Nearly 6.9 Million Cosmetic Procedures in 2002, Says American Society for Aesthetic Plastic Surgery; Surgical Procedures Increase 1 Percent; Largest Gains for Tummy Tucks, Breast Augmentations

NEW YORK -- Nearly 6.9 million cosmetic surgical and non-surgical procedures were performed in the United States in 2002, according to statistics released today by the American Society for Aesthetic Plastic Surgery (ASAPS). Compared to 2001, surgical procedures increased 1 percent to 1.6 million, while non-surgical procedures declined 23 percent to 5.3 million. ASAPS, which annually conducts the nation's most authoritative survey of U.S. physicians performing cosmetic surgery, says the overall number of cosmetic procedures (surgical and non-surgical) has increased 228 percent since 1997.

"Last year's increase in surgical procedures, while small, speaks to people's strong motivation for making positive changes in their lives -- despite worries about the economy and world tensions," says Franklin DiSpaltro, MD, president of the American Society for Aesthetic Plastic Surgery, founded in 1967 as the only plastic surgery organization devoted exclusively to cosmetic surgery education and research.

Among the most significant increases in the surgical category for 2002, compared to the previous year, were abdominoplasty (tummy tuck), up 17 percent; breast augmentation, up 15 percent; breast reduction, up 9 percent; facelift, up 6 percent; and breast lift, up 4 percent.

Surgical procedures accounted for 23.5 percent of all cosmetic procedures, while nonsurgical procedures were 76.5 percent of the total. DiSpaltro says that part of the reason for the higher number of non-surgical procedures is that popular treatments such as Botox, collagen injections and microdermabrasion must be repeated on a regular basis in order to maintain their benefits.

"Non-surgical procedures are playing an important role in modern plastic surgery practice, but patients need to understand that these noninvasive treatments cannot achieve the same or as long-lasting results as a surgical procedure," says DiSpaltro. "However, in many instances, non-surgical procedures can be beneficial in helping to enhance and maintain the results of surgical improvements. For younger patients, non-surgical procedures may sometimes allow them to delay more extensive surgery a while longer, letting them 'hold the line' against wrinkles with a variety of soft tissue fillers, Botox and skin resurfacing treatments."

Other trends to watch:

Top Surgical Procedures

The five most popular cosmetic surgical procedures in 2002 were lipoplasty (liposuction), 372,831; breast augmentation, 249,641; eyelid surgery, 229,092; rhinoplasty (nose reshaping), 156,973; and breast reduction, 125,614. (Note that breast reduction may be covered by insurance, depending on terms of the policy and individual patient factors.)

Six new surgical procedures were added to the ASAPS survey for 2002. These included umbilicoplasty (belly button enhancement) and breast nipple enlargement, both of which have been reported as trends by the media. ASAPS statistics show that the actual number of these procedures was extremely small, with umbilicoplasty ranking 32nd (2,082 procedures) and breast nipple enlargement ranking 35th (540 procedures) among the 36 procedures surveyed. Since 1997, the number of cosmetic surgical procedures performed in the U.S. has increased 67 percent, according to ASAPS statistics.

Top Non-surgical Procedures

The top five non-surgical procedures were botulinum toxin injection (Botox), 1,658,667; microdermabrasion, 1,032,417; collagen injection, 783,120; laser hair removal, 736,458; and chemical peel, 495,415.

Botox injection continued to rank first among all cosmetic procedures, increasing a modest 4 percent since 2001 but more than 2400 percent since 1997. Microdermabrasion, a procedure that uses fine crystals to gently polish the skin, showed the highest one-year gain of any nonsurgical procedure, up 13 percent.

Gender Distribution

Males had 12 percent (807,692) of all cosmetic procedures, while females had 88 percent (6,081,857) of the total. The percentage of procedures attributable to males and females respectively was virtually unchanged from 2001. The top surgical procedure for both men and women was lipoplasty (liposuction).

Age Distribution

Among five designated age groups included in the survey, the greatest number of procedures (44 percent) was performed on people ages 35 to 50, with lipoplasty (liposuction) being the most popular surgery and Botox injection the most popular nonsurgical treatment. Those 18 years old and younger accounted for just over 3 percent of cosmetic procedures, down slightly from 2001. Among this age group, nonsurgical procedures including chemical peel, microdermabrasion and laser hair removal were the most popular. The most frequently performed surgical procedure for people 18 and under was ear reshaping, often done on very young children, and nose reshaping. Men and women 65 and older had 5 percent of procedures, with eyelid surgery as the top surgical procedure and Botox injection the most popular nonsurgical treatment in this age group.

Racial and Ethnic Distribution

Racial and ethnic minorities accounted for 19 percent of all cosmetic surgery procedures, an overall 2 percent increase from 2001: Hispanics, 8 percent; African-Americans, 5 percent; Asians, 4 percent; and other non-Caucasians, 2 percent.

ASAPS Members Performed Highest Number of Procedures Per Doctor

Among all physician groups surveyed, members of the American Society for Aesthetic Plastic Surgery performed the highest average number of cosmetic procedures per doctor (623 procedures) in 2002. Ninety-seven percent of ASAPS members operated in an accredited surgical facility (a requirement for ASAPS membership as of July 2002, with temporary extensions currently granted only for members in the process of accreditation). ASAPS members are certified by the American Board of Plastic Surgery and specialize in cosmetic surgery of the face and body.

ASAPS, working with an independent research firm, compiled six-year data for procedures performed 1997-2002 by multiple specialists, including plastic surgeons certified by the American Board of Plastic Surgery; head and neck surgeons certified by the American Board of Otolaryngology; and dermatologists certified by the American Board of Dermatology. More than 14,000 questionnaires were mailed nationwide to a random sampling of physicians most likely to perform several or more of the 36 top cosmetic procedures. Results of the survey were used to project national data on the number of cosmetic procedures performed in 2002 by nearly 23,000 physicians.

Source: American Society for Aesthetic Plastic Surgery

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