At the beginning of each year, the two primary plastic surgery specialty organizations in the United States the American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS) survey their members to compile information about what procedures they performed during the last year and how many. The societies then crunch the numbers, interpret them, and release them. The result is a summary of the state of plastic surgery in the U.S. and some prognostication as to where it's heading.
In the spring of 2008, the news was good. Cosmetic surgery was continuing on an upward trend, with nearly 11.8 million cosmetic procedures performed in the U.S. in 2007, according to ASPS. The breakdown was 1.8 million surgical cosmetic procedures and 10 million minimally-invasive cosmetic procedures. Overall, there was a 7% increase in the total number of cosmetic procedures over 2006.
As for who was having cosmetic work done, ASAPS reported that women had nearly 10.6 million of the total, or 91%, which was up by 1% over 2006. Men accounted for the other 9%, or 1.1 million procedures, which reflected a rise of 17% over the previous year. Traditional racial and ethnic minorities (Hispanics, African-Americans, Asians, other non-Caucasians) had approximately 21% of all cosmetic procedures. In that subgroup, Hispanics lead the way with 9%, followed by African-Americans (6%), Asians (5%), and non-Caucasians (2%). People in the 35 to 50 age bracket had the most (5.4 million, or 46% of the total), followed by the 51 to 64 year olds (25%), 19 to 34 (21%), 65 and over (6%) and 18 and younger (2%).
Broken down by age group, the largest percentage of procedures by far were performed on people in the 35 to 50 year old category (47%), followed by 51 to 64 year olds (25%), 19 to 34 year olds (21%), 65 and over (6%), and 18 and under (2%).
The top 5 surgical cosmetic procedures in 2007 were liposuction, breast augmentation, eyelid surgery, abdominoplasty, and breast reduction. The top 5 nonsurgical cosmetic procedures were BOTOX® Cosmetic injections, hyaluronic acid injections, laser hair removal, microdermabrasion, and intense pulsed light (IPL) treatment.
The most popular plastic surgery procedures for women were breast augmentation, liposuction, eyelid surgery, abdominoplasty, and breast reduction, while the most popular for men were liposuction, eyelid surgery, rhinoplasty, breast reduction for gynecomastia, and hair transplantation.
The bill for all these cosmetic procedures totaled $13.1 billion, or $1 billion more than the previous year.
More than half (54%) of cosmetic procedures were performed in an office facility. Freestanding surgical centers accounted for 29%, with the remaining 17% performed in hospitals.
As for hot plastic surgery trends that are likely to carry into the near future:
Breast augmentation is expected to remain popular with women with the reintroduction in 2006 of silicone implants and new options that are currently working their way through the U.S. Food and Drug Administration approval process. These include highly cohesive gel implants known as "gummy bears", which are already being used in other countries.
Related to breast augmentation, the mommy makeover continues to rack up adherents. The idea is that moms can get their figures back into their prepregnancy prime with a combination of breast augmentation, breast lift, and tummy tuck (sometimes with a little liposuction thrown in for good measure).
Injectables and noninvasive treatments like Botox® and the fillers Restylane® and Juvederm™ are expected to remain popular and probably expand out to more people. These procedures help return youth to skin by erasing laugh and smile lines, and the results last for months with little to no down time required up front.
Laser hair removal can take care of a few stray hairs or a whole chest full, making it popular with men and women alike. This permanent solution to unwanted hair has seen a 21% increase in the number of procedures performed since 2000.
And what would the future be without more new technology? New technologies including non- and minimally invasive ultrasonic devices, acoustic pulse treatments, and light therapies promise to melt fat and cellulite fast and efficiently, with little bruising or swelling and minimal down time. They could give liposuction a run for its money one day. But for now there's no substantiated proof that they work. At least one FDA-approved study is underway, so there may be some more positive news in the coming years.
Finally, ASAPS surveyed consumers in 2008 about their attitudes towards cosmetic surgery, and the results were generally positive. Just over half of the men and women who participated in the survey said they approve of cosmetic surgery, and 31% of the women and 20% of the men said they would consider cosmetic surgery for themselves, either now or in the future. Thirty-four percent of 25 to 44 year olds responded in the positive, as did 27% of 18 to 25 year olds and 45 to 54 year olds. Perhaps even more telling was the fact that 78% of the women and 79% of the men said that if they had cosmetic surgery in the future, they would not be embarrassed if people outside their immediate family and close friends knew about it.
"Twenty years ago people thought only movie stars and rich women had plastic surgery," concludes Foad Nahai, MD, president of ASAPS. "Now people grow up knowing friends and family who openly talk about the plastic surgery procedures they have had or the ones they plan to have in the future."
Bitar Cosmetic Surgery Institute
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Bitar Cosmetic Surgery Institute
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George Washington University Hospital
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Washington DC, DC 20037