An international survey of over 35,000 plastic surgeons has revealed major changes in the popularity of surgical and nonsurgical procedures – while breast augmentation, liposuction and botulinum toxin continue to boom around the globe, the numbers seeking eyelid surgery, rhinoplasty, fat grafting and chemical peels have fallen markedly.
A worldwide survey by the International Society of Aesthetic Plastic Surgery (ISAPS) has reported 10,607,227 surgical procedures were performed by plastic surgeons worldwide in 2018 (up 15% since 2014), plus a further 12,659,147 nonsurgical procedures (up 24.5% since 2014).
However, while total procedures (surgical and non-surgical) increased most recently by 5.45% in 2018, surgical procedures as a total that year fell by 0.6%.
- Face and neck procedures fell by 17.2%
- Breast procedures rose by 9.7%
- Body and extremities procedures rose by 6% while total nonsurgical procedures rose by 10.4%
- Injectables rose by 14.5%
- Facial rejuvenation fell by 4%.
Among the trends highlighted by the survey, the most popular surgical procedures were breast augmentation (17.6% of 2018 treatments and up 27.6% in total since 2014) and liposuction (16.3% of 2018 treatments and up 20.8% in total since 2014). By far the most popular non-surgical procedures were botulinum toxin (48.2% of 2018 treatments and up 20.8% in total since 2014) and hyaluronic acid (29.5% of 2018 treatments and up 27.9% in total since 2014).
Other increasingly popular surgical procedures include abdominoplasty (up 23.2% since 2014), breast lift (up 29.7% since 2014), breast reduction (up 19.1%) and buttock augmentation (implants and fat transfer, up 35.8% since 2014).
Meanwhile major falls in popularity since 2014 include eyelid surgery (down 29.8%), rhinoplasty (down 16.9%), fat grafting (face, down 78.1%) and facelift (down 19.7%). In the non-surgical sector, other falls in popularity since 2014 include hair removal (down 39.3%) and chemical peel (down 20.8%).
In Australia Over 4% Had ‘Cosmetic Procedures’
In Australia, the survey reported plastic surgeons performed 202,642 cosmetic procedures (on a national population of 24 million) in 2018:
- 102,404 surgical procedures (4.2% of population); and
- 100,238 non-surgical procedures (4.1% of population).
Those figures compare with:
- USA: surgical (4.5% of population) and non-surgical (8.7%);
- Brazil: surgical (7.1%) and nonsurgical (3.6%);
- Germany: surgical (4.6%) and non-surgical (6.5%);
- Italy: surgical (4.7%) and nonsurgical (9%); and
- Argentina: surgical (6.3%) and non-surgical (7.4%).
Among the specific cosmetic procedures performed by Australia’s plastic surgeons in 2018 were:
- Surgical
- Breast 38,937 (38%)
- Face and Head 34,893 (34.1%)
- Body and Extremities 28,574 (27.9%)
- Non-surgical
- Injectables 71,840 (71.7%)
- Other (hair removal, fat reduction) 17,896 (17.9%)
- Facial rejuvenation 10,502 (10.5%)
Australian Emphasis On ‘Hospital’ Location
The survey highlighted that Australia recorded by far the greatest number of cosmetic procedures performed in hospitals – indeed we were the only country where over 70% of cosmetic treatments by plastic surgeons were hospital-based.
In contrast, in the USA the figure was only 19.2%, in Argentina 28.5%, in Italy 37.9% and in Germany 44%.
In distinguishing where cosmetic procedures were performed ‘by location’ the survey noted noted:
- Worldwide
- Office facility 28.2%
- Hospital 51.1%
- Free-standing surgicenter 19.6%
- USA
- Offi ce facility 55.5%
- Hospital 19.2%
- Free-standing surgicenter 25.1%
- Australia
- Office facility 20%
- Hospital 72.1%
- Free-standing surgicenter 7.9%
Australian ‘Medical Tourists’ Go To Thailand And India
The survey also reported that in terms of ‘Medical Tourism’, most foreign patients travelling to Australia for cosmetic procedures came from New Zealand, followed by the United Kingdom and Singapore.
And among Australian patients travelling overseas seeking cosmetic procedures in foreign countries, the largest number headed to Thailand followed by India.
26.7% Australian ‘Bigger Breast’ Women 17 Or Under
A potentially controversial figure revealed by the ISAPS survey was that in 2018 Australia had the world’s second largest cohort of women ‘aged 17 or younger’ who underwent breast augmentation.
At 26.7% of Australia’s 2018 total breast augmentation procedures that was more than 2.5 times the rate in the USA (10%), 4 times the rate in Argentina (6.5%), almost 5 times the rate in Italy (5.7%) and more than 7 times the rate in Germany (3.7%).
The overall ‘worldwide’ rate for breast augmentation for ‘women 17 or younger’ performed by plastic surgeons was 12.2% and, apart from Brazil (32.6%), other notable rates were Mexico (21.2%), Colombia (6.3%), India (6.1%) and Thailand (5.7%).
The ISAPS survey noted that the reasons reported by plastic surgeons for breast augmentations to patients 17 and under included:
- Congenital absent breast (Poland’s syndrome) 9.4%
- Severe asymmetry 22.4%
- Congenital micromastia 11.7%
- Tubular breast 23%
- Purely cosmetic bilateral augmentation 32.7%
- Other 0.9%
Global Trends
Top 10 Non-Surgical Procedures
These are the trends for each of the Top 10 non-surgical procedures performed by plastic surgeons globally in 2018.
