Cosmetic Surgery Is on the Rise

Number of Procedures Jumped 20% in 2003, With Liposuction Leading the List

From the WebMD Archives

Feb. 20, 2004 -- Americans are getting extreme and not-so-extreme makeovers en masse, according to newly released statistics, which show that the number of cosmetic procedures jumped 20% in 2003 -- that's about 8.3 million procedures.

"Last year, people may have been holding off because of the economy, 9/11, and the war, and maybe now we are inured to some of the bad news and feeling better about the economy, so we are more willing to part with our money and psychologically more willing and able to undergo cosmetic procedures," says White Plains, N.Y.-based plastic surgeon Robert Bernard, MD, president of the American Society for Aesthetic Plastic Surgery (ASAPS), the group that complied and released the new statistics.

The number of surgical procedures increased 12% from 2002, while the number of nonsurgical procedures increased 22%, according to the new statistics.

The top five surgical cosmetic procedures in 2003 were:

The top five nonsurgical cosmetic procedures in 2003 were:

Other nonsurgical procedures will likely increase further in the coming years due to the advent of new wrinkle-removing fillers, Bernard predicts for WebMD. The FDA approved Restylane on Dec. 12, 2003, for the treatment of moderate to severe wrinkles around the nose and mouth. Restylane is made with hyaluronic acid, which is a substance normally found in the skin that adds volume and fullness to the skin. Others are expected to be approved in the near future, he says.

In terms of age:

  • People aged 35-50 had the most procedures, 45% of the total.
  • People aged 19-34 had 24%;
  • People aged 51-64 had 23%;
  • People aged 65 and over had 5%;
  • And people aged 18 and younger had less than 3%.

Venus and Mars

Women are more than twice as likely as men to consider plastic surgery, and this gap may be widening. Specifically, 34% of women polled in a new ASAPS survey said they would consider cosmetic surgery, compared with 14% of men. Men and women aged 45 to 54 comprised the age group most likely to consider cosmetic surgery.

Women had 87% of the cosmetic procedures done last year. The number of cosmetic procedures increased 16% for women between 2002-2003.

The top five surgical cosmetic procedures for womenin 2003 were:

  • Liposuction
  • Breast augmentation
  • Eyelid surgery
  • Breast reduction
  • Rhinoplasty

"The number of men having procedures has increased substantially, but it hasn't increased significantly relative to women," Bernard says. "About 1.1 million men had cosmetic procedures in 2003 -- an increase of almost 31% over 2002, so more men are having cosmetic procedures, but not more relative to women," he says.

Thirteen percent of cosmetic procedures in 2003 were done in men, up from 12% in 2002.

The top five surgical procedures for men were:

Post-Weight Loss Surgeries on the Rise

Also on the rise, not surprisingly, are body-contouring procedures that typically follow weight loss surgery. Abdominoplasties (tummy tucks) increased by 42%, lower body lifts by 127%, and thigh lifts by 109%, compared with 2002.

Growing numbers of Americans, including NBC Today Show weatherman Al Roker and singer Carnie Wilson, are opting for weight loss surgery, or bariatric surgery. According to The New York Times, weight loss surgery procedures increased 40% last year.

And gastric bypass surgery isn't the last surgery such people will undergo, says Lawrence Reed, MD, a New York City-based plastic surgeon.

Mirroring the newly released statistics, Reed says that this year he is doing significantly more thigh lifts, upper arm lifts, lower body lifts, and abdominoplasties on patients who have lost dramatic amounts of weight and want to tighten and tone the remaining flabby skin.

"There has been a tremendous increase in body sculpture because people are generally concerned about weight and more and more are undergoing weight loss procedures," he says.

The J-Lo Effect

Buttock augmentation increased by 533% in 2003 to 3,885 procedures, the new statistics show. "It definitely could be influenced by J-lo," says Reed. Singer/actress Jennifer Lopez is known for her generous buttocks, and so are some other pop stars like Grammy-award winner Beyonce Knowles.

"In general, the new stats show that the economy is getting better," Reed says. "Last year, nonsurgical procedures increased more because they are less expensive, but now that the economy is better, they are opting for surgical procedures," he says.

Risks Should Not be Underestimated

Recently, the death of novelist Olivia Goldsmith, who suffered a heart attack as she went under anesthesia for a procedure to remove loose skin from her chin, cast light on the fact that cosmetic surgery is surgery and does, in fact, come with real risks.

"Doctors should discuss risks, complications, and alternatives to surgery so their patients have a full understanding of the consequences of what they are contemplating," Bernard says. "Patients come in and they know the routine because they are seeing more than one doctor and are talking to friends who say, 'don't tell the doctor this or they won't operate,' so some people will withhold information," he says.

And they don't realize they are doing themselves a disservice, Bernard adds.

For example, the doctor asks, "do you smoke?" And you say "No," but you are really a pack-a-day smoker. This affects the risk and possibly the types of surgery you choose, he says.

To make sure you get the best possible outcome, always choose a board-certified plastic surgeon and "don't to go into a plastic surgeon's office with a preconceived idea of the procedure," he says. "Go in and have conversation with plastic surgeon and tell him what you perceive as a problem, and have a dialogue with the doctor."

To find a board-certified plastic surgeon near you, visit the ASAPS web site at

Show Sources

SOURCES: Robert Bernard, MD, president, American Society for Aesthetic Plastic Surgery. Lawrence Reed, MD, plastic surgeon, New York.
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