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Considering Plastic Surgery? Join the Crowd.

Aug 16, 2019

Beauty-conscious Americans are seeking out plastic surgeons at an ever-increasing rate. From breasts to bellies to butts, cosmetic surgery changes their body image, creating proportion, getting rid of excise fat or skin and overcoming genetic flaws.

Minimally invasive cosmetic procedures are surging, with patients in their forties, and even their thirties, leading the growth demographic.

Gone are the days of older ladies discretely slipping into the office for a face lift. Plastic surgery has gone mainstream, as the selfie generation comes of age.

How Many People Get Plastic Surgery A Year?

Over 23 million people had some type of cosmetic surgery or reconstructive plastic surgery in 2018, a 2% increase from 2017.

According the Plastic Surgery Statistics report from American Society of Plastic Surgeons (ASPS), in 2018  there were:

  • 7 million cosmetic procedures
    • 8 million cosmetic surgery procedures
    • 9 million cosmetic minimally invasive procedures.
  • 8 million reconstructive procedures

Overall, the number cosmetic surgical procedures increased by 1% from 2017. But the real growth driver in 2018 is found in the number of minimally invasive procedures which jumped by 2% from the previous year.

Botox treatments, chemical peels, laser hair removal and soft tissue fillers lead in popularity, as seen below in a figure from the ASPS report.

It should come as no surprise that the number of clients seeking these types of treatments is on the rise. They’re accessible and affordable, without the post-op recovery period that follows a surgical procedure.

Figure 1: This data table is from the ASPS 2018 Statistics on Plastic Surgery Report.

It’s interesting to note that the jump in popularity from 2000 to 2018 is 225%.The corresponding data point for cosmetic surgical procedures during the same period shows a drop of 5%.

It seems logical to conclude that as less invasive techniques continue to show positive results, the patient pool will increase but some surgical options may become less relevant.

What’s Trending in Plastic Surgery?

As noted above. there may be a correlation between the rise in minimally invasive procedures and the drop in cosmetic surgical procedures between 2000 and 2018. But before we dive into the details, let’s clarify how the data is categorized.

Data Definitions

Here are three basic definitions that define our understanding of data on plastic surgery. The trends we focus on in this article are related to elective cosmetic procedures.

Cosmetic Plastic Surgery: Cosmetic surgery, such as breast augmentation or liposuction, are procedures that require anesthesia and are performed by a surgeon. These procedures are elective and are not covered by health insurance.

Minimally invasive Cosmetic Procedures: Minimally invasive cosmetic procedures are typically done in office by a doctor. They do not require anesthesia and are not surgical procedures. They are considered elective and are not covered by health insurance.

Reconstructive Plastic Surgery: Plastic surgery that is related to a medical condition, such as burn victims or breast cancer patients who have had a mastectomy. These procedures are covered by health insurance.

The number of patients seeking elective cosmetic treatments – surgical or minimally invasive -rose by roughly a quarter of a million people between 2017 and 2018. The number of reconstructive plastic surgeries did not show any change.

Most Common Cosmetic Procedures

When it comes to cosmetic surgical techniques, it’s quite apparent that body-altering procedures are at the top of the list.

By far, the most common cosmetic surgical procedure is breast augmentation with 313,735 procedures performed in America alone.

This has been consistent since 2006, according to ASPS.

Top 5 Cosmetic Surgeries

The top 5 cosmetic surgical procedures in 2018, according to ASPS are as follows:

PROCEDURE

# IN 2018

DIFFERENTIAL 2017

Breast augmentation

313, 000

UP 4%

Liposuction

258,000

UP 5%

Nose re-shaping

213,000

DOWN 2%

Eyelid Surgery

206,000

DOWN 1%

Tummy Tucks

130,000

NO CHANGE

Two cosmetic surgical procedures showing significant growth in 2018 were buttock enhancement with fat grafting – increasing by 10%, and hair transplantation which shot up by 19%.

Top 5 Minimally Invasive Cosmetic Procedures

According to ASPS, these are the most common minimally invasive procedures in America for 2018.

PROCEDURE

# IN 2018

DIFFERENTIAL 2017

Botulinum Toxin Type A

7.4 Million

UP 3%

Soft Tissue Fillers

2.6 Million

UP 2%

Chemical Peels

1.38 Million

UP 1%

Laser Hair Removal

1 Million

DOWN 1%

Microdermabrasion

790,000

DOWN 4%

 

In an interesting juxtaposition, as cosmetic surgeries trend toward to body-altering procedures, the most popular non-surgical options are all about the face. Since 2000, the number of Botox injections have risen by 845% – the largest increase of any cosmetic procedure of any type.

