AT A GLANCE

Key Takeaways

• Millennials are the most anxious generation about visible aging, with 52% worrying about it at least once a week, compared to 38% of Gen Z, 31% of Gen X, and just 23% of Baby Boomers.
• Gen Z is already the generation most likely to have gotten treatment, with 15% receiving a cosmetic or aesthetic treatment in the past year, more than double the rate of Gen X and Boomers (4% each).
• Gen Z believes maintenance should start before 30 at nearly four times the rate of every other generation, with 64% saying so compared to 27% of Millennials and just 17% of both Gen X and Boomers.
• Nearly half of Americans (47%) point to social media, AI-generated images, or beauty filters as the single biggest reason people are starting aesthetic maintenance earlier, and Gen Z leads that blame at nearly 60%, more than double Boomers’ 28%.
• 13% of Gen Z have used credit or financing to pay for beauty or aesthetic expenses, compared to just 2% of Gen X and 1% of Boomers, a financing gap concentrated almost entirely among the youngest adults.
• 84% say beauty filters and 81% say AI-enhanced images have made it harder to know what’s realistic, yet Boomers agree at higher rates (90% and 89%) than Gen Z (76% and 70%), despite using the technology far less.
• 72% of Americans consider maintaining their appearance a form of long-term self-care, but Gen Z is the least convinced of that framing (61%), trailing every older generation (75-78%).
• Safety (82%) and looking unnatural (77%) remain the top fears holding Americans back from treatment. Yet, Gen Z reports the lowest concern of any generation on safety and cost specifically (78% and 74%), and only 6% say they’d never be comfortable considering treatment, versus 31% of Boomers.

WHEN MAINTENANCE BEGINS

Gen Z Has Moved the Starting Line For Aesthetic Maintenance

“Preventive maintenance,” or the practice of getting procedures before any wrinkles or lines appear, has become the new norm among Americans. Instead of setting up a Botox appointment when wrinkles appear, more people than ever believe in starting aesthetic maintenance while young in order to maintain that appearance. Professional aesthetic maintenance is gaining a younger clientele than ever before, even though not everyone thinks it’s necessary.

Almost half of Americans (47%) believe that aesthetic maintenance (e.g., Botox, fillers, and other anti-aging treatments) should be started before age 35, including 32% who believe this should start by age 30. Another 22% believe that aesthetic maintenance should begin before age 26, including 14% who believe women should get these treatments before age 21. This is more than the 13% who say treatments should begin at the first visible signs of aging, meaning more people are comfortable with teenagers getting injections than the idea of aging naturally.

However, these numbers are heavily influenced by the younger generation, who place far more importance on aesthetic maintenance. Three-quarters (73%) of Gen Z believe that aesthetic maintenance should start before age 35, including 64% who think it should start before age 30. This is over double the amount of millennials who said before 30 (27%), three times the amount of Gen X and boomers who agreed (17% each). With most members of Gen Z only approaching their thirties, they already feel the need to invest in anti-aging procedures before they’ve even aged.

Gen X and boomers believe in a more extended timeline. A third (31%) of Gen X believe that aesthetic maintenance should only begin once you see visible signs of aging, and 20% of boomers agreed. However, even more boomers hadn’t given it much thought in the first place: 26% of the generation wasn’t sure when aesthetic maintenance should start, the most of any generation. Because many of these procedures gained popularity in the 90s and 2000s, many boomers never had to incorporate them into their lives, or consider when they should seek them out themselves.

WHAT’S DRIVING IT

Blame the Feed: What’s Driving Younger Treatment

Everyone has a theory about why people are starting aesthetic procedures younger. Some point to the front-facing camera, and to the hours spent watching your own face react on a Zoom call. Others blame the filters that smooth a jawline before a photo is even taken, or the AI tools turning out perfect faces that were never real to begin with. While new tech makes it easier to post a stunning selfie, it can stunt self-image in return.

Social media is the leading suspect. A third of Americans (34%) named it the single biggest reason people are starting aesthetic maintenance younger, followed by general appearance pressure at 21%. Combined with AI-generated images (8%) and beauty filters (5%), screen-driven causes accounted for almost half (47%) of responses. Far fewer people credit the beauty industry itself: only 5% cited more affordable treatments, and another 5% named greater acceptance of cosmetic procedures. Whatever else has changed, Americans believe the pressure is coming through the phone screen.

Gen Z points the finger hardest. Nearly 4 in 10 (39%) cite social media on its own, and 13% name AI-generated images specifically, the highest AI attribution of any generation. Their combined attribution to social media, filters, or AI reaches nearly 60%, while just 13% blame general appearance pressure, the lowest of any generation. Millennials follow the same pattern at lower intensity (33% social media, 45% combined). However, the second-loudest voice belongs to Gen X, where 36% cite social media and 48% point to screen-driven causes overall. Blaming the feed is not only a young person’s position.

