FROM HEAD TO TOE
COSMETIC SURGERY: A
PERSPECTIVE ON AGING
Mark E. Chariker, MD, FACS
T
he realm of cosmetic surgery is
on the rise in the US and globally.
Based on the American Society of
Plastic Surgery (ASPS) statistics re-
leased last March, non-invasive fat
reduction increased 6% to nearly
377,000 procedures, breast aug-
mentation was up 4% to 313,735 procedures
and liposuction increased by 5% to 258,558 procedures.
Breast augmentation took the number one place among the
top five most popular cosmetic surgical procedures. Liposuction
came in second, with rhinoplasty (down 2%), blepharoplasty
(down 1%) and abdominoplasty (0% change) rounding out the
top five surgical cosmetic procedures. ASPS member plastic sur-
geons performed about 12,000 more liposuction procedures and
13,000 more breast augmentations in 2018 versus 2017. While
buttock implant procedures went down by 28% and were among
the least performed procedures in 2018, buttock augmentation
with fat grafting went from 20,301 procedures in 2017 to nearly
25,000 in 2018, a 19% increase.
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LOUISVILLE MEDICINE
The incidence of cosmetic procedures (surgical and nonsur-
gical) was approximately 17.7 million reported by the ASPS with
15.9 million of those being noninvasive or minimally invasive. The
national numbers are estimated to exceed 55 million per year in-
cluding procedures performed by non-surgeons, non-physicians
and dentists. The economic pressures continue to trend upwards,
with nonsurgical procedures creating the majority of procedures.
Intuitively, one would conjecture the driving force is to look more
attractive, but a study in The Journal of the American Medical
Association (JAMA) Dermatology, notes that, “Often, the moti-
vation is not simply to look attractive, but to address serious psy-
chological and emotional issues.” In the July issue of the Aesthetic
Surgery Journal, women having a cosmetic procedure described
age discrimination or the fear of age discrimination as the driving
force for their decision to have the anti-aging procedure. In 2007
in Silicon Valley, it did not help aging patients when Mark Zucker-
berg, then 22, told attendees at a Stanford University conference,
“Young people are just smarter.” During the Great Recession, com-
plaints of age discrimination from both men and women to the
Equal Employment and Opportunity Commission skyrocketed.