases over the past year or so (perhaps related to a return to in-person weddings as Covid fears abate), we have also noticed some specific new wedding prep trends coming to the fore. The emergence of less invasive approaches to common concerns has likely stoked the popularity of pre-nuptial adjustments as well. These procedures tend to focus most on the face, trunk, and arms in our practice. Women and men are seeking out these procedures, with an approximate 75% female predominance.

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Wedding Facial Prep

The face is, of course, heavily photographed over the course of a wedding, and we are seeing a post-covid trend carry over into wedding preparations. During the pandemic, perhaps from spending an increased amount of time staring at themselves on Zoom, we saw a growing awareness of concerns regarding the appearance of the eyes, neck, and jawline. Interestingly, these are also the areas not obscured by masking.

Patients are increasingly reporting that their eyes are “making them look tired,” and they want to appear rested in wedding photos. Excess upper eyelid skin and bulging fat creating “bags” below the lower eyes are the most frequent cause for this, with upper lid skin laxity being a much more common issue than lower lid fat herniation in those preparing for their weddings. Upper-lid skin excess can be easily addressed with a simple upper eyelid lift (upper blepharoplasty). This procedure takes approximately forty-five minutes to perform and can be done with local anesthesia. There are 4-5 days of social downtime, but most patients can expect to return to work from home by the day after the procedure. Fat herniation causing under-eye bags can be addressed with a lower blepharoplasty. This procedure is done under twilight or general anesthesia and involves making a small incision behind the lower eyelid and removing excess fat. Downtime and return to work are similar to upper blepharoplasty. For those with only minor upper or lower lid issues, AccuTite bipolar radiofrequency skin tightening may be a good approach. This minimally invasive treatment has no visible scarring and uses energy to tighten and rejuvenate the skin in the area.

Neck & Jawline Rejuvenation

The chin and jawline also figure prominently in pre-wedding portrait planning. Issues here tend to involve skin laxity, fat excess, or both. For a little excess fat under the chin (the “submental region”), liposuction under local anesthesia is often a great approach. This quick win takes less than an hour, is performed under local anesthesia, and has about two days of social downtime. We like to add VASER ultrasound energy to further tone the region and minimize bruising. In cases of mild to moderate skin laxity, FaceTite bipolar radiofrequency is a great addition to the procedure. More severe cases may require an open neck lift, but this is fairly uncommon in those getting wedding ready.

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Targeting the Trunk - Flank Contouring

The trunk is another common target of wedding preparation. These patients are generally looking for help with the finishing touches to look perfect in their wedding outfits. Flank, or “love handle” liposuction is especially popular in this context. These spot fat reduction procedures are an extremely straightforward way to target stubborn fat deposits that just aren't responding to diet and exercise. Love handle liposuction generally takes about an hour to complete and can be done under local anesthesia. Many patients can even get back to a desk job the day after their procedure. Flank contouring is often the finishing touch that helps that tuxedo jacket or form-fitting wedding dress fit just right.

Emsculpt Neo is a noninvasive treatment that combines radiofrequency energy and electromagnetic energy to significantly reduce fat (average 30% decrease), build muscle (average 25% increase), and tighten skin. This is extremely popular for those looking to address that last little bit of an abdominal bulge interfering with their wedding wardrobe.

Superbly Sculpted Arms

Arm contouring is especially popular with brides-to-be that have sleeveless wedding gowns. Achieving a superb arm contour begins with a careful examination. We are looking specifically to see if there is excess fat, skin laxity, or both, and where that extra fat is located if it is present. The two main regions fat accumulates in the arm are the deltoid fat pad (most visible from the front and side) and triceps fat pad (most visible from the side and when the arm is raised). Isolated excess fat can be treated under local anesthesia with liposuction. VASER ultrasound can be added to enhance contour and minimize bruising. BodyTite radiofrequency energy is a great option to tighten mild to moderate skin excess. A mini brachioplasty (mini arm lift) can be added if there is more significant skin laxity towards the armpit. Unlike a traditional arm lift that requires a long scar spanning from the armpit to the elbow, a mini arm lift’s scar is sort, horizontal, and hidden in the armpit itself.

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Timing for Wedding Prep

It’s especially important to consider timing with any of these wedding prep procedures. We advise our patients to have these procedures about three months prior to the big day. This gives ample time for swelling to resolve and a significant amount of skin tightening to occur. This timeline is a bit more complicated in the context of wedding gown and tuxedo fittings, as these procedures can make your dimensions something of a moving target. To be on the safe side, we encourage our patients to ideally have any procedures they are planning at least three months prior to their fittings as well.

As we come out of the era of Covid restrictions and in-person weddings are coming back in full force, wedding preparations are coming with them. Covid-era Zoom-enhanced self-awareness is melding with the arrival of advanced technology to shape modern pre-wedding plastic surgery trends. As more impressive changes are possible with less invasive procedures, enthusiasm for pre-nuptial plastic surgery is on the rise.

Darren Smith, M.D., FACS is a board certified plastic surgeon practicing in New York City. He is a known expert in aesthetic surgery and cosmetic injectable treatments.