Boomers see it differently. Only 23% cite social media, the lowest of any generation, and their combined attribution to social media, filters, or AI stops at 28%. Instead, 36% blame general appearance pressure, more than any technology-specific cause, and the highest of any generation. Because boomers watched beauty standards shift for decades before the first filter existed, the pressure reads to them as the constant and the platform as the new arrival. Men and women split along similar lines, with men more likely to blame technology directly (50% vs. 43%) and women leaning toward general appearance pressure (27% vs. 14%). However, the generation pointing hardest at the feed is not the one most worried about aging itself.

WHO WORRIES MOST

The Generation Losing the Most Sleep Over Aging

Most people spend more time thinking about aging than they would admit. It’s not always a conscious worry, either. They pause before posting a selfie, or look in the mirror a little longer each morning, trying to spot wrinkles. Some people experience this a few times a year – but others go through it daily.

Over a third of Americans (37%) worry about visible signs of aging at least once a week, including 9% who worry about it every day. A quarter (24%) say they never worry about it at all. Compare that to the 13% who believe aesthetic maintenance should wait until visible signs of aging appear, and the mismatch is clear: far more people are worrying about aging than are waiting for proof of it.

Millennials worry the most. More than half (52%) worry about visible aging weekly or more, the highest of any generation, and only 16% say they never worry, the lowest of any generation. Gen Z sits noticeably lower at 38%, despite having the strongest belief in preventative maintenance. However, a share of Zoomers is keeping pace: 15% of Gen Z said they worry about aging every day, only a point behind their generational predecessors. While fewer zoomers on the whole are worrying, they’re worrying far more intensely.

Older generations are not as concerned. Under a third (31%) of Gen X worry weekly or more, and 24% say they never worry. Boomers worry least of all, with only 23% worrying weekly or more and 38% saying they never worry about visible signs of aging. This could be attributed to a few things. For one, older generations have had decades to watch their faces change and accept aging as a natural process. These generations also joined social media as adults, when they were less vulnerable to the unrealistic expectations these platforms can create. Gen Z and millennials joined social media as children and teens, and formed their self-image based on what they saw.

BARRIERS TO TREATMENT

The Fears That Keep People Out of the Chair

There’s usually a gap between wanting a treatment and actually booking one. Most people aren’t stuck on whether it works; they want to know they’ll still look like themselves, and that they can trust the person holding the needle. Those are reasonable things to want, and they’re exactly what a first consultation is for.

When considering cosmetic procedures, Americans had these worries on their minds:

• Safety risks or side effects (82%);
• Cost (81%);
• Choosing the wrong provider (78%);
• Looking overdone (77%);
• Not knowing enough about the treatments (72%).

No single barrier dominates, which is part of the problem. Someone considering a consultation is usually weighing all of them at once – especially women.

Women were more cautious than men on nearly every fear tested, and by a consistent margin. They were likelier to worry about safety (87% versus 78%), cost (87% versus 75%), choosing the wrong provider (83% versus 73%), and looking overdone (82% versus 73%). That caution likely comes from proximity. A woman who has watched her friend’s results settle badly or seen results from an inexperienced injector has a much more specific fear than a man who is only vaguely aware of these procedures.

However, young Americans are all-in on cosmetic procedures. Only 8% of Americans had received a cosmetic or aesthetic treatment in the past year, but that number nearly doubled among Gen Z (15%). Only 6% of Zoomers said they would never be comfortable considering one, the lowest of any generation. That isn’t to say they aren’t worried – but those worries aren’t always stopping them. Gen Z reported the lowest cost concern of any generation (74%), while millennials had the lowest safety concern (77%).

Gen X reported the greatest concern of any generation on both safety (89%) and cost (88%), with baby boomers close behind at 86% and 84%. Only 4% of each had received a treatment in the past year, less than a third of the number of Zoomers who had done the same. Nationally, 15% said they would never be comfortable considering treatment under any circumstances, but that climbed to 19% among Gen X and 31% among boomers, more than five times Gen Z’s rate.

Paying for it is where the generations separate further. More than 1 in 8 Gen Z respondents (13%) had used credit or financing for beauty and aesthetic expenses, along with 9% of millennials. That figure drops to 2% among Gen X and 1% among boomers. Aesthetic maintenance has become highly normalized for Gen Z, and many of them see these procedures as no different from a haircut or a manicure. Even if they’re not experiencing anxiety, they have just as much desire to look young.

