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Trends and truths: Facelifts, fat and Botox

Article-Trends and truths: Facelifts, fat and Botox

Several notable trends emerged this year from the annual statistics released by the American Society of Plastic Surgeons (ASPS) last month: Breast augmentation with fat is up by 72%. Labiaplasty continues to grow in popularity. And the facelift has made a comeback into the top five cosmetic surgical procedures in 2016.

ASPS released their 2016 statistics March 1, 2017, showing member plastic surgeons reportedly performed 17.1 million cosmetic procedures — from surgery to noninvasive — in the U.S., up 3% from 2015.

All About Fat

Minimally invasive fat injections rose 13% from 2015 to last year, while fat grafting to augment the buttocks increased 26% and fat transfer to increase breast size shot up 72%, according to an ASPS press release.

The popularity of injection-based Kybella (Allergan) increased 18% from the ASPS’ 2015 statistics. And non-invasive fat reduction procedures, such as CoolSculpting (Zeltiq) and Liposonix (Valeant Pharmaceuticals), increased 5%. Liposuction remains among the top cosmetic surgeries in the U.S. But while demand for liposuction was up 6% from 2015, and liposuction was the number two in the top five cosmetic surgeries, liposuction numbers are down 34% since 2000.

NEXT: Examining the Face


Examining the Face

The top five cosmetic surgical procedures in 2016 were:

  1. Breast augmentation
  2. Liposuction
  3. Nose reshaping
  4. Eyelid surgery
  5. Facelifts

All increased in demand in the single digits.

Although the number of facelifts performed was up 4% from 2015 (131,106 in 2016), facelifts have lost some ground — 2%, according to the statistics — since 2000.

Dr. TorkianBeverly Hills facial plastic surgeon Behrooz Torkian, M.D., says the recent climb in the facelift’s popularity makes sense for a couple of reasons.

For years, cosmetic physicians and surgeons and consumers thought fillers and devices might be able to achieve what a facelift could, but without the surgery, he says. But approaches, such as using volume fillers to increase volume in the cheeks and lateral face, only go so far.

“Yes, we can get a little bit of an upward pull in the tissue when the volume in the face has been augmented, but we can’t really get a lift. And there’s still going to be jowling and bagginess,” Dr. Torkian says.

As facelift outcomes become more refined and natural looking, surgeons and patients are going back to the traditional facelift, he says.

“I think it’s a natural swinging of the pendulum,” Dr. Torkian says.

Another reason for the uptick in facelifts, according to Dr. Torkian, could be that fillers and botulinum toxin A are becoming a gateway for younger patients to have facelifts. In essence, patients in their 30s, 40s and 50s like the results they get with fillers and neurotoxins and don’t want to go back, he says.

“So they’ve already entered into this cosmetic realm. They may have never expected or thought of themselves as the type of people who would get facelifts…. But now, all of the sudden, they’re sitting in the doctor’s office every couple of months or so and are getting exposed to it and used to the idea,” Dr. Torkian says. “We may actually be seeing the gateway effect taking place now, where we lure these people in with these nonsurgical procedures and, when it’s time for them to do their surgical procedures, they’re more open to it.”

NEXT: Implants, Labiaplasty & Botox


Implants, Labiaplasty & Botox

Silicone implants are the clear choice for most breast augmentations. Among the 290,467 breast augmentations performed in 2016, 84% were done with silicone implants, verus 16% with saline.

Labiaplasty, only tracked by ASPS since 2015, increased 39% in 2016, compared to the prior year. ASPS members reported performing 12,000 labiaplasties last year.

Botulinum toxin reigns among the minimally invasive cosmetic options. Plastic surgeons performed 15.5 million minimally invasive procedures in 2016, of which botulinum toxin type A was number one in the top five, with more than 7 million procedures in 2016. Soft tissue fillers came in second at more than 2.6 million procedures. Rounding out the top five minimally invasive cosmetic procedures by plastic surgeons last year: Chemical peels, up 4% from 2015; laser hair removal, which was a percentage point down from 2015; and microdermabrasion, which also fell from the prior year in popularity, by 3%.  

While the number of lip reductions performed by member plastic surgeons was relatively small at 3,547 in 2016, that was up 283% from the prior year.

Taking a closer look at individual fillers, demand fell from 2015 to 2016 for calcium hydroxylapatite, Radiesse, by 5%. Polylactic acid filler Sculptra and polymethyl-methacrylate microspheres Artefill also fell in demand by 4% each in 2016.

Disclosure: Dr. Torkian reports no relevant disclosures.

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