8.5 million cosmetic procedures done in 2001
Women, baby boomers make up most patients
The past stigma that was associated with use of cosmetic surgery to improve appearance has decreased dramatically. Fifty-five percent of Americans approve of cosmetic surgery, with 34% of women and 19% of men saying that they would consider cosmetic surgery now or in the future, according to a 2002 consumer survey conducted by the American Society for Aesthetic Plastic Surgery (ASAPS) in Los Alamitos, CA.
Not only are Americans saying that they approve of cosmetic surgery, but they are actually seeking the procedures, according to the 2001 ASAPS physician survey. Nearly 8.5 million cosmetic surgical and nonsurgical procedures were performed in 2001, a 48% increase over the previous year’s total of 5.7 million. The five most popular surgical procedures in 2001 were lipoplasty (385,390), eyelid surgery (246,338), breast augmentation (216,754), rhinoplasty (177,422), and facelift (117,034).
While women still account for the majority of the procedures (88%), men had more than 1 million cosmetic procedures that represented 12% of the total, an increase over the 11% represented by men’s procedures in 2000. The top three surgical cosmetic procedures for men were lipoplasty, rhinoplasty, and blepharoplasty or eyelid surgery.
Baby boomers, ages 35-50, had 44% of all cosmetic procedures. "The younger age group of patients typically undergo breast augmentation, liposuction, and rhinoplasty," says Malcolm D. Paul, MD, president of ASAPS. "The safety of these procedures, particularly the validation of the safety of augmentation mammoplasty and liposuction, have caused the increase in these numbers."
Plastic surgeons expect to see a continued increase in the numbers of procedures due to the number of baby boomers who want to "look as good as they feel," Paul says. Public acceptance of cosmetic surgery, safety of the procedures, and new procedures that are effective but less traumatic than conventional procedures are factors that will contribute to a continued increase, he adds. Some of the newer procedures include endoscopic brow lifts, power-assisted suction lipectomy that is less traumatic than traditional lipectomy, and minimal incision necklifts and facelifts, Paul says. (See "Mini-facelifts offer quick recovery, attract patients," Same-Day Surgery, March 2002, p. 36.)
Another new method for cosmetic surgery is the lipoplasty-only breast reduction, says James Baker Jr., MD, of Winter Park, FL, chair of the ASAPS Breast Surgery Committee. Breast reduction surgeries increased by 28%, from 90,042 in 2000 to 114,926 in 2001, and Baker expects that number to continue increasing as the benefits of lipoplasty breast reduction become more well known.
Because breast tissue is predominantly fatty tissue, it is ideal for lipoplasty, Baker says. Patient selection is important because the greater the amount of fatty tissue in the breast, the easier it is to shape and the better the results will be, he explains. "Perimenopausal and menopausal women have breasts that are mostly fat, so they are the best candidates," Baker adds.
Women who want a small-to-moderate reduction in breast size also are good candidates, he says. "A large, droopy breast for which the patient wants a significant reduction is not appropriate," he says. If you try to remove too much fat, it is harder to maintain an appropriate shape, and the nipple moves too much out of its normal position, Baker explains. "The best results are obtained with women who want to decrease their bra size by no more than one or two cups," he adds.
The advantage of breast reduction lipoplasty is that it is minimally invasive, Baker says. "There are tiny incisions that are made in the crease of the breast, and the patient is up and following her normal schedule the next day," he explains. This compares to conventional breast reduction that requires suture removal the following week and seven to 10 days before the women returns to a normal schedule, he adds.
Operating room time is significantly less. One hour or less is required for lipoplasty vs. three hours for the traditional surgery, which means less time under general anesthesia for the patient, Baker says. Many times, a surgeon also will have a woman undergoing traditional breast reduction spend one night in the hospital, he adds. One point that Baker makes about tools for the surgery is "a surgeon must use a rounded, blunt tip cannula to avoid disturbing breast tissue."
Another benefit of breast reduction lipoplasty is that it does not leave any scar tissue or other type of mass that might distort future mammograms, Baker says.
As with most cosmetic procedures, breast reduction surgery is most often a self-pay procedure, he says. "Occasionally, if the woman has experienced severe neck pain or lower back pain and a certain amount of breast tissue has to be removed, an insurance company will cover the procedure." Baker sees an increase in the number of women seeking breast reduction lipoplasty. "Because it is most often a self-pay, the lower cost of lipoplasty breast reduction, as a result of less OR time and no hospital stay, and quicker recovery, will appeal to many women," he says.
Sources
For more about cosmetic procedures, contact:
• Malcolm D. Paul, MD, 1401 Avocado Ave., Newport Beach, CA 92660. Telephone: (949) 760-5047. E-mail: [email protected].
• James L. Baker Jr., MD, 400 W. Morse Blvd., No. 203, Winter Park, FL 32789. Telephone: (407) 644-5242. E-mail: [email protected].
To obtain a free copy of the results of the 2001 American Society for Aesthetic Plastic Surgery (ASAPS) survey, contact: ASAPS Communications Office, 36 W. 44th St., Suite 630, New York, NY 10036. Telephone: (212) 921-0500. Fax: (212) 921-0011. E-mail: [email protected]. Results of the survey, along with downloadable graphs and spreadsheets, can be seen at www.surgery.org.
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