His best work is invisible, Julius Few says. “I’m the guy you come to if you want to be able to tell people you did nothing and that’s believable. That is my job. No one should know anything other than, ‘My God, how can this person genetically be so gifted to look so good?’”
Few is also genetically gifted: tall, Black, and handsome, with a Poindextrous tone of voice. I met him recently at his office in Chicago, where he has practiced, researched, and refined the art of plastic surgery for two and a half decades. But first I met a woman waiting in his office named Alison Parenti, a Chicago native who carried a Margaux bag and introduced herself as a member of Dr. Few’s product team. I was late, due to train trouble.
It was Dr. Few Skincare that brought me to the Few Institute, his practice high above North Michigan Avenue. The dark glass bottles of moisturizer and Oil-Serum are made in Italy and have the sheen of luxury cars; you can find them at Neiman’s and Goop. But it’s his less perceptible work I find more interesting. Few is the Margaux bag of plastic surgeons and has spent years cultivating an outsize influence on the way we look from a place of relative obscurity—i.e., not New York or L.A. By his own claim, he has come up with Botox lip flips and tear-trough filler; he invented “stackable treatments”; he popularized the cannula as a safe alternative to the syringe for injections. “I get ideas that are random,” he tells me.
One of his most notable contributions to the cosmetic canon involves re-inventing “facial threads,” a non-surgical lifting technique that borrows from marionette physics. He had seen and been disappointed by the first generation of facial threads, which were made of polypropylene plastic or garden twine.
Around 2015, the president of the London-based aesthetics company Sinclair approached Few about their new product. Sinclair’s threads, called Silhouette InstaLift, utilized polyesters that degraded into skin gradually over a year, stimulating collagen production as they wore thinner. But in Paris, where Few witnessed them in action, doctors were stringing them all wrong—against the movements of the facial muscles rather than with them. One of his first stops after returning to Chicago was the cadaver lab. When he was satisfied with his work, he solicited four living female patients to receive his first threads. This, he says, is how he ended up meeting Gwyneth Paltrow.
Not long after his field trip to Paris, Few began traveling to Los Angeles to treat a California-based clientele, sometimes using his friend the surgeon and Botched star Paul Nassif’s office, sometimes making house calls. A longtime client who lived in Chicago happened to be a childhood friend of Paltrow’s; this client was also in Few’s initial threads cohort. (Fortuitously, all four of Few’s patient-zero group were friends of Paltrow’s.)
By his own claim, he has come up with Botox lip flips and tear-trough filler; he invented “stackable treatments”; he popularized the cannula as a safe alternative to the syringe for injections.
Few takes care of other household names, but none have been as openly supportive as Paltrow. “One of my really close friends happens to be a plastic surgeon, and his name is Julius Few,” Paltrow said in 2020, when I interviewed her for Allure. (Few had given her injections of Xeomin, a neuromodulator she was promoting.) He became known as a “holistic plastic surgeon” after a fateful In Goop Health Summit, when a participant posed a question that was more of a comment: “You certainly seem more holistic and naturopathic than any other plastic surgeon I’ve heard speak!”
Such a moment can contain the apotheosis of a plastic surgeon’s career, something akin to aesthetic knighthood: the endorsement of not only an Oscar winner but a lifestyle brand—and a title! “To me, being able to work on a famous face is like you’re an artist who is at MoMA,” he says. “It’s a level of refinement that is the ultimate.” Part of the legacy Few has stitched together came to him by chance or cosmos—everything else was grasped for and seized. The threads are hard to see, but then you look closely and there they are.
“Bring your chin up to the sky, just a little bit.” Few was directing a patient, a woman in her 50s, while he disappeared a finger-long needle into her cheek, bound for the inner corner of her eye. “You should feel nothing, really. That’s the way this should work.”
For a few reverent seconds, all of us watched Few’s hands. One: cannula-wielding, barely pulsing. The other: dancing along the tear trough as it flooded with hyaluronic acid. The needle came out. “It did exactly what it was supposed to do,” he remembers, pleased with the results. So was the patient, who began reminiscing about when she met the doctor.
“I’m the guy you come to if you want to be able to tell people you did nothing.”
Most plastic surgeons are known for a certain drama. Not Few. I had heard about regular patients who go to Few because they love him, and then follow up with another doctor they know will give them the dramatic work they really want. His worst reviews tend to feature the Silhouette threads, which do not seem to give people the results they are looking for—I’m being generous. Then again, it’s not a bad thing to be known as a minimalist, and especially not for Few, who has made it his whole thing.
This is a trait his mentors used to mock when he was a resident fooling around with filler. “Why are you wasting your time doing this?” they’d ask, but what they’d meant was: Why be a surgeon just to do the non-surgical? “I felt fundamentally like that was wrong,” he explains. He brings up heart surgery by way of example: catheters have done a wonderful job of reducing the need to open up a human chest. “Everybody wants the less invasive thing,” Few says. “I don’t have anybody who comes in and says, ‘What’s the most disruptive thing you can do to me surgically?’”