Top 5 Reconstructive Plastic Surgeries

The most common reconstructive plastic surgeries in 2018 are as follows:

PROCEDURE

# IN 2018

DIFFERENTIAL 2017

Tumor Removal

4.4 million

NO CHANGE

Laceration Repair

253,000

NO CHANGE

Maxillofacial Repair

204,541

NO CHANGE

Scar Repair

182,850

NO CHANGE

Hand Repair

138,340

NO CHANGE

Maxillofacial surgeries address facial injuries, reconstructing broken bones and treating congenital birth defects like cleft palate. Since the year 2000, these procedures have increased by 158%.

Why Do People Get Plastic Surgery

Cosmetic Procedures

There is no question that Americans are focused on body image when it comes to surgical procedures. Though it’s easy to write off their motivations for larger breasts or well-rounded butts off as vanity, that would be a superficial perspective.

Most cosmetic surgeries help create a more proportionate body shape for the patient’s frame. Genetic pre-dispositions can be overcome, and extreme weight-loss after-effects addressed. Women who’ve experienced significant body changes due to childbirth or breast feeding can restore their previous shape, greatly enhancing self-esteem.

Figure 1: This data table is from the ASPS 2018 Statistics on Plastic Surgery Report.

It’s interesting to note that the jump in popularity from 2000 to 2018 is 225%.The corresponding data point for cosmetic surgical procedures during the same period shows a drop of 5%.

It seems logical to conclude that as less invasive techniques continue to show positive results, the patient pool will increase but some surgical options may become less relevant.

What’s Trending in Plastic Surgery?

As noted above. there may be a correlation between the rise in minimally invasive procedures and the drop in cosmetic surgical procedures between 2000 and 2018. But before we dive into the details, let’s clarify how the data is categorized.

Data Definitions

Here are three basic definitions that define our understanding of data on plastic surgery. The trends we focus on in this article are related to elective cosmetic procedures.

Cosmetic Plastic Surgery: Cosmetic surgery, such as breast augmentation or liposuction, are procedures that require anesthesia and are performed by a surgeon. These procedures are elective and are not covered by health insurance.

Minimally invasive Cosmetic Procedures: Minimally invasive cosmetic procedures are typically done in office by a doctor. They do not require anesthesia and are not surgical procedures. They are considered elective and are not covered by health insurance.

Reconstructive Plastic Surgery: Plastic surgery that is related to a medical condition, such as burn victims or breast cancer patients who have had a mastectomy. These procedures are covered by health insurance.

The number of patients seeking elective cosmetic treatments – surgical or minimally invasive -rose by roughly a quarter of a million people between 2017 and 2018. The number of reconstructive plastic surgeries did not show any change.

As for the rise in minimally invasive procedures, America is a society that worries about the stigma of aging. Patients often share that the person they see on the outside doesn’t properly align with how they feel on the inside.

Frown lines on the forehead, crow’s feet around the eyes, thinning lips or sinking cheeks can give a false impression of tiredness or lack of energy.

These simple, low-risk procedures not only change what clients see in the mirror, they change the perception of them by the public at large.

Reconstructive Plastic Surgery

People who get reconstructive surgery don’t need much motivation. Though changes in self-esteem may be forthcoming – consider the impact of a cleft palate being repaired – the driver for their procedures is medical.

The demographic includes people with tumors, women who have had mastectomies – breast reconstruction has risen by 29% since 2000. Reconstructive surgery is used to address conditions like carpal tunnel, rheumatoid arthritis and other injuries or deformities that affect the function of the hand.

Growing Number of Plastic Surgery Procedures

Cosmetic Procedures

The primary reason for virtually every cosmetic procedures is to enhance appearance. But that decision can result in a better quality of life, driven by increased self-esteem and self-confidence that can lead to a positive change in professional and social interactions.

According to a study in 2013 by the American Society for Aesthetic Plastic Surgery, patients who had undergone cosmetic surgery felt happier with their bodies in overall. Their self-esteem was higher, they had less anxiety about their appearance and said they felt healthier after the procedure.

The data in ASPS 2018 report shows that the total number of cosmetic procedures in the U.S. – surgical and minimally invasive – has risen by 163% since 2000. When you factor in the economic impact of the recession from 2007 through 2009, that growth is even more dramatic.

Reconstructive Procedures

According to ASPS, the total number of reconstructive surgeries did not increase between 2017 and 2018 in the U.S. There was a 4% rise in the burn care and an 8% increase in pelvic floor reconstruction –  a restorative surgery for the collapse in the pelvic muscular structure, often a result of childbirth.

