The American Society of Plastic Surgeons (ASPS) annual report is out and the latest numbers show a steady demand for plastic surgery—overall, 28 million cosmetic procedures were performed in the United States in 2023. ASPS has coined this increase as a “New Normal,” or a settling of sorts in a post-pandemic climate. Apparently, there’s not much that can keep us away from our treatments and procedures. They note a 5 percent year-over-year rise, despite challenges in recent years, like the pandemic and economic uncertainty. As we dig into the numbers, one thing remains clear: Our focus on keeping up appearances remains strong.
“While the data suggests that the drastic growth of plastic surgery during the immediate post-pandemic period has stabilized, the demand for aesthetic procedures remains comparatively robust,” says ASPS President Steven Williams, MD.
“Whether through surgical toning or noninvasive treatments, it’s clear that patients are more interested in a holistic, well-rounded approach to body enhancement,” he adds. “As health and wellness continue to be priorities, there are certain areas that only these types of procedures can address, which is a trend widely seen within the 2023 Procedural Statistics report.”
While the report touches on various economic indicators, Newport Beach, CA plastic surgeon Sanjay Grover, MD notes that the steady rise in people undergoing plastic surgery suggests that consumers are still willing to invest in aesthetics, although they are being more cautious. “Things are changing as we head into 2024, with the looming recession, inflation, rising interest rates, and mortgage rates, along with the uncertainty of the upcoming election,” says Dr. Grover. “People are thinking a bit harder about high-ticket items.“
Facelifts Are Up, Especially With Men
Facelifts are becoming more popular with patients, with an 8 percent increase, making them one of the fastest-growing surgical procedures. This trend transcends gender, with a notable 17 percent rise in men opting for facelifts, indicating increasing acceptance of male cosmetic enhancements. The report suggests that career advancement is a motivating factor.
“We’ve seen an increase in all men’s procedures. From nonsurgical to surgical. Men are starting to take more advantage of the services offered,” explains Louisville, KY plastic surgeon Chet Mays, MD. “This has to do with more widespread acceptance in the mainstream media and social media of people having cosmetic procedures. Our current president had a facelift before he started running for office if you look back at his before pictures.”
Nose reshaping among men has also increased by 10 percent and eyelid surgeries by 9 percent, and their interest in plastic surgery extends beyond the head. There has also been a 10 percent increase in chest and core enhancements.
Injectables Remain Popular
Despite headlines suggesting a decline in filler usage, the statistics paint a different picture. Injectable treatments continue to see significant growth. Last year alone, approximately 15.8 million injectable procedures were performed. The immediate benefits of Botulinum toxin type A (Botox, Daxxify, Dysport, Xeomin, Jeuveau) and fillers are undeniable. Wrinkle relaxers saw a 9 percent increase over the past year, while both hyaluronic acid and bio-stimulatory fillers also enjoyed an 8 percent rise, indicating persistent demand for these temporary treatments. Much like the lipstick effect, injectables can be an accessible luxury for patients, even during uncertain economic times.
“We’ve also been seeing the steady rise in demand of neurotoxins from men, which is not entirely surprising, given the desire to maintain a youthful appearance is not gender specific,” says David Moatazedi, CEO of Evolus, the manufacturer of the neurotoxin Jeuveau. “In fact, last summer we unveiled new creative to be inclusive of our increasingly diversified customers.”
Mixed Trends in Breast Procedures
Breast procedures have seen their ups and downs, but the numbers show a trend leaning toward a more natural outcome or a more streamlined look. Breast lifts continue to be popular with a 7 percent increase and breast implant removals went up by 9 percent, proving the pendulum has swung toward a smaller bust. “Breast lifts just continue to become more popular,” notes New York plastic surgeon B. Aviva Preminger, MD. “Women are less and less willing to accept sagging breasts that result from age, weight fluctuations and breastfeeding.”
“This very much seems to coincide with the trend to smaller implants and implant removal that we have seen in the last few years,” says Tucson, AZ plastic surgeon Raman Mahabir, MD. “The preferred aesthetic is trending to smaller breasts. The increase in breast reduction we are seeing seems to mirror that same trend. Breast lifts are a way to rejuvenate the breasts that does not involve implants. They look better, perkier, more youthful but not necessarily larger.”
Breast reductions, particularly among Gen Z, have seen a 10 percent uptick, highlighting a focus on comfort and proportion. “Younger patients have more access to social media and are aware of their options and parents are becoming more in tune and aware of their daughters’ needs during their teen years and the impact large breasts can have on esteem and physical activity,” adds Dr. Preminger.
Body Surgery and Minimally Invasive Treatments are Up
Body contouring procedures are on the rise, with liposuction maintaining its top status as the number-one plastic surgery procedure. “Other procedures that have gone up include lower body lifts, which are up 5 percent, arm lifts, which are up 8 percent, thigh lifts, up 2 percent,” says Baltimore plastic surgeon Michele Shermak, MD. “These procedures are probably associated with our rising number of weight-loss patients through some of our GLP-1 medications.”
“The tummy tuck has been in the top five of most popular procedures for the last three years, so it’s not going anywhere,” says Rochester, NY plastic surgeon Ashley Amalfi, MD. “We’re seeing so many tummy tucks. Tummy tucks remove that extra skin, so even in some of our thinner patients who have been moms or have lost a lot of weight, it gives you that tight, beautiful, flat look. So tummy tucks are here to stay.”
When it comes to in-office treatments, minimally invasive solutions continue to outpace surgery, growing by 7 percent. Treatments like laser hair removal and skin resurfacing (like chemical peels and microdermabrasion) are also rising. These trends suggest that we’re opting for treatments that are easy to undergo, with shorter recovery times. “Nonsurgical procedures are more popular because they are less expensive and less downtime,” adds New York plastic surgeon Mokhtar Asaadi, MD.
Demographic Breakdown: Who’s Getting What?
When it comes to cosmetic procedures, Gen X and older Millennials (aged 40-54) lead in the use of Botox (48%) and hyaluronic acid fillers (52%), along with a preference for liposuction and tummy tucks. Millennials, especially those aged 30-39, are driving trends in breast and buttock augmentations using fat grafting, emphasizing body-enhancing treatments.
In the 30-39 age group, there was a significant year-over-year increase in filler procedures. But Gen Z isn’t far behind. Many are also starting preventive measures like ‘Baby Botox’ to keep wrinkles from forming. They are also increasingly opting for surgeries like breast augmentations, with a 16 percent boost in demand. And perhaps not surprisingly, they’re already exploring facial procedures such as facelifts and facial fat grafting.
No matter the age group, Dr. Williams advises being diligent in verifying your surgeon’s qualifications as we continue to bring steady traffic to the surgeon’s office. “As patients increasingly prioritize their aesthetic health, it remains imperative that they also prioritize education and safety by seeking out board-certified plastic surgeons,” cautions Dr. Williams. “This becomes even more important as patients increasingly try to differentiate quality care and truth among the messages they receive in social media and paid advertisements.”
