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Now that 2008 is in the books, it would be interesting to look at the trends and statistics in cosmetic surgery and see what has changed…or what is the same. Unfortunately, we will have to wait until the summer when the surveys and statistics for last year are available. However, the numbers from 2007 have been in since last summer and a review of these and the impact from the economic downturn in the U.S. can make for some predictions as to what happened in cosmetic surgery in 2008.

According to the 2007 statistics on cosmetic plastic surgery from the American Society of Aesthetic Plastic Surgery, roughly 12 million cosmetic surgical and non-surgical procedures were performed in the U.S. with expenditures of over $13 billion. I suspect we will see in 2008 that these numbers are roughly the same and perhaps even down a bit. The last quarter of the year saw a dramatic dwindling of patients undergoing procedures although this may have been tempered by the peak of the ‘holiday cosmetic season’ when many plastic surgeons post their highest monthly averages in December due to being being off work and those patients having procedures may have already saved or budgeted for them at that point. While 2007 saw an 8% increase in procedures compared to 2006, 2008 will likely show zero growth.

Cosmetic surgery accounted for 2/3rds ($8 billion) of the expenditures compared to non-surgical procedures (e.g., Botox) but these dollar figures highly skew the number of procedures performed. Because each surgery costs considering more than any non-surgical procedure (often 10 – 20 times more), cosmetic surgical procedures pale in comparison to non-surgical procedures in terms of numbers, roughly 1.5 million (surgery) to over 10 million (non-surgery) procedures. This dramatic trend of increasing non-surgical procedures will likely continue to be seen from 2008, representing by far the largest growth area of cosmetic procedures.

The top five surgical procedures in 2007 were liposuction, breast augmentation, eyelid surgery (blepharoplasty), abdominoplasty (tummy tuck), and breast reduction. (although breast reduction should really be considered a reconstructive plastic surgery procedure as the vast majority are paid for by health insurance) Facelift or rhinoplasty (nose job) should really displace breast reduction from this list. The top five non-surgical procedures in 2007 were Botox, injectable fillers, laser hair removal, microdermabrasion, and light and laser treatments. The popularity of these surgical and non-surgical procedures in 2008 will not change and the types and order of popularity should not change.

Women still account for the vast majority (91%) of cosmetic patients in 2007 and should remain around the same number, making decreasing to 90% in 2008. While it is true that more men than ever are having cosmetic procedures, calling it as jumping on the bandwagon, is a bit overstated. In 2007 men having cosmetic procedures, particularly non-surgical, increased significantly. (up 20%) However I would wager that a large amount of this increase was for one non-surgical cosmetic procedure only…laser hair removal. Go to any facility that has a high volume laser hair removal business and you will find that nearly half of their patients are men…for back hair removal. This one procedure accounts for much of the male cosmetic procedure trend. In 2008 this upward male trend for cosmetic procedures will likely continue, mainly in the non-surgical procedures.

In 2007 the age range with the most cosmetic procedures was 35 to 50, accounting for nearly half of all cosmetic procedures. It is this age range, and the non-surgical procedures that is done in this group, which has accounted for much of the large increase in cosmetic procedures done in the past 10 years. Liposuction and Botox remains the most popular procedures in this age group. The next age range (51 – 64) accounted for a quarter of the procedures (eyelid surgery headed the most common surgical procedure to no surprise) while senior citizens (age 65 or older) had a mere 5 percent. (seniors don’t spend a lot of money on cosmetic procedures due to retirement and fixed incomes) The age range of 19 to 34 rivals the senior group in number of procedures but breast augmentation and laser hair removal dominate the procedures. It is this age range that I suspect will see some drop in 2008 as they are one of the most cost sensitive groups due to their student status and early work force entry) Contrary to many reports of a boom in teenage plastic surgery, teens accounts for only 2% of the number of cosmetic procedures with ear surgery (otoplasty) and laser hair removal being the most popular procedures. Their number hardly represents a boom and that perception is largely media hype. In 2008, these age ranges will likely not have shifted at all as the ability to afford procedures relative to other household expenses is what drives cosmetic procedures for the vast majority of people.

Dr. Barry Eppley

Indianapolis, Indiana

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