ISAPS Reports Continuing Rise in Aesthetic Surgery Worldwide

Total surgical and nonsurgical cosmetic procedures increased by 7.4 percent in 2019, according to the International Society of Aesthetic Plastic Surgery (ISAPS) 2019 Global Survey.

The 7.4 percent increase is higher than in 2018 (5.6 percent). Both surgical and nonsurgical procedures increased in 2019 (7.1 percent and 7.6 percent respectively) compared to an increase only in nonsurgical procedures in 2018, the survey showed.

Despite a 3.6 percent decrease in the numbers of procedures in the last year, breast augmentation remains the most common cosmetic surgical procedure, making up 15.8 percent of all procedures. The top five most popular surgical procedures remain breast augmentation, liposuction, eyelid surgery, abdominoplasty, and rhinoplasty. 

The top five nonsurgical procedures also remained the same: botulinum toxin, hyaluronic acid, hair removal, nonsurgical fat reduction, and photo rejuvenation, ISAPS reports.

The decrease in breast augmentation procedures is notable, especially considering the 20.6 percent increase over the past five years. This may relate to issues surrounding Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). In fact, surgery to remove implants increased by 10.7 percent in 2019. 

Face and head procedures increased by 13.5 percent, compared to a 14.7 percent decrease the previous year. Eyelid surgery has increased in popularity among men, ISAPS notes.

Buttock surgery showed the highest growth for all surgical procedures. Specofcally, buttock augmentation increased by 38.4 percent in 2019 and by 65.9 percent since 2015, and buttock lifts by 25.5 percent in 2019 and by 77.6 percent since 2015.  Additionally, labiaplasty increased by 24.1 percent in 2019 and by 73.3 percent since 2015.

The use of nonsurgical injectables is up by 8.6 percent.  While botulinum toxin remains the most used, the highest percentage increase is seen for calcium hydroxyapatite, up 64.9 percent in 2019. The use of hyaluronic acid also continues to rise, up 15.7 percent since 2018, the survey showed.

Poly-l-lactic acid and microablative procedures also increased significantly: 24.1 percent and 34.2 percent, respectively.

The most common surgical procedures in women remain breast augmentation, liposuction, and eyelid surgery. Among men, the top three are gynecomastia, eyelid surgery, and liposuction.

The most popular nonsurgical procedures for both genders are botulinum toxin, hyaluronic acid, and hair removal, ISAPS reports.

Plastic Surgery Across the Globe

Most surgical procedures took place in women aged 35-50. Most breast augmentations (53.9 percent) and rhinoplasties (64.5 percent) took place in 19-34-year-olds, whereas botulinum toxin injectables were most popular among those aged 35-50 (46.1 percent of total). Rhinoplasty continues to be the most common cosmetic procedure in patients 18 years or younger.

The USA saw an 8.7 percent decrease in surgical procedures, but again performed the most procedures worldwide (15.9 percent of total), as well as 19.3 percent of all nonsurgical procedures and 77.8 percent of injectables. Brazil performed the most surgical procedures (13.1 percent of total) and nonsurgical procedures there rose by 28 percent. 

The top 10 countries of 2019 were USA, Brazil, Japan, Mexico, Italy, Germany, Turkey, France, India, and Russia.

USA and Brazil are estimated to have the most plastic surgeons, with more than 25 percent of the world total. Asian countries follow with China in third place, Japan in fourth, and South Korea in fifth.

Surgical procedures continue to be performed primarily in hospitals (47.9 percent worldwide), apart from the USA where 62.7 percent of procedures are performed in an office facility.

The countries seeing the highest proportion of foreign patients remain similar to last year: Thailand (33.2 percent), Mexico (22.5 percent) and Turkey (19.2 percent). 

About the Survey

A questionnaire was sent to approximately 25,000 plastic surgeons in ISAPS' database. The questionnaire focused on the number of surgical and nonsurgical procedures performed in 2019, and some ancillary questions related to medical tourism. The results were compiled, tabulated, and analyzed by Industry Insights, an independent research firm based in Columbus, OH.