When Susan Beach looked in the mirror after losing more than four stone, she expected to feel delighted by the woman staring back at her.
The mother-of-two and realtor from Rochester, New York, had transformed her body after deciding to overhaul her lifestyle during the Covid-19 lockdown.
The weight had steadily fallen away and Susan had finally achieved the figure she had wanted for years.
But there was one part of her transformation she hadn’t anticipated.
Her face, she says, appeared to be ‘melting’.
As she lost weight, the skin around her cheeks and jaw became loose and droopy, while lines and wrinkles she had barely noticed before seemed suddenly more pronounced.
What should have been a source of pride gradually became a new insecurity.
‘You think, “When I lose weight, my life will be perfect”. But after all that hard work, I was still unhappy with how I looked,’ says Susan, now 54.
Susan Beach from Rochester, New York, before her cosmetic procedures. After the pandemic she lost over four stone and realized her face was ‘melting’
Susan, 54, after he cosmetic procedures has newfound confidence
She tried countless skincare products promising to firm and lift her skin, followed by chemical peels and Botox.
But nothing, she felt, made enough of a difference.
And as the years passed, Susan became increasingly self-conscious about her appearance.
She began to dread having her photograph taken and, at family gatherings, would position herself at the back of group shots in the hope of avoiding the camera.
It was a struggle that those closest to her found difficult to understand.
Her husband of 30 years, Rob, and their three children, now aged 23, 25 and 28, repeatedly reassured her that they loved her as she was and that she didn’t need to change anything.
‘But they didn’t know the struggle I had inside,’ Susan says.
For years, she went back and forth over whether to have cosmetic surgery.
By 2024, with her children grown up and out of the house, Susan decided she was finally ready to do something she had contemplated for years – have a facelift.
One day at work, in the office she shared with her sister Jenny, she asked whether Jenny thought it was time to go ahead.
Her sister didn’t hesitate: ‘Yep,’ she said. ‘It’s time.’
Today, the picture couldn’t be more different.
After undergoing a series of cosmetic procedures to lift the loose skin and restore the volume she had lost from her face, Susan says she finally feels comfortable with her appearance again.
She no longer hides when a camera comes out. In fact, her phone is now ‘absolutely full’ of selfies – and she says she sometimes has to pinch herself when she sees the person staring back at her.
And Susan isn’t the only one stunned by the transformation.
When her surgeon shared before-and-after photographs on social media, the images sparked a whirlwind of reaction, with strangers repeatedly claiming she appeared decades younger.
Susan says her husband Rob was supportive and helped her throughout her recovery process
‘Is this real?!?!?! COME ON. Impossible to believe in the age of AI. Looks 25 years younger,’ one person wrote on Instagram.
Another said: ‘I audibly gasped and exclaimed “holy sh**” at this,’ while a third added: ‘Holy smokes she looks 25 years younger, absolutely stunning.’
‘In the comments on social media people say I went from 60s to 30s or 40s,’ the mother-of-two says. ‘Many people say I look like I could be the daughter.’
But Susan insists looking younger was never the main objective.
‘Everyone says how much younger I look, and yes, I do feel much younger,’ she says. ‘However, I did not go in there wanting to look younger necessarily. I just wanted to look different than I did. Looking younger was a wonderful perk!’
Susan, it must be said, is far from alone in being unhappy with the effect major weight loss had on her face.
It is well known that significant weight loss can dramatically change the appearance of the face.
Just as diet and exercise reduce fat elsewhere in the body, fat is also lost from beneath the skin of the face, where it helps give the cheeks, temples and other areas their youthful volume.
As this padding disappears, the skin can become looser and previously subtle lines and wrinkles more obvious. The cheeks may appear hollow, while sagging around the jaw can create more prominent jowls.
The effect has become widely known as ‘Ozempic face’ following the huge rise in the use of weight-loss injections such as Ozempic and Wegovy, also known as GLP-1 drugs.
Now, with millions of Britons and Americans using the shots, plastic surgeons are reporting a surge in patients seeking treatments to correct these changes.
A survey released this year by the American Academy of Facial Plastic and Reconstructive Surgery found 67 per cent of facial plastic surgeons had seen an increase in patients seeking treatment related to rapid weight loss – a 45 per cent rise on the previous year.
And demand appears to be translating into more surgery. Facelifts increased by 13 per cent in the US last year, while neck lifts rose 21 per cent.
Data from the British Association of Aesthetic Plastic Surgeons reported a similar trend – with face and neck lifts increasing by 11 per cent in the past year.
Experts say the weight-loss drug boom is likely to be one factor driving the increase, although similar changes to the face can occur following any substantial weight loss.
For milder changes, treatments such as injectable fillers can replace some of the lost volume, while lasers and other skin treatments may improve fine lines and skin texture.
Side-by-side comparison photos of Susan two years post surgery
Dr Vito Quatela says each patient’s cosmetic procedure journey is ‘individualized’
The entire surgery took about 10 hours
But these cannot remove significant amounts of loose skin. Where substantial sagging has developed around the lower face and neck, only a facelift – in which deeper facial tissues are repositioned and excess skin removed – can produce a dramatic and longer-lasting change.
Susan already knew which surgeon she wanted to see.
Her younger sister had previously undergone eyelid surgery with Dr Vito C Quatela, a Rochester facial plastic surgeon with more than 35 years’ experience, and had highly recommended him.
But deciding she wanted surgery and actually making the call were two different things.
Susan describes herself as a ‘Virgo who plans everything down to the smallest detail’ and says she was plagued by anxiety and second thoughts.