In today’s society, the perception of plastic surgery is often focused on the cosmetic. But the ability to restore some sense of normalcy in appearance and function to injured patients is a source of professional pride and personal satisfaction for many surgeons.

What’s Contributing to the Rise?

Technology is definitely a factor in the continuing growth of cosmetic surgeries and in-office procedures. New medical devices and techniques are continually being developed.

Botulinum Toxin Type A (Botox), which is by far the most popular minimally invasive cosmetic treatment, was only approved for cosmetic use by the FDA in 2002. Since that time, numerous new injectables have entered the marketplace – including dermal fillers that plump lips and smooth deep facial creases.

The rise of social media has opened up discussion about outcomes, convenience, cost and patient satisfaction. Medical professionals are able to share information online to educate people on their procedures, helping to frame expectations on risk and reward and sharing before and after photos.

Here are five factors that have significant influence on the growth of cosmetic surgery and minimally invasive procedures:

1.   Social Media

This article began by noting that people in their forties were the largest growth demographic for cosmetic procedures, followed by millennials in their thirties. Both age groups tend to be prolific users of social media, especially millennials.

The shareable nature of social media content is highly regarded by most users. But for some, photos published online that they find less than flattering can kickstart interest in cosmetic surgery.

Another huge factor is celebrity influence. Lips like Kylie Jenner. Breasts like Cardi B. A butt like Kim Kardashian. Bella Thorne, who turned 21 in 2018, shared her chemical peel experience on social media. With massive numbers of followers, these social influencers inspire fans to follow in their footsteps.

2.   Technological Advances

New devices, techniques and technologies continue to dominate the industry, often to the benefit of minimally invasive procedures. Lasers, fillers like Juvéderm or Cool Sculpting, the fat-freezing procedure that breaks up smaller areas of fat tissue for natural expulsion from the body are all recent advances that are already mainstream.

The innovations we can expect to see are exciting and have potential to positively impact patient quality of life. Ongoing 3D printing research has developed a tissue engineering technique that grows hair follicles. The FDA has recently approved the first bioabsorbable mesh that provides support for reconstructive surgeries and slowly dissolves.

Innovation will continue to thrive, increasing positive outcomes for consumers and offering patients more incentives to pursue cosmetic and surgical procedures.

3.   Affordability

This is an obvious driver behind the rise in minimally invasive cosmetic procedures. All cosmetic treatments, including surgeries, are elective – which means patients pay out of pocket.

Costs vary based on location, but it’s apparent that the expense of a surgical facelift versus a cosmetic injectable is radically different. Minimally invasive procedures don’t have downtime for recovery either – no time off from work, no loss of income. For patients, it’s a no brainer.

For the economics of the industry, this affordability is attracting a younger clientele in larger numbers. The logical expectation is a long-term relationship with patients that may not have been possible in previous years.

4.   Acceptance

The stigma against cosmetic procedures is diminishing. American society values physical beauty, and cosmetic procedures that enhance their features or figures are no longer considered taboo.

This increased acceptance of new norms can definitely be tracked to online education regarding procedures, expectations and the ability to identify qualified medical practitioners. Social media is a resource for testimonials, including before and after photos.

What was once a punchline is now an accessible, affordable and widely used solution for younger women and men who want to improve their appearance.

5.   Health Benefits

As have been discussed, cosmetic enhancements tend increase self-confidence, reduce anxiety in social and professional interactions and improve body image.

There are also physical health benefits from cosmetic and plastic surgery procedures. A rhinoplasty can be used to help patients breath more easily. Reconstructive surgery for carpal tunnel is a critical solution for people who regularly use computers.

Surgical removal of fat isn’t a cure for obesity, but can provide the motivation for changes in exercise and nutrition. Breast reduction reduces back pain and eliminates bra straps that cut into shoulders.

Who’s Getting Plastic Surgery?

Now that the “why” has been discussed, let’s look at the statistics behind patient demographics, as pulled from ASPS 2108 Plastic Surgery Statistics report.

All these data are related to cosmetic procedures, not reconstructive surgery.

How Many Women?

Women represent 92% of U.S. patients in 2018, for a total of 14.7 million procedures, up 2% from 2017. 1.5 million of those procedures were surgical, representing a rise of 1% from 2017 and 13.3 million were minimally invasive, an increase of 2%.

How Many Men?

Men represented 8% of U.S. patients in 2018, for total of 1.3 million procedures, a drop of 1% from the previous year. Of those, 215,000 were surgical and showed no loss or gain from 2017. The remaining 1.1 million procedures were minimally invasive, showing an off-trend decline of 2%.

How Many Teenagers?