FILTER & EDITING HABITS

Inside America’s Camera Roll

A quick search for photo editing apps in the app store yields thousands of results, each with hundreds of downloads and reviews. People turn to these programs en masse, looking to whiten their teeth or edit out a pimple. But for some, these tools become less of a feature and more of a lifeline.

Roughly a quarter of Americans (27%) use in-app beauty filters at least weekly, and 19% use AI-powered photo editing tools with the same frequency. Built-in smartphone editing tools are slightly more popular than dedicated filter apps, with 28% reaching for them weekly or more. Even if they know these filters can distort their self-image, people are still using them to make their selfies picture-perfect.

The habit is more common among younger Americans. Gen Z leads in both major categories, with 41% using in-app filters at least weekly and 45% using built-in smartphone editing tools at the same rate. Millennials trail closely on filters at 40%, and actually edge ahead of Zoomers on AI-powered editing tools, at 28% vs. 27%. The drop-off after that is steep. Only 15% of Gen Xers use in-app filters weekly or more, and only 12% use AI editing tools. Boomers are nearly absent from the category altogether, at 7% for filters, 6% for built-in editing tools, and 3% for AI tools. Everyone up through millennials edits regularly, and almost no one after them does.

Perhaps surprisingly, men edit their photos more than women in every category tested. Nearly a third of men (30%) use in-app beauty filters weekly or more, compared with 24% of women. That pattern holds for built-in smartphone editing tools (32% versus 23%) and dedicated apps like Facetune (22% versus 15%). Women may edit less than men across the board, yet they are far more likely to say filters (75% versus 64%) and AI images (73% versus 64%) are actively fueling appearance pressure. This may be the reason that women are using these apps at lower rates: they’re more aware of the ways they can distort their self-image, and instead decide not to use them at all. Meanwhile, men are feeling vulnerable to the beauty standards enacted on them, and are still learning how to handle the pressure to look perfect. Their reality is changing fast — even if they don’t think the filters are to blame.

PERCEPTION VS. REALITY

Nearly Everyone Thinks Filters Distort Reality

Beauty apps, automatic filters on cameras, and AI editing tools have made it easier than ever to change a photo of yourself. You can change the lighting, slim down your nose, move the position of your head – and it all seems harmless until the person in the selfie looks nothing like the person in the mirror. However, the filters and tech that allow people to post their idealized selves online are affecting their confidence in real time.

The vast majority of Americans (84%) agreed that beauty filters have made it harder to maintain realistic beauty expectations, and 81% say the same of AI-enhanced images. Others believe that distortion is doing real damage. When asked whether filters make people feel more pressure to live up to beauty standards, 70% agreed, and 68% said the same of AI images.

Boomers were especially tough on beauty enhancement technology. Nine in ten (90%) boomers agreed that beauty filters distort reality; 89% of them said the same about AI images. Another 70% of boomers agreed that beauty filters and AI increase the pressure people feel to maintain their appearance. Gen Z sat at the opposite end, with 76% agreeing filters distort reality and 70% saying the same of AI images, the lowest agreement of any generation. It seems that by growing up alongside these filters and features, Gen Z has learned to internalize – or outright ignore – the pressures they create.

Gen X and millennials landed in between. Both agreed at similar rates that filters distort reality: 86% of Gen X and 84% of millennials said so, with 87% and 81% saying the same about AI images. However, millennials didn’t believe that distortion led to real pressure. Nearly three-quarters (73%) of Gen X agreed that filters and AI increase the pressure people feel about their appearance, the most of any generation; millennials agreed the least, at 67%. Millennials know that filters have changed beauty standards, but stop short of saying filters are what make anyone feel bad: a notable position for the generation that worries most about aging.

Methodology

Sarah Mess, MD, surveyed 1,000 U.S. adults via an online poll to examine attitudes toward aesthetic maintenance, the age at which treatment should begin, and the role of social media, filters, and AI-generated imagery in shaping appearance expectations. The survey also explored self-care framing, barriers to treatment, and actual maintenance behaviors. Results were analyzed across demographic segments, including generation and gender. Results are post-stratified where available. Percentages reflect self-reported data and may sum to more than 100% when multiple selections were allowed.

About Sarah Mess, MD

Sarah Mess, MD, is a board-certified plastic surgery practice and medical spa in Columbia, Maryland, serving patients across the Baltimore and Washington, D.C. area. Led by Dr. Sarah A. Mess, the practice pairs surgical expertise with a full range of non-surgical treatments, including neuromodulators, dermal fillers, and laser skin resurfacing. Every plan starts with a conversation about what a patient wants to change, which is where questions about timing and realistic expectations get answered.

Fair Use Statement

The findings and graphics on this page are available for non-commercial reuse. If you share them, please attribute Sarah Mess, MD, and include a link back to this original research so readers can review the full results and methodology.