On ‘Over 50 & Flourishing’: Dr. Oren Tepper Pushes Back on the Anti-Surgery Backlash

When it comes to beauty and aging, few topics spark as much debate as plastic surgery. For some, it represents empowerment and a sense of choice. For others, it still carries stigma and judgment.

On Over 50 & Flourishing, host Dominique Sachse sat down with Dr. Oren Tepper, a board-certified plastic surgeon in New York City, to discuss what’s really happening in the world of aesthetics today. Sachse opens the conversation by pointing out a cultural shift she’s noticed online. “There’s this trend of going natural,” she points out. “Letting gray come in, aging naturally, abandoning certain things that were popular.” While she appreciates individuality, she also admits that there is “almost this online bullying against women who are now opting to do [plastic surgery procedures].” 

Dr. Tepper acknowledges that shame has been a big part of the conversation in the past, but he sees change happening. “I definitely have seen that trend, and I think it hit sort of an all-time low in terms of people feeling ashamed or being shamed for considering and doing this stuff,” he explains. “I think things have come back the other way, which I’m pleased about.” 

Plastic surgery is about individuality 

At the heart of the discussion is a simple but powerful idea—choice. Tepper believes that plastic surgery should always be tailored to the individual. In his practice, the first thing he asks a patient isn’t about what procedure they want—it’s about motivation. “The very first question really is what’s bringing them here,” he explains. “Are they doing it for themselves? And that’s, for me, one of the most important checkpoints before considering doing anything.” 

This emphasis on self-driven decisions shifts the narrative away from societal pressure. It’s not about pleasing a partner, fitting into a trend, or avoiding criticism online. It’s about aligning with what makes someone feel confident and comfortable in their own skin. 

Meeting expectations matters most 

When undergoing a procedure—cosmetic or otherwise—realistic expectations should be set. Tepper emphasizes that the best outcomes occur when a surgeon and patient are aligned from the outset. “The best outcome is meeting expectations. And that’s irrespective of what I can do. It’s irrespective of the procedure,” he says. 

To help bridge the gap between vision and reality, he utilizes advanced tools such as 3D imaging. By showing patients potential results, he ensures they’re speaking the same “language.” While it’s not a guarantee of the exact outcome, it helps eliminate confusion and uncertainty. “At least we have the same target, we have the same goals, we have the same endpoint in mind,” Tepper explains. 

Addressing the stigma 

Both Sachse and Tepper acknowledge how frustrating it can be when assumptions are made. Sachse shares that she’s even accused of having procedures she never had: “They just assume by my looks that I’ve had certain things done.”

Tepper agrees that judgment often overshadows reality, and that needs to change. “It’s tough to see that sort of pushback,” he says. “But part of that, I think, is the willingness of men and women to talk about their experience.” 

As more people share their stories—openly and without shame—the stigma starts to fade. Tepper views this shift as crucial, not only for those considering surgery, but also for how society perceives aging in general. 

Freedom over perfection 

Ultimately, the conversation reframes plastic surgery as something far more personal than cosmetic enhancement. It’s about defining beauty on your own terms, not chasing perfection. As Sachse puts it, “I am all about individuality. I’m about information. I’m about truth. And I’m about a person making the best decision for his or her life.” 

For those navigating their own choices, this is a reminder that empowerment comes in many forms. Whether it’s embracing gray hair, opting for Botox, or considering a facelift, the most essential factor is that the decision to have, or not have, plastic surgery is yours.  

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