Finally, in June 2024, she picked up the phone and booked a consultation.
‘I’m a nervous person and when I made the phone call, which is always the first step, no matter what you’re trying to do to improve your life, that first step is the hardest thing,’ she says.
‘So once I made that phone call, I put it out of my mind until I knew it was coming up.’
At an initial appointment, Susan explained what bothered her about her face and was shown computer-generated images of how she could potentially look after surgery.
Seeing that possible transformation was enough to convince her to continue.
When she later met Dr Quatela, however, it became clear that what she was contemplating would be far more extensive than a simple facelift.
Together, they settled on five procedures: a facelift, endoscopic forehead lift, chin implant with chinpexy, lip lift and full-face laser resurfacing.
The bill came to around £37,800 ($50,000), she estimates.
And on August 15, 2024 – after roughly two months of consultations and years of agonizing over whether to have surgery at all – Susan finally went ahead.
It would be no minor procedure.
Susan poses with her daughter in a selfie – something she used to dread. She says she now loves taking photos
Susan was under anaesthetic for around ten hours as Dr Quatela and his team worked on virtually every area of her face, from her forehead to her neck.
The facelift itself involved lifting and repositioning tissue in the lower face and neck, including the jowls that had begun to sag following her weight loss.
But Dr Quatela says modern facelifts are about more than simply pulling loose skin tighter.
‘A facelift today isn’t just about pulling the skin – it’s a contouring operation,’ he says.
In Susan’s case, he lifted her jowls to create a more heart-shaped contour to her face and performed a forehead lift to address loose skin higher up.
He also inserted a small chin implant and performed a procedure known as a chinpexy, repositioning the pad of fatty tissue over the chin that had begun to tip downwards.
According to Dr Quatela, correcting this can also sharpen the jawline and reduce the appearance of jowls.
‘Lifting the dropped chin pad certainly changes the contour of the lower face tremendously,’ he says.
Finally, Susan underwent laser resurfacing across her face to tackle something the surgery itself could not – the crepey texture, lines and wrinkles in her skin.
Susan’s reasoning for having so much done at once was straightforward – if she was going under anaesthesia, she says, she was ‘going to get it all done’.
Her husband Rob drove her to the surgical center for the 2pm operation. By the time it was over, around ten hours later, it was close to midnight.
When Susan woke, the transformation was impossible to see.
Her face was almost entirely obscured by bandages and thick ointment from the laser treatment. It was badly swollen and bruised, with drains and screws protruding from her head and stitches running along her hairline and around her ears.
Yet Susan says she wasn’t horrified.
She was ecstatic.
Taken to a private recovery area where a nurse was available around the clock, she remembers lying awake, too excited to sleep.
‘I was like a kid in a candy store in the recovery center,’ she says. ‘I couldn’t believe I had done it.
‘It was over. It was the scariest thing I could ever think of to do, and I had done it.’
Remarkably, Susan says she experienced little pain the following day. A headache was treated with a nerve block, an injection of local anaesthetic, and Rob arrived that morning to take her home.
He was, she admits, somewhat taken aback by the sight of her swollen and bruised face.
Their children were even less prepared.
‘They just wanted their mom back while I was healing,’ Susan says.
For the first few days, she needed considerable help.
She couldn’t shower normally or get in and out of the bath unaided, while the swelling around her jaw was so severe that she could barely open her mouth.
She survived largely on soup and coffee drunk through a straw, with Rob helping her around the house.
Susan ultimately took around two weeks off work.
But looking presentable and being fully healed were two very different things.
Dr Quatela warns patients that it can take around six months for the swelling and other effects of such extensive surgery to completely settle.
‘The two phases of healing are when you’re presentable, and when everything is better,’ he says.
Often, he adds, patients are pleased with the results long before the healing process is complete because they can already see the changes to their neck, eyes and facial contours.
For Susan, the real turning point came around two months after surgery.
By then, the worst of the swelling and bruising had subsided and she felt comfortable putting on makeup and going out again.
On October 15, her extended family was holding a party.
Only a few months earlier, the prospect of being photographed at such a gathering would have filled Susan with dread.
This time, she couldn’t wait.
‘I could not get there fast enough,’ she says.
She dressed up, did her makeup and arrived feeling, she says, ‘the most like herself’ she had in years.
‘My relatives knew I had something done, but they couldn’t tell what,’ Susan says.
More striking was what happened when the cameras came out.
The woman who had once hidden at the back of family photographs now wanted to be in them. And that change has lasted.
‘Now my phone is full of selfies, absolutely full of selfies,’ she says.
Susan jokes that anyone finding it might assume she was ‘a very egotistical person’.
But even now, she says, she sometimes looks at the photographs and has to remind herself that the woman staring back really is her.
Susan is aware that spending £37,800 ($50,000) on cosmetic surgery will strike some people as excessive – and that others believe ageing is something that should simply be accepted.
But she rejects the idea that wanting to change her appearance was merely an act of vanity.
‘Whatever it takes to help you have confidence and self-love for yourself is the most important thing to do,’ she says.
For Dr Quatela, the aim of surgery like Susan’s is not to make a patient look like somebody else, but to alter a series of relatively small details which, taken together, can dramatically change the face.
He describes himself as a ‘three-dimensional problem solver’ who tries to picture the finished result before he begins operating.
‘Each one of those little things makes a small difference,’ he says. ‘But when you put it all together, it’s a big difference. It’s transformational.’
Susan agrees. ‘Life is too short to hide from the world because you don’t like how you look,’ she says.
‘Go out there and do it, start living again.’