Worldwide Non-Surgical Procedures By Plastic Surgeons
- Botulinum Toxin 6,097,516 – up 20.8% since 2014
- Hyaluronic Acid 3,729,833 – up 27.9% since 2014
- Hair Removal 916,869 – down 39.3% since 2014
- Non-surgical Fat Reduction 473,316 – down 1.1% since 2017
- Photo Rejuvenation 436,656 – down 25.0% since 2017
- Chemical Peel 408,485 – down 20.8% since 2014
- Micro-Ablative Resurfacing 201,797 – down 6.4% since 2017
- Full Field Ablative 192,880 – up 11.4% since 2017
- Calcium Hydroxylapatite 129,038 – down 50.9% since 2014
- Poly-L-Lactic Acid 72,756 – up 0.4% since 2014
Top 20 Surgical Procedures
These are the trends for each of the Top 20 surgical procedures performed by plastic surgeons globally in 2018.
Worldwide surgical procedures by plastic surgeons
- Breast Augmentation 1,862,506 – up 27.6% since 2014
- Liposuction 1,732,620 – up 20.8% since 2014
- Eyelid Surgery 1,099,960 – down 29.8% since 2014
- Abdominoplasty 888,712 – up 23.2% since 2014
- Rhinoplasty 726,907 – down 16.9% since 2014
- Breast Lift 710,014 – up 29.7% since 2014
- Fat Grafting (face) 542,305 – down 78.1% since 2014
- Breast Reduction 534,294 – up 19.1%
- Facelift 398,798 – down 19.7% since 2014
- Buttock Augmentation (implants & fat transfer) 346,432 – up 35.8% since 2014
- Gynaecomastia 269,720 – up 36.2%
- Ear Surgery 262,078 – up 5.6% since 2014
- Neck Lift 225,578 – down 16.7% since 2017
- Brow Lift 220,055 – down 13.3% since 2017
- Upper Arm Lift 138,922 – up 29.2% since 2014
- Labiaplasty (excluding vaginal rejuvenation) 132,664 – up 25.0% since 2014
- Facial Bone Contouring 98,727 – down 25.2% since 2014
- Thigh Lift 84,508 – down 2.6% since 2017
- Lower Body Lift 81,147 – down 8.5% since 2017
- Buttock Lift 43,734 – up 0.85% since 2017
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2018 Statistics at a glance
Top 5 surgical procedures worldwide
absolute numbers and changes compared to 2017
1. Breast Augmentation 1,862,506 procedures +6,1%
2. Liposuction 1,732,620 procedures +9,2%
3. Eyelid Surgery 1,099,960 procedures -22%
4. Abdominoplasty 888,712 procedures +9,7%
5. Rhinoplasty 726,907 procedures -20,7%
Top 5 nonsurgical procedures worldwide
absolute numbers and changes compared to 2017
1. Botulinum Toxin 6,097,516 procedures +17,4%
2. Hyaluronic Acid 3,729,833 procedures +11,6%
3. Hair Removal 916,869 procedures -8,8%
4. Nonsurgical Fat Reduction 473,316 procedures -1,1%
5. Photo Rejuvenation 436,656 procedures -25%
Top 5 surgical procedures for women
1. Breast Augmentation 1,841,098 procedures
2. Liposuction 1,482,395 procedures
3. Eyelid Surgery 872,367 procedures
4. Abdominoplasty 812,387 procedures
5. Breast Lift 710,014 procedures
Top 5 nonsurgical procedures for women
1. Botulinum Toxin 5,344,764 procedures
2. Hyaluronic Acid 3,382,281 procedures
3. Hair Removal 766,768 procedures
4. Nonsurgical Fat Reduction 392,494 procedures
5. Photo Rejuvenation 382,843 procedures
Top 5 surgical procedures for men
1. Gynecomastia 269,720 procedures
2. Liposuction 250,225 procedures
3. Eyelid Surgery 227,593 procedures
4. Rhinoplasty 188,696 procedures
5. Ear Surgery 98,728 procedures
Top 5 nonsurgical procedures for men
1. Botulinum Toxin 752,752 procedures
2. Hyaluronic Acid 347,552 procedures
3. Hair Removal 150,101 procedures
4. Nonsurgical Fat Reduction 80,822 procedures
5. Photo Rejuvenation 53,813 procedures
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46,300 Plastic Surgeons Globally
The International Society of Aesthetic Plastic Surgery (ISAPS) was founded in 1970 and is the world’s leading professional body for board-certifi ed aesthetic plastic surgeons, with members in over 100 countries.
ISAPS estimates there are 46,300 plastic surgeons globally and 35,000 of these were invited to complete a questionnaire primarily focused on the number of specifi c surgical and non-surgical procedures performed in 2018, along with some ancillary questions related to medical tourism.
The top 30 countries and estimated numbers of plastic surgeons were:
- USA 7,009 (15.1% of global total)
- Brazil 6,393 (13.8%)
- China 3,000 (6.5%)
- Japan 2,663 (5.8%)
- South Korea 2,330 (5%)
- India 2,300 (5%)
- Russia 1,880 (3.9%)
- Mexico 1,656 (3.6%)
- Italy 1,600 (3.5%)
- Germany 1,417 (3.1%)
- Turkey 1,400 (3%)
- Argentina 1,375 (3%)
- Spain 1,031 (2.2%)
- Colombia 1,026 (2.2%)
- France 925 (2%)
- Chinese Taipei 686 (1.5%)
- Venezuela 586 (1.3%)
- United Kingdom 578 (1.2%)
- Egypt 540 (1.2%)
- Australia 535 (1.2%)
- Canada 530 (1.1%)
- Peru 507 (1.1%)
- Thailand 375 (0.8%)
- Greece 340 (0.7%)
- Iran 324 (0.7%)
- Belgium 300 (6%)
- Netherlands 270 (0.6%)
- Austria 260 (0.6%)
- Portugal 258 (0.6%)
- Saudi Arabia 226 (0.5%)
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