Hugh Hefner's ex Holly Madison reveals why she has 'no regrets' about undergoing a lower facelift at 46

Holly Madison has lifted the lid on her decision to get cosmetic surgery, revealing exactly why she's "really happy" with the results.

The former Girls Next Door star, 46, opened up about going under the knife during the Wednesday, June 24 episode of DearMedia's "Derm Approved" podcast, telling host Dr. Shelia Farhang she has "no regrets" about the procedure.

"I've had a lower facelift on my jawline," Madison said. "I'm really happy I got it done."

The reality star, who shares two children with ex-husband Pasquale Rotella, explained that she wanted to tackle jowling and tighten up her lower face after struggling with the after-effects of pregnancy.

"A little bit of lipo under my chin. I just felt like after having kids, you know, I gained a lot of weight with my pregnancy and there was just nothing I could do," she explained. "There were no lasers or anything that could really do what I wanted it to do so I found somebody whose before and afters I really loved."

Madison said she took around two weeks off from filming her own podcast to recover, staying at a Los Angeles hotel with a nurse by her side throughout.

Holly Madison was in a relationship with Hugh Hefner for seven years during which she lived at the Playboy Mansion as his lead girlfriend. (Photo by Chad Buchanan/Getty Images)

Holly Madison's approach to going 'under the knife'

When it came to deciding exactly what work to have done, Madison said she followed a strict "less is more" philosophy with her surgeon.

"I'd rather have it not go far enough," she said, "and then I can go back and maybe do more rather than have it go too far and I'm looking like the Joker."

Farhang agreed, pointing out it's much trickier to dial things back once you've gone under the knife. "It's so much harder to scale back after you've gotten too much, especially when you're cutting," she said.

Madison admitted the scars from her surgery sit just in front of her ears, and she's not bothered about hiding them.

"If you look close, you can totally see it, but I don't care," she said. "I'm kind of open about it. I already talked about it on my podcast."

The best-selling author has previously spoken about trying to steer clear of toxic beauty standards while raising her kids, saying she's relieved her own children aren't falling for them either. (Photo by Denise Truscello/Getty Images for Grant A Gift for Autism)

What other beauty treatments has Holly Madison had?

Far from shying away from the topic, Madison has been candid about the cosmetic work she continues to maintain, including Botox, IPL laser treatments and CO2 laser work under her eyes.

The best-selling author has previously spoken about trying to steer clear of toxic beauty standards while raising her kids, and says she's relieved her own children aren't falling for them either.

"I'm very relieved because my daughter and my son both roast me for dyeing my hair, they roast me for having extensions. They roast me when I wear a lot of makeup, so I think I'm good," Madison told PEOPLE in November 2023. "Knock on wood, I think they're not going to fall into the trap of trying to make themselves look over-processed or trying too hard for the beauty standard because they are over it."