National report — With the number of cosmetic procedures performed nationally rising each year, the line between dermatology and plastic surgery continues to blur, as dermatologists devote more time to cosmetic procedures and plastic surgeons embrace less-invasive treatments.
According to figures released in February by the American Society for Aesthetic Plastic Surgery (ASAPS), the number of surgical and nonsurgical procedures performed in the United States last year jumped 44 percent over the previous year, to a total of nearly 11.9 million. The largest increase occurred in nonsurgical procedures, which rose 51 percent.
"The main reason for the increase perhaps could be that patients in general want to achieve maximal results with no downtime, and for a very low fee. Injectables are associated with two of these three goals," says Peter Fodor, M.D., ASAPS, president and associate clinical professor of plastic surgery at the University of California, Los Angeles.
Botox, fillers rank high
Currently, botulinum toxin (Botox, Allergan) and hyaluronic acid-based fillers such as Restylane (Q-Med) rank at the top of patients' wish lists. Less costly and invasive than surgical procedures, injections performed with such products often allow patients to return to work the same day.
"Injections are less frightening to a patient than a surgical procedure," Dr. Fodor tells Cosmetic Surgery Times.
For botulinum toxin, the U.S. Food and Drug Administration's approval for treating glabellar lines has erased much reluctance on the part of patients who initially worried about that material's toxic potential.
"Once Botox gained FDA approval," Dr. Fodor says, "patients became more liberal about requesting it."
Furthermore, injectables of all kinds hold particular appeal for male patients, who value quick recoveries perhaps more than do females. Last year, nonsurgical procedures performed on men rose nearly 80 percent.
Compared to prior years, "Cosmetic procedures in general are more readily accepted. They've really come out of the closet," Dr. Fodor says.
Increasing media coverage, particularly from makeover shows, has taught the public "there are other procedures beyond facelifts available," adds Ben M. Treen, M.D., a solo practitioner in Greenville, S.C., whose cosmetic practice has grown between 10 percent and 20 percent over the past two years.
Clearly, changing consumer demands are changing the face of both dermatology and plastic surgery.
The American Academy of Dermatology (AAD) takes no official position regarding ASAPS research.
But based on a now 2-year-old AAD member survey, "We know that on average, dermatologists spend about 12 percent to 15 percent of their practice time doing cosmetic work, either surgical or nonsurgical procedures," says David A. Pariser, M.D., AAD secretary-treasurer. "That creates a significant worry for the specialty of medical dermatology. Because the people who do more cosmetic work tend to be younger dermatologists, it is one of the reasons why we feel there is now a workforce shortage in medical dermatology that will increase in the next handful of years."