As the “forgotten generation” squashed between the culturally dominant Boomers and millennials, the people born between the late 60s and 80s often go under the radar in conversations about Botox online.

But that generation is now arriving at plastic surgeons’ offices not just for wrinkle treatments, but for facelifts once reserved for patients 15 years their senior, driven by a wave of GLP-1 weight-loss drugs that are hollowing cheeks, sagging jowls, and accelerating facial aging in ways Botox simply can’t fix.

The youngsters who watched Michael Jackson and Madonna on MTV are now middle-aged adults who are feeling the “natural signs of aging that occur in your 40s and 50s,” according to Dr. Bob Basu, the president of the American Society of Plastic Surgeons.

“Men and women want to restore the best version of themselves, and I think that helps to drive demand for minimally invasive procedures,” Basu told Fortune.

Gen X is also going beyond fillers and Botox and into surgeries once reserved for more elderly patients, a trend that’s driven by both awareness of facial aging and GLP-1s.

“You know, 25 years ago, the people who would get face lifts are basically a 60-plus crowd. That’s not the case anymore,” Basu told Fortune. “We’re seeing more and more patients in their 40s and 50s that are opting for facial rejuvenation.”

Basu explained that GLP-1s can often lead to loss of volume and sagging in people’s cheeks, jowls and necks, hence the demand for surgery in the Gen X group that would otherwise be fairly young for those procedures.

The American Academy of Facial Plastic and Reconstructive Surgery reported a 50% rise in fat-grafting procedures in 2024, with surgeons directly attributing the spike to “Ozempic face” — the hollowed cheeks and sagging skin that follow rapid GLP-1-driven weight loss. One in four facial plastic surgeons now anticipates GLP-1s will continue driving demand for both surgical and nonsurgical treatments.

A 2025 American Society for Dermatologic Surgery survey of more than 3,500 consumers found that the respondents in the elder millennial and Gen X range wanted to look as young as they feel or better for their age, and are worried about lines and wrinkles around the eyes and mid-face.

Surgeons also point to a lasting “Zoom boom” effect — Gen Xers who have now spent years staring at their own faces on video calls during the pandemic and become acutely aware of their facial aging in a way prior generations never experienced.

Meredith Finn, a paid leave specialist and Gen Xer, first started getting Botox after hearing about it from her mom’s country club friends, and has been getting injections a few times a year ever since.

“I just started to feel like I was seeing more lines around my eyes or something, and thought I would just go check out this doctor my mother had heard was good,” Finn told Fortune.

The economics of fillers and Botox compared to plastic surgeries

Finn said she would get injectables more often if she could afford it. Botox treatment costs $420 on average, much cheaper initially than surgery, but it requires injections every few months to maintain the results, since the neuromodulator wears off.

With surgery, on the other hand, the results are permanent, which could be cheaper and more effective in the long run. This may explain why nearly two in five of all surgical procedures were done by Gen X, though double the number of people opted for minimally invasive procedures.

Still, the sheer scale of Gen X’s appetite for injectables is striking: people between 40 and 54 underwent close to 11 million minimally invasive procedures in 2024, accounting for more than half of all neuromodulator injections — Botox, Dysport, Daxxify and similar treatments — that year, more than millennials, Gen Z, and a slice of Boomers combined, according to the latest data from the American Society of Plastic Surgeons.

“The reality is minimally invasive may not be the best option to achieve their goals, and so many times, surgical procedures are the best route,” Basu said.

Gen X currently drives beauty sales for products focused on anti-aging and can increasingly afford to pay for multiple thousand-dollar-a-piece cosmetic surgeries, with its buying power projected to hit $23 trillion in the next decade, the highest spending generation in the world.