You Could Get a $50,000 Facelift for Less Than Half-Price

17.12.2025, 16:16 allure.com

Everyone loves a deal. But there are certain products and services in life where it could be, let’s say, less than optimal to shop for the deepest discount. Engagement rings come to mind. Criminal defense attorneys. Shellfish. And most people would probably add plastic surgery to the list. The old adage, “you get what you pay for,” carries a particular sting when it comes to your face or your body. And yet you may have noticed some social feeds recently touting a specific kind of aesthetic bargain, for example this TiKTok about influencers getting discounted plastic surgery from surgical fellows at Lenox Hill Hospital in New York City.

After talking to plastic surgeons at every level—from residents and fellows to board-certified surgeons—I can confirm that this is a legitimate and longstanding medical practice occurring not just at Lenox Hill, but at teaching hospitals and academic institutions all over the country. Plastic surgery fellows routinely operate at discounted rates in the process of advancing their training and honing their aesthetic skills. Patients of all stripes can take advantage—the opportunity isn’t exclusive to social-media somebodies—and there’s nothing unsavory about it.

Historically, though, “fellows’ clinics” were something of an insider’s secret, my sources say. “It was known within the hospital community that there was this program where you can have surgery done at a lesser cost, but a fellow does the procedure,” explains J. Madison Clark, MD, chief of the division of facial plastic and reconstructive surgery at UNC Chapel Hill, director of the department’s fellowship program, and chair of the fellowship committee for the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). “The nurses would talk amongst themselves to find out which fellows had good hands, and then a nurse who might be ready for a facelift would schedule with that fellow.” But recently, thanks largely to social media, word has spread beyond hospital walls. On the heels of the aforementioned TikTok, Dr. Clark’s office fielded multiple calls from people asking how much his fellows charge for a facelift. In the 10-year history of the fellowship, this is the first time he’s ever received such inquiries.

While many fellowships do offer substantial price cuts—on the order of 50% or less of the particular surgery’s going rate—“I don’t want to give the impression that it’s dirt cheap,” says Mark G. Albert, MD, program director for the Aesthetic Surgery Fellowship at Manhattan Eye, Ear, and Throat Hospital (MEETH), a division of Lenox Hill Hospital. In light of the attention his program has received of late, he says, “I think it's important to set the record straight” about both the costs involved and the quality of care at these clinics. But first…

For starters, “these are not medical students experimenting on you,” says Dr. Clark. Fellows are full-fledged, licensed plastic surgeons who’ve graduated from accredited residency programs and thus have completed their formal training. But instead of going straight into practice, they’ve chosen to devote an extra year to learning the nuances of aesthetic surgery, specifically. “They'd otherwise be out in the community operating, but they're seeking the highest level of training possible,” says Dr. Albert.

While each fellowship has its own flavor (MEETH emphasizes facial surgery, for example, where other programs may focus on breast and body), they’re all designed to offer an intensive deep dive into aesthetic surgery under the mentorship of some of the biggest names in the field. A surgeon who scores a top fellowship “can get, like, a 15-year head start on anyone who goes straight into practice out of residency,” says Faryan Jalalabadi, MD, a fellowship-trained, board-certified plastic surgeon in Beverly Hills.

Surgeons generally play a dual role in fellowship. In the early months, they’re observing in the operating room and helping to care for their program directors’ patients. When they scrub in on a senior surgeon’s case, they’re assisting—holding the retractor, cutting sutures—but they’re not typically doing any portion of the procedure unless the patient has consented to it, which is pretty rare. “If a plastic surgeon is charging $100,000 for a facelift, the person having it done is going to expect that surgeon to be their [only] surgeon,” notes Dr. Clark. “They don’t want to have the quote-unquote medical student doing any part of that.”

“These are not medical students experimenting on you.”

Once fellows have proven themselves to be safe and competent, they’ll usually be given “the green light to start seeing their own patients in the fellows’ clinic,” says board-certified plastic surgeon Bob Basu, MD, who is a fellowship director and the president of the American Society of Plastic Surgeons (ASPS). “By the time someone is six months into my fellowship, they’ve probably seen at least 200 breast augmentations, just to give an example, and that’s in addition to everything they saw and did in their six to nine years of residency.” In other words: “This is not a newbie dabbling in surgery,” he says.

