Every spring I look forward to reviewing the American Society of Plastic Surgeons (ASPS) and American Society of Aesthetic Plastic Surgeons (ASAPS) annual statistics. This is a time to reflect on how our industry is doing and also how your own practice compares to the national numbers.
ASPS STATISTICS-2012
The ASPS, founded in 1931, is the leading plastic surgery organization worldwide. It currently has more than 7,000 physician members and represents more than 94% of all board-certified plastic surgeons in the United States. The ASPS statistics are collected through an online national database for plastic surgery procedures known as Tracking Operations and Outcomes for Plastic Surgeons. These data are combined with an annual survey that is sent to the American Board of Medical Specialists, which includes about 24,000 physicians most likely to perform cosmetic and reconstructive plastic surgery procedures (retrieved March 18, 2013, from http://www.plasticsurgery.org).
According to Gregory Evans, MD, ASPS President, "For the third consecutive year, the overall growth in cosmetic surgery continues to be driven by a significant rise in minimally-invasive procedures, while surgical procedures remain relatively stable. We are aware, however, that patients who begin with less invasive treatments with a plastic surgeon may opt for more invasive, surgical procedures once required" (retrieved March 20, 2013, from http://www.plasticsurgery.org).
Cosmetic Surgical Procedures
The ASPS 2012 statistics indicate that the top-five cosmetic surgical procedures are identical to the top five of 2011, but the order was slightly different. Augmentation mammoplasty was the most popular cosmetic surgical procedure in 2011 and 2012, but there was a 7% decrease from 2012 versus 2011. Of the 286,274 procedures performed in 2012, 62% were silicone and 38% were saline breast prosthesis.
The second most common procedure was rhinoplasty surgery with a negligible change from 2011. In 2011, the third most common procedure was liposuction, closely followed by blepharoplasty and then rhytidectomy. In 2012, the third most common was blepharoplasty, followed by liposuction and then rhytidectomy (see Table 1).
There was an overall 2% decrease in cosmetic surgery procedures compared to the previous year with buttock lift (36%) and buttock implants (25%) as the procedures having the largest percentage of decrease in popularity. It appears from this information that U.S. consumers are still being very careful with their spending for luxury items or procedures. This is to be expected, as the United States apparently is still recovering from its recession.
Cosmetic Minimally Invasive Procedures
Although the cosmetic surgery procedure numbers are down, there is an increase in popularity of the cosmetic minimally invasive procedures. The top-five procedures all had a positive increase from the previous year. It can be speculated that this may be due to an influx of better technologies and products or that consumers still want to improve their appearance but may not be willing to invest in the higher priced surgical procedures. Either way, the increased percentage is welcomed sight to the plastic surgery industry (see Figure 1).
To be expected, the use of neuromodulators increased again last year. It is important to note that the botulinum toxin type A numbers shown in Table 2 are of the anatomic sites injected, not the number of total units. With the recent approval of Xeomin (incobotulinumtoxinA) by the Food and Drug Administration, it will be safe to say that the numbers will increase again next year.
The use of soft tissue fillers maintains its popularity evidenced by a 5% increase from the previous year and a 105% increase from 2000. The introduction of a larger portfolio of longer lasting dermal fillers has allowed us to provide better results for our clients (see Table 2).
Reconstructive Procedures
There was a 1% overall increase in reconstructive procedures performed in 2012. The top-five reconstructive procedures were the same as the previous year with a very minimal percentage change from 2011 (see Table 3). There were more than 68,000 female breast reduction surgical procedures done in 2012, which is an 8% increase from 2011. There was a 5% increase in male breast reduction (gynecomastia) from last year, which may be attributed to increased awareness and acceptance of the operation.
ASAPS STATISTICS-2012
The ASAPS, founded in 1967, is the leading professional organization of plastic surgeons certified by the American Board of Plastic Surgery who specializes in cosmetic plastic surgery. There are more than 2,600 members worldwide. The ASAPS statistics represent data from multiple specialties such as plastic surgery, otolaryngology, and dermatology. A paper-based and online questionnaire was distributed to 23,000 board-certified physicians in these specialties, and the surveys results are used to project national totals (retrieved March 23, 2013, from http://www.surgery.org).
Cosmetic Surgical Procedures
In 2012, there were more than 10 million cosmetic procedures performed in the United States. Surgical procedures accounted for 17% of the total number of treatments and 61% of total expenditures. The nonsurgical procedures made up 83% of the more than 10 million procedures and made up 39% of total expenditures. The ASAPS statistics also show that women had more than 9.1 million cosmetic procedures, which is 90% of the total procedures performed in the United States. This is a 252% increase from 1997. Men had almost 1 million cosmetic procedures, which is 10% of the total for 2012. This is an increase of more than 106% since 1997 (see Table 4).
Similar to the data results from ASPS, breast augmentation surgery was the most popular cosmetic surgery performed in the United States in 2012. Of the 330,361 surgeries performed, 28% were saline implants and 72% used silicone implants. The recent approval of the anatomical shaped breast prosthesis in the United States may tip the percentage even more.
The top-seven procedures from 2012 for ASPS and ASAPS are all the same, but the order is slightly altered (see Table 5). Interesting to note from the ASAPS statistics is that in the past 16 years, there has been a 360% increase in the number of abdominoplasty procedures and a 540% increase in the number of mastopexy procedures performed in the United States.
Nonsurgical Procedures
The trend toward providing aesthetic services within a plastic surgeons office has provided the plastic surgeon with an extra source of income and is a way to keep a client in their practice. The steady increase of aesthetic nonsurgical procedures is not surprising because of a better quality of products, procedures, and technologies available. There was a 10.4% increase in nonsurgical procedures from 2011 to 2112 and a 461% increase since 1997. There was a 3.9% decrease in laser hair removal, but this may be due to the fact that this procedure is readily available outside of a physician's office (see Table 6). As with ASPS, the top nonsurgical procedure was botulinum toxin type A injections, which include Botox (onabotulinumtoxinA) and Dysport (abobotulinumtoxinA). The second most popular procedure performed was injectables. Of the 1,623,345 procedures reported, 1,423,705 were hyaluronic acid products, including Juvederm, Perlane/Restylane, Belotero, Prevelle, and Elevess (see Figure 2).
The information that can be obtained through data collection methods is extremely important to the practitioner's practice. Understanding the global trends will help guide us toward our own personal goals we have set for ourselves.
For more information about ASPS and ASAPS statistical data, please go to the following Web sites: http://www.plasticsurgery.org (American Society of Plastic Surgeons)