What Happened To Simon Cowell's Face, According To A Plastic Surgeon

As is expected of anyone who has spent decades in the spotlight, Simon Cowell has undergone a significant transformation over the years. However, the iconic former "American Idol" judge's facial changes go well beyond aging. Cowell has admitted to relying on Botox and fillers, but has denied having undergone extensive plastic surgery. Dr. Brandon Richland, board-certified plastic surgeon at  Richland MD and Richland Aesthetics, told Nicki Swift that Cowell is telling the truth.

Dr. Richland looked at a 2017 picture of Cowell (seen on the left) to explain the changes seen in the 2024 picture (right), noting that excessive nonsurgical procedures can exacerbate the effects of aging. Dr. Richland could tell that Cowell was already using Botox and fillers in 2017, evidenced by the extra volume seen in his cheeks and lower face. "This often happens when filler is used to try to lift sagging skin instead of actually removing the excess skin surgically," Dr. Richland explained. "It creates a puffy or 'pillow-face' effect that can actually make a person look more tired because the weight of the filler pulls down on the tissues over time."

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Dr. Richland concluded that Cowell continued to rely on Botox and fillers through 2024. "The forehead and glabella are very smooth, which is uncommon for a male of his age," he said. While this may be the desired result, it comes with a tradeoff. "When we over-paralyze the forehead, the brow often loses its natural arch and begins to descend, which is exactly why his eyes look so much heavier and more crowded now," Dr. Richland explained. 

Simon Cowell struggled with his changing image as he aged. In his efforts to counteract some of the effects of aging, the music mogul was open to trying whatever new method was available. "I also had a sheep placenta facial once, which was quite out there," he told Mirror in 2015. Cowell has also undergone nonsurgical facelifts, which rely on bioplastic thread to pull on the skin. "There's lots of things you can do now," he told The Sun in 2018.

The "America's Got Talent" judge has no problems being open about all this. "Vain? Yeah, I am. But to be honest with you, I can't think of one person who is on TV who isn't vain," he told the Daily Mail in 2008. But it eventually caught up to him. When Cowell began to look unrecognizable to fans in videos, he knew he had gone too far. In fact, he even started to double-take when looking at old photos. "I saw a picture of me from 'before' the other day, and didn't recognize it as me," he told The Sun in 2022.

When Cowell's son, Eric (seen above in 2024), began to notice, he knew he had to stop with the fillers. "Enough was enough," he said. Since then, he began to change his approach to wellness, focusing on diet, exercise, and water intake. And according to Cowell, lab tests suggest he's younger than his chronological age. "I've actually aged backwards by eating better, more exercise, less stress, certain supplements," he told The Sun in 2025.