Fellowships may introduce surgeons to specific techniques they haven’t seen before, though. “I saw zero deep plane facelifts in my residency, and I operated in the biggest medical center in the world,” says Dr. Jalalabadi. The deep plane (an advanced technique that releases and repositions the tissues in a lasting and natural-looking way) was a focus of his fellowship, however, and is now, four years later, a mainstay of his practice. “My fellowship program had a strong clinic built in, where I could book my own cases and I had supervision,” he says. “It’s crazy, the amount of learning that happens when you actually do a technique for the first time.”

Which is precisely the point of a fellows’ clinic: Instead of merely watching or assisting, fellows can devise surgical plans and operate autonomously, but with the safety net of having a mentor nearby. In the clinic, “the co-surgeon model is flipped,” says Tyler Safran, MD, a dual fellowship-trained plastic and reconstructive surgeon in Montreal. “The fellow becomes the primary surgeon of record, and the senior surgeon is assisting or at least available to help.” When Jason Bloom, MD, a double board-certified facial plastic surgeon and co-director of the Facial Plastic & Reconstructive Surgery Fellowship program at the University of Pennsylvania, allows fellows to do aesthetic cases in his private surgery center, he’s “always around in case they have questions,” he says. “I could be in the other room operating, or I could be across the parking lot at my office, but I’m nearby to assist if needed.”

Some residency programs offer similar experiences—what’s known as resident aesthetic clinics or chief cosmetic clinics—enabling plastic surgery residents in their final years of training to perform injectable treatments or surgical procedures on patients for a nominal fee. (Residents’ clinics have been around since the late ’80s; today, upwards of 75% of plastic surgery programs have them.) A critical difference between residents’ clinics and fellows’ clinics is the degree of oversight. Residents require direct supervision, as in a senior surgeon (a.k.a., an attending) in the room with them. When a fellow is operating, however, “there’s not necessarily going to be an experienced surgeon looking over their shoulder,” says Dr. Clark. “Some fellowship directors may do that, but that's largely going to be the exception rather than the rule.”

Every plastic surgery resident must log a certain number of surgeries across the breadth of the specialty, including a minimum of 150 aesthetic cases. “By your final years of residency, you’re functioning as a surgeon,” says Matthew Farajzadeh, MD, a plastic and reconstructive surgery chief resident at UC Davis. “You still have supervision, and you still have to answer to the attendings, but you’re fully working as a surgeon in the hospital.” Otolaryngology (ENT) residents, who may be training to become facial plastic surgeons, have their own case requirements. In both fields, each five- to eight-year residency affords its own mix of cases and its own unique ratio of reconstructive to cosmetic procedures.

With certain exceptions, dedicated “aesthetic training is probably the weak point of the majority of plastic surgery residency training programs,” says Jacob M. Marks, MD, a fellowship-trained plastic surgeon in Gilbert, Arizona. Training tends to focus more heavily on the reconstructive side of surgery. Dr. Clark says the same for otolaryngology: “Most residencies don’t have a lot of cosmetic exposure.” Studies have even shown that graduating plastic surgery residents feel “deficient in performing aesthetic procedures, particularly those of the face.” This is partly due to the fact that patients paying out-of-pocket for elective cosmetic surgery generally prefer to see surgeons in private practice rather than in the hospital setting where residents work.

Addressing the gap in hands-on aesthetic training are resident cosmetic clinics. Here, senior residents take the lead on cases, consulting with patients, planning and executing operations, and handling follow-up care. “I know in the outside world, people are like, ‘Why would anyone go and get something done by a resident?’” says Milind Kachare, MD, a fellowship-trained plastic surgeon in St. Louis. “But you’re not only being taken care of by that resident. They’re fully monitored by an attending surgeon.” As a rule, residents can’t fly solo in the OR because they’re not yet licensed plastic surgeons. “Any procedure they perform is under the supervision of an attending surgeon—a professor, program director, or faculty member,” says double board-certified facial plastic surgeon Babak Azizzadeh, MD, who is a fellowship director and the president-elect of the AAFPRS. “But that supervision can be light or severe”—meaning the attending may obs