Adriana Lima at 45: what the Madrid photos can and cannot tell you
Three years after social media called her unrecognizable, the same audience is calling her ageless. A facial plastic surgeon on what photographs can reveal about the neck, and where they stop being reliable.
Dr. Masoud Saman6 min read
On Friday, September 18, Adriana Lima walked the black carpet at El Corte Inglés's closing party for the 84th Mercedes-Benz Fashion Week Madrid, held for the first time at the Museo Reina Sofía. She wore a black open-back dress with strap detailing, her hair pulled into a tight bun, long drop earrings and restrained makeup. Within hours the photographs had hundreds of thousands of views, and the comments had settled on a theme: she looks twenty-five, not forty-five.
The same audience said something very different in November 2023, when photographs from a Los Angeles film premiere led commenters to call her face swollen and unrecognizable and to speculate about a facelift and filler. She answered then with a makeup-free selfie and a caption about being a tired mother of five. She later said the photos surprised her too, and added, “I will never be 16 again.”
I have not examined her
I have not examined her, and she has publicly denied having cosmetic surgery. What follows is my reading of two photographs, with the reasoning laid out so you can weigh it yourself. Most of what changes a face between two photographs has nothing to do with surgery, and the table below covers those variables. The neck is where I think the evidence points somewhere else, because two structures there change in ways that are much harder to explain with weight, lighting or styling.
What changes a face between two photographs
| Variable | What it does on camera |
|---|---|
| Body fat and training | Midface and jawline fullness track overall body fat closely. Reports around her June birthday describe boxing, cardio and a structured diet. |
| Postpartum recovery and sleep | Fluid retention and fatigue soften contour. The 2023 photos came roughly a year after the birth of her youngest child. |
| Lens and distance | A wide lens close to the subject enlarges the center of the face. A long lens from the press line flattens it. |
| Lighting | Direct flash erases shadow and rounds the cheeks. Side light carves the cheekbone and jaw. |
| Hair and styling | A tight bun lifts the temples and exposes the jawline. Hair worn down softens and widens the lower face. |
| Makeup | Contour placed under the cheekbone can suggest hollowing that is not structurally there. |
Any two or three of these, stacked in one direction, can make the same person look five years older or ten years younger. None of them requires an operation.
Why buccal fat is always the first guess
Buccal fat removal, sometimes called bichectomy, takes out part of a fat pad that sits deep in the cheek. It has become the reflexive explanation for any sharper midface online, and one Turkish outlet repeated earlier claims about Lima in its Madrid coverage.
Here is what the rumor usually misses. In the forties, the buccal fat pad deflates and descends on its own, and the whole midface loses volume with it. A lean, well-trained forty-five-year-old will often show more cheekbone than she did at thirty simply because there is less fat covering it. That is also why I am cautious about removing buccal fat in patients over thirty-five. The hollowing that looks sculpted at forty can look gaunt at fifty-five, and fat removed from the cheek cannot be returned in its original form.
What the neck shows
Comparing a 2021 red carpet photograph with the Madrid images, two details stand out to me. Both are consistent with a deep neck lift, possibly performed alongside an endoscopic facelift.
The fullness under the chin is gone
The anterior bellies of the digastric muscles run from the chin back toward the hyoid bone, just beneath the platysma. When they are prominent, they create a fullness under the chin that liposuction cannot change. In the 2021 photograph there is softness beneath the chin. In Madrid that area sits flat and the angle between chin and neck is sharp. In a deep neck lift, once the fat beneath the platysma has been addressed, these muscles can be partially reduced to produce exactly that change.
The contour below the jaw has flattened
The submandibular salivary glands sit just under the jawline, roughly halfway between the chin and the angle of the jaw. With age they descend and can show as a rounded bulge below the jaw. In the Madrid photographs that bulge is no longer visible, and the jawline runs as a single line from chin to ear. Careful partial reduction of the gland is one of the maneuvers that separates a deep neck lift from a conventional facelift, which generally leaves the glands where they are.
When the fullness under the chin is gone and the jawline runs unbroken from chin to ear, the work almost certainly went beneath the platysma.
Where this reading could be wrong
I hold my own analysis to the same standard as everyone else's. In the 2021 image she is smiling, turned three-quarters, with her head tipped slightly down. In Madrid her chin is raised, her head is turned toward profile, one arm is lifted, and she appears leaner. Each of those can tighten a neck on camera. The two anatomical changes above are why I read this as surgical, and the differences in pose are why I would never call it certain without an examination.
The lesson for patients
The useful takeaway has little to do with one supermodel. In three years the public read the same bone structure as ruined and then as ageless, based on weight, lighting, styling and mood. If strangers cannot read a famous face reliably from professional photographs, your own phone camera and a comparison with a photo from your twenties are not a sound basis for a surgical decision either.
When patients bring me side-by-side images, I ask them to set the older photo aside. The goal I work toward is an optimal version of the face in front of me at its current age, in proportion and in motion, rather than a reconstruction of an earlier one.
Did Adriana Lima have plastic surgery?
She has publicly denied it, and no one outside her care team can know for certain. In my reading of recent photographs, the changes under her chin and along her jawline are consistent with a deep neck lift, although pose, weight and lighting also change how a neck photographs.
What is a deep neck lift?
A neck lift that works beneath the platysma muscle as well as above it. Depending on the anatomy, it can include removing fat under the muscle, reducing the digastric muscles and partially reducing the submandibular glands, which together create a sharper angle under the chin and a cleaner jawline than skin and fat work alone.
What is buccal fat removal?
An operation that removes part of the deep fat pad in the cheek through a small incision inside the mouth, to slim the lower midface. It is permanent and best reserved for carefully selected younger patients.
Can weight loss change the shape of the face?
Yes. Facial fat compartments shrink with overall body fat, which can sharpen the cheekbones and jawline, and in some people makes the face look older rather than younger.
Why do celebrities look so different from one photo to the next?
Lens choice, distance, flash, hair and makeup vary enormously between events, and each can change facial proportions on camera without any change to the face itself.