ISAPS 2021 Data: U.S. Is Plastic Surgery Capital of the World

And the winner is … the USA.

Plastic surgeons in the U.S, performed the most plastic surgery procedures worldwide (24.1% of the total), with 30.4 percent of all non-surgical procedures and 15.5 percent of all surgical procedures in 2021, according to the latest stats from the International Society of Aesthetic Plastic Surgery (ISAPS).

Brazil came in second, with 8.9 percent of the total, and Japan (5.7%) took third.  The USA and Brazil are estimated to have the most plastic surgeons, with more than 30% of the world's total. Asian countries follow with China in third place, Japan in fourth, and South Korea in fifth.

And the most plastic surgery popular procedure worldwide was Liposuction, with more than 1.9 million procedures and a 24.8 percent increase from 2020, overtaking breast augmentation by 3.8 percent

The big picture

There was a 19.3 percent overall increase in procedures performed by plastic surgeons in 2021 with more than 12.8 million surgical, and 17.5 million non-surgical, procedures performed worldwide, ISAPS reports. This 19.3 percent increase shows recovery from 2020, which saw an overall drop of 1.8 percent in all procedures and a 10.9 percent decrease in surgical procedures due to the impact of COVID-19 on global practice.

The new report shows a continuing rise in aesthetic surgery with a 33.3 percent increase over the last four years.

Both surgical and non-surgical procedures showed increases since the last survey (18.5% and 19.9% respectively) with a significant increase of 54.4 percent in non-surgical procedures in the last four years.

The top five most popular surgical procedures remain liposuction, breast augmentation, eyelid surgery, rhinoplasty, and abdominoplasty. 

The top five non-surgical procedures are botulinum toxin, hyaluronic acid, hair removal, skin tightening, and fat reduction.

Breast augmentation remains the most common surgical procedure for women, with only a slight increase of +0.5 percent in the last four years. By contrast, surgery to remove implants increased by 22.6 percent (+49.6% in the last four years), and breast lifts by 31.4 percent in the last year.

Face and head procedures increased by 14.8 percent with eyelid surgery being the most common procedure, and the most popular surgical procedure among men. Thigh lift showed the highest growth for all surgical procedures (+53.1%). Buttock lifts and buttock augmentation have also increased by 45.7 percent and 40.5 percent respectively since 2017.

The other most common surgical procedures in women remain liposuction and eyelid surgery. Among men, the other top two are gynecomastia (increasing notably) and liposuction, according to the 202i statistics.

"These data clearly reflect the experience of recovery from the previous year's negative impact of COVID-19 on aesthetic procedures and numbers now exceed the pre-pandemic ones,” says Gianluca Campiglio, MD, PhD, a plastic surgeon in Milan, Italy, in a news release. “We noticed an interesting increase in surgical procedures related to so-called "body contouring", such as liposuction, which is now ranked as the most common procedure, ahead of breast augmentation for the first time in many years, and also a similar emerging trend for abdominoplasty, thigh lift, and buttock augmentation. The lower increase in breast augmentation, and related increase in implant removals, also reflects our experience following publication of reports on BIA-ALCL in the preceding year."

Most breast augmentations (53.1% of the total) and rhinoplasties (63.7%) took place in 19–34-year-olds, whereas botulinum toxin injectables were most popular among those aged 35–50 (47.2% of the total), ISAPS reports.

Botulinum toxin remains the most common non-surgical procedure for both men and women and across all age groups, with more than seven million procedures performed by plastic surgeons worldwide. This also becomes the most common aesthetic procedure in patients aged 18 years or younger, overtaking rhinoplasty in previous years.

There has been a notable increase in hyaluronic acid injections (+30.3%) and Dr. Campiglio says this may relate to the growing use of this product in other parts of the body such as the buttock.

Surgical procedures continue to be performed primarily in hospitals (43.5% worldwide) or office facilities (35.6%). The countries seeing the highest proportion of foreign patients are Turkey, Colombia, Mexico, and Thailand.

About the survey 

Survey participants completed a questionnaire that primarily focused on the number of specific surgical and non-surgical procedures performed in 2021, along with some ancillary questions related to the impact of COVID-19, surgeon demographics, and the prevalence of medical tourism. Data from a total of 1,003 plastic surgeons were compiled for this survey. The results were compiled, tabulated, and analyzed by Industry Insights, Inc.