Of all the patient age groups, teenagers make up the smallest demographic. Young people between the ages of 13 and 19 had a total of 227,000 procedures in 2018, down by 1%. Of that total, 65,000 were surgical procedures, also down by 1%. The remaining 162,000 minimally invasive procedures showed no change from the previous year.

Cosmetic Surgeries Compared by Country

How does cosmetic surgery in the U.S. stack up against other countries around the world? Americans lead globally with roughly 18.4% of procedures, worldwide, followed by Brazil with 10.4%

These data in the figure below are provided by International Society of the Aesthetic Plastic Surgery (ISAPS) for the year 2017.

Figure 2: * Rankings are based solely on those countries from which a sufficient survey response was received, and data were considered to be representative.

ISAPS collects it’s data by surveying plastic surgeons around the world and does not draw industry growth comparisons between countries, procedures or years.

What Does the Future Hold for Plastic Surgery?

The future of plastic surgery is a continued commitment to innovation. Insights from the data provided clearly demonstrate the shift in consumer patterns:

  • The preference ratio between minimally invasive cosmetic procedures and surgical options has broadened dramatically –15.9 million to 1.8 million.
  • The largest consumer age group are people between 40 and 54 years of age, followed by people between 30-39.
  • Both age groups consume minimally invasive procedures at a much higher rate than cosmetic surgery.
  • Surgical procedures that continue to show growth are typically related to body sculpting. Breast augmentation has consistently remained number 1 on the list since 2006.

All of this indicates that the market is ripe for invention to further motivate consumer demand. The simplest, least intrusive and most affordable procedures are clearly driving the growth surge. This rise in demand will continue to provoke research into new surgical techniques, medical devices and injectables.

Rewards

Though some surgeons may feel concern at shift away from surgical procedures, the growing demand for minimally invasive services presents new economic opportunities. Offices that invest early in vetting and adopting new devices, injectables and techniques may gain a competitive edge.

Relationships with patients begin earlier and last longer. Minimally invasive procedures involve repetitive treatments which contribute economically, as well as chances to build rapport.

Younger patients may be more apt to share their experiences on social media, offering positive (and free) word of mouth advertising. Surgeons can to share their expertise in new arenas, like Instagram or Snapchat, broadening their customer outreach.

Risks

There are always risks when it comes to innovation. The biggest one is being left behind. Medical professionals who ignore modernization do so at their own peril. Keeping yourself and your staff updated on what’s current in the industry will serve practitioners well.

It’s also important to remember that many of these minimally invasive procedures can be performed by someone other than a plastic surgeon. Don’t price your services out of the market.

In Closing

Some of the best plastic surgeons in the country have already begun capturing the shift in trends. Dr. Paul Chasan, MD, FACS is a nationally renowned plastic surgeon in rhinoplasty, face lifts, and breast augmentation who has a private surgical center and medical spa in San Diego, California.

Asked about the shift toward minimally invasive procedures, Dr. Chasan replied, “We saw this happening years ago. I opened Ranch & Coast Plastic Surgery and Medical Spa for both surgical and non-surgical services. Breast surgery is always on trend, but with current health concerns, we also are doing a lot of explantations. Rhinoplasty and facelifts will also always stick around. Now with non-surgical services – CoolSculpting, Botox, dermal fillers and Laser Rejuvenation are just the start. We recently added a non-pharmaceutical option for erectile dysfunction, and in the next few months we will be introducing some new, innovative, and non-invasive ways to reduce the signs of aging.”

It’s exciting time for our industry,” he added, “but it’s important to make sure this work is done by certified professionals. This is still a medical procedure and patient safety is the first priority.”

Sources

2018 Plastic Surgery Statistics Report, American Society of Plastic Surgeons https://www.plasticsurgery.org/news/plastic-surgery-statistics

International Society of the Aesthetic Plastic Surgery: 2013: Research ties plastic surgery to higher self-esteem, better mood  https://www.surgery.org/consumers/plastic-surgery-news-briefs/research-ties-plastic-surgery-higher-self-esteem-mood-1049817

CNN.com: 2002: FDA approves Botox to smooth wrinkles: http://www.cnn.com/2002/HEALTH/04/15/botox.fda/index.htm

Medgadget.com: 2019: 3D-Printing Utilized to Grow New Human Hair https://www.medgadget.com/2019/06/3d-printing-utilized-to-stop-hair-loss.html

ECNmag.com: 2018: Surgical Innovation Receives FDA Clearance to Market Bioabsorbable Mesh https://www.ecnmag.com/news/2018/10/surgical-innovation-receives-fda-clearance-market-bioabsorbable-mesh

2017 Global Statistics, International Society of the Aesthetic Plastic Surgery https://www.isaps.org/medical-professionals/isaps-global-statistics/

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