You've probably heard of Silicon Valley, but have you heard of Silicon Alley? Beach? Hills? Forest?

As tech has become more mainstream, technology enclaves have cropped up well outside of the original tech capital of the US. Similarly, the aesthetics industry has seen its own medical aesthetics enclaves emerge well outside of our industry's traditional centers of gravity. The average person might think of New York, Miami, and Los Angeles as bastions of plastic surgery: all three places are large cities that are centers of social mobility; two are close to beaches, where bodies are often on display; and one is the entertainment capital of the world, where beauty and youthfulness are both prized assets. These are the places where a density of plastic surgeons created the competition and access to knowledge sharing that helped push the industry forward, where doctors went to cut their teeth and where consumers went to access best-in-class care.

But we're now in an era when nearly 40 percent of US adults are considering having a cosmetic treatment in the next year. Cosmetic procedures have gone mainstream, and we've seen the number of US beauty capitals multiply in tandem. What's interesting is that some of the places that boast the highest number of plastic surgeons and medspas by population might not be the most intuitive to the average observer.

RealSelf recently conducted a study to determine where these places are. Our goal was not only to identify them, but also to start thinking about what these places have in common, and what practices in cities and towns all over the country can learn from these beauty enclaves.

Here's what we learned

See the graphic maps on page 56 to see what our research about the top 10 metro areas with the most plastic surgeons and medaesthetic providers per capita revealed.

One of the most important things to know about aesthetics consumers are the set of triggers that compel them to investigate having a procedure done in the first place. The RealSelf 2018 Aesthetics Interest Survey uncovered the top motivators for consumers considering cosmetic procedures, and they include appearing youthful at work, improving one's self confidence and, for women, having children.

Those triggers offer some clues about the cities that made it to the top of our lists, as many of them are places where these triggers for considering cosmetic procedures cluster geographically. For example, five of the top ten cities for both medaesthetics procedures and plastic surgery are located near beaches—four in California and one in Miami—where self-confidence and weight-loss imperatives to have work done converge.

What binds the top 10 cities besides the beach? Jason Pozner, MD, a Boca Raton-based plastic surgeon who uses RealSelf, posited that in addition to year-round beach weather, south Florida was also the site of a critical mass of sophisticated consumers. “There is more awareness of technology, and consumers know more now,” he says. “They do their homework prior to a visit.”

Remember our “Silicon” centers of tech innovation? A number of them and other tech enclaves are represented on both the top plastic surgery and medaesthetics lists, including Seattle, San Francisco, San Jose, Los Angeles, Phoenix, Denver, and Austin. David Mabrie, MD, a plastic surgeon working in San Francisco, told us he sees many patients who see plastic surgery as a means to win a competitive edge in their careers. “The San Francisco Bay Area has always been home to urban professionals who want to look their best, and my practice has increasingly attracted these industry leaders,” he says, adding that the area's base of tech industry patients has grown as technology businesses have expanded beyond the core of Silicon Valley into the East Bay and within the City of San Francisco itself.

What about Salt Lake City, Utah? With 6.6 plastic surgeons per capita, Salt Lake made it into our top five cities for plastic surgery by population. Utah has the second-highest birth rate in the nation and one of the lowest average ages for first-time mothers. This drives the prevalence of “mommy makeover” procedures in Salt Lake.

What to Do About It

If you're working in a smaller market, explore how your demographics might align with those of our top metro areas and use that information as a jumping off point to give some thought to refreshing both your services and your marketing. Plastic surgeon and RealSelf Chief Marketing Officer Lara Devgan, MD runs a practice in New York, but said practices in smaller communities all over the country have an opportunity to thrive, in particular as cosmetic procedures continue to go mainstream.

“As innovation and medical advancements continue to disrupt this market, I expect consumer interest to grow and expand beyond major metros into suburbs and other smaller markets,” she explains.

Plastic surgeons might also consider adding medaesthetic treatments to their procedure menus. Dr. Devgan has responded to the growing popularity of non-invasive treatments by adding those services, as have other doctors across the nation.

“Consumer demand for medical aesthetic treatments is growing as new technologies and treatment options have made aesthetics more accessible to a wider audience,” she notes. By being mindful of how geography and demographics might affect the specific priorities of aesthetic consumers in their backyard, our industry has a golden opportunity to capture more consumers who have expressed interest in undergoing cosmetic procedures—and letting them do it close to home.