One of Few’s lifetime achievements came early in his career with the launch of Restylane, which would become the first hyaluronic-acid facial filler to be approved by the Food and Drug Administration, in 2003. Concerns about the formation of raised keloid scars in patients of color almost limited its approval to fair-skinned patients. In the plastic-surgery and dermatologic communities, ethnic diversity is scarce today and was scarcer decades ago. In 2004, about 3.6 percent of the plastic-surgery workforce in the United States was Black, and recent studies suggest this figure has more or less stayed the same. This disparity shaped the practice and led to, among other things, critical misinformation about skin of color in dermatology and plastic surgery.
Few knew that this was fundamentally unjust. And yet he grounded his argument not in the spirit of diversity but of commerce. “I told them, ‘If you only cater to this very specific sliver of reality—and we know that probably somewhere around 10 percent of eligible participants for cosmetic treatments actually do it—you don’t have much of a market,’” he says. The C.E.O. and founder of Medicis, the company behind Restylane at that time, offered to fund a study through Northwestern University that Few organized. (In 2014, Galderma acquired the rights to Restylane and a number of other injectables after entering a partnership with the parent company of Medicis, Valeant Pharmaceuticals.) The researchers discovered that not only were fillers fine for people of color but the results were superior because melanated skin tends to be thicker than fair skin. Restylane was approved for all.
Since then, Few has been tapped by a number of makers of fillers and other cosmetic injectables for a number of different projects. And he is remunerated accordingly: between 2017 and 2023, he received around a quarter of a million dollars from Galderma, Allergen, and Merz Aesthetics, the maker of Xeomin, for consulting fees and honoraria, according to Open Payments data from the Centers for Medicare & Medicaid Services.
His current philosophy on filler: Even less is even more. Part of the appeal of filling with hyaluronic acid, a substance already found in the body, has been the belief that it’s temporary and metabolized completely in less than a year. “The truth is, I think some component or percentage of original filler stays there essentially forever,” says Few. “To some percentage point, for much longer than we thought.” His touch is lighter now than it’s ever been.
On the morning I visited the Few Institute, “somebody highly visible” had apparently already been treated. Had I not been two hours late to our meeting—had the train I rode into downtown Chicago not rammed into a dump truck that had been unfortunately parked on the tracks in Gary, Indiana—it’s possible I would have caught a peek, but probable that I would have sooner seen Oprah Winfrey on my train playing the banjo with a hot dog. Privacy is not a privilege but an unalienable right to all of Few’s patients, even the nobodies.
Sometimes they arrive by a freight elevator that connects the clinic’s back door to the building’s parking garage. The waiting room is chairless, and patients are taken directly to treatment rooms with names such as Skyline or Mag Mile. Appointment schedules are double-checked for potential interpersonal conflict. “It’s like air-traffic control,” said Shahnaz Moinuddin, a nurse injector who has been with Few since he opened his practice. “We’ve got ex-wives and wives, a lot of stuff going on.” Some patients live blocks away and rely on Few’s nursing staff to smuggle them to and from home; they don’t want their doormen to know.
Nowadays, it’s common enough to see advertisements for plastic surgeons, be they banner ads for Brazilian Butt Lifts or viral before-and-afters on Instagram. When Few became board-certified, in 2001, the climate was much more hostile to personal public relations. The American Medical Association had banned physicians from advertising their services for most of its history, and even after these bans softened, digitally native surgeons—perhaps you see them in your feeds now?—have attracted derision from other, and usually older, practitioners.
Few has always had a canny approach to personal P.R. He gave one of his first interviews to his old University of Michigan roommate, Sanjay Gupta, on CNN. This led to other media opportunities. Few directed public relations for the American Society for Aesthetic Plastic Surgery from 2006 to 2013, before becoming the society’s commissioner of cosmetic medicine. “My dream opportunity was to be on a Barbara Walters special,” he says. He ended up doing two, including a 20/20 report in 2012 called “The Cutting Edge: Younger than Ever.”
The Hollywood Reporter recently announced the opening of Few’s new Santa Monica clinic with a photo of him and Paltrow, and the article prompted so many bookings that Few has decided to quiet his public-relations efforts, if not outright mute them: he was, after all, explaining this to a reporter who was interviewing him. Few was happy to talk about Paltrow and other friends whose names I’d already heard, but he offered little other detail about his personal life. Only when I asked about his current relationship status did he reveal he was engaged—to Parenti, on his product team. The wedding will be next summer, in Italy. I noticed they had matching Margaux bags: sage for her, navy for him, both suede.
Brennan Kilbane is a New York–based writer. He is originally from Cleveland, and his interviews and essays have appeared in GQ, New York magazine, and Allure, where he was recently on staff as a features writer
