Times they are a-changin’ and so are our ideas about beauty and what – or who – is the most beautiful.

How do we know?

People magazine, of course.

Each year, People Magazine curates a World’s Most Beautiful list, and researchers from Boston University School of Medicine took a look back to see if they could identify any changes in age, sex, race, skin type, hair color, eye color and skin conditions between 1990 and today.

They compared 50 celebrities from the 1990 list to 135 celebrities from the 2017 list and found some important differences. In 1990, lighter skin trumped darker skin among the chosen few, but in 2017, the gap between the two skin types lessened as growing numbers of darker skin beauties made People’s coveted list. The proportion of celebrities of nonwhite races also increased from 24 percent in 1990 to 40 percent in 2017, the study found. Celebrities of mixed race were represented by one person (2 percent) in 1990 and by 14 people in (10.4 percent) in 2017. There’s more: The average age of celebrities on the list increased from 33.2 in 1990 to 38.9 in 2017.

Dr. Rizk responds:

These findings make perfect sense. Our standards of beauty are shifting, and we are embracing women and men of different cultures and realizing that age is just a number. This is very much in line with our collective avoidance of the term ‘anti-aging’ as we are seeing that beauty is, in fact, ageless. My facial plastic surgery patients don’t want to look younger, they want to look like the best versions of themselves. It is all about natural and subtle enhancements today. Gone are the days when more dramatic and severe results were in favor and fashion. Today, most patients also want to embrace their culture and heritage, rather than to erase it. This is a paradigm shift from what we saw in years past and it resonates with consumers.

That said, there are subtle differences among skin types and thickness, bone structure and aesthetic goals among people of all ethnic backgrounds and generations that can affect facial plastic surgery results. Some darker skin types may be more prone to keloid or scarring issues, for example. Skin of color is also often thicker than fair skin types, which can affect the outcomes of surgical procedures.

It is important to choose a facial plastic surgeon who has experience treating various skin types. My toolbox for such patients may include Arnica Montana pellets, vitamin C and bromelain, plus topical scar gels to minimize inflammation following surgery to minimize bleeding and swelling and encourage faster healing. Always ask to see before and after photographers of patients with similar backgrounds and ages when evaluating a plastic surgeon or facial plastic surgeon’s work. Asking these questions will allow you to make a more informed decision. A candid discussion about expectations will also help minimize the chances of disappointment and dissatisfaction with your results. As our ideals of beauty are changing, and it is important that your idea of beauty and that of your surgeon are very much aligned.