The American Society of Plastic Surgeons began tracking trends in the field in 1992, when 412,901 men and women sought some sort of enhancement surgery. In 2001, a little more than 7.4 million had some sort of surgical or non-surgical work done, an increase of 1,692%. (Plastic surgery is different from reconstructive surgery. Reconstructive surgery deals with such things as tumor removal, hand surgeries and laceration repair. 1.4 million such operation were performed in 2001).
Roughly 99,000 men had plastic surgery in 1998, representing 9% of patients. In 2001, more than 965,000 went for some nips and tucks, an increase of 875%. Their share of total cases more than doubled to 20%. Admittedly, we are talking about a small subset of men — there are about 50 million men between the ages of 20 to 49. But a growing number of men have become concerned about their looks. Men are being held to standards of physical beauty the way women have been: men need flat stomachs and have suddenly started to count calories. For some older men, a red sports car when they hit 40 or 50 simply won't do any more.
What kind of work are men getting done? Mostly procedures to smooth out wrinkles in the face and make them appear younger. Chemical peels, the most popular non-surgical procedure, improve skin texture by removing damaged layers of skin. It is most helpful for those with wrinkles, blemishes, or uneven skin pigmentation.
Hair transplantation was the second fastest growing procedure. It was the fourth most popular surgical procedure for men. The hair transplant industry has been conservatively estimated at $1 billion. Men want a full head of hair because our culture sees baldness in negative terms: a man without hair is boring and unsexy. The number of transplants does not even address the chemical treatments, such as Rogaine.
Dermabrasion is a process of surgical scraping to "refinish" the top layers of skin. Treatments can soften scars or lines in the face, particularly around the mouth. Collagen and fibril injections are rather similar. Collagen, which gives skin its elasticity, diminishes naturally as the body ages. In collagen injections, the substance is injected under the skin to smooth out lines and wrinkles. Fibril is used to fill in facial lines and creases and restore the skin's natural healthy look. Fibril is a gelatin powder compound that is mixed with the patient's own blood then injected to plump up skin. Chin augmentation involves adding synthetics or biologicals to the area below the lower lip to make the face more prominent or to perhaps give it greater symmetry.
Women aren't letting their numbers um…sag, however. The panel on the next page shows the fastest growing plastic surgeries for women. Females clearly still fuss over their features, with the number undergoing procedures increasing 587% from 1998 to 2001, from 946,784 to 6.5 million. Chemical peels were the most performed non-surgical procedure for women in 2001, with the numbers increasing from nearly 65,000 to 1.1 million in this four-year period. Other procedures remain popular: facelifts, liposuction, and eyelid surgery. Breast augmentation remains so popular — it was the top surgical procedure in both 1998 and 2001 — that its growth was minimal during this period.
Who goes for these procedures? In 2001, the largest category was for those between 35 and 50, with slightly more than 600,000 patients falling into this segment (37% of total patients). This really isn't surprising, as this is when the aging process first begins to show on the body. This was the top age bracket in 1998 as well. Most patients underwent procedures to slow/erase the aging process — to "grow old gracefully" as the saying goes. This age group got excess fat removed, lines smoothed from around their eyes, new breasts, and their tummies tucked. The next age group with the most patients was 19 to 34. They seemed slightly more interested in improving their looks. This age group got the most nose reshapings (151,092) and breast enlargements (122,045).
In looking at the youngest age group (18 or less) one can't help but wonder how many of these teenagers, still growing into both their bodies and their sexuality, are influenced by fashion and fitness magazines. There were nearly 24,000 ear surgeries, nearly 2,600 breast augmentations, over 1,000 chin augmentations, and over 43,000 nose reshapings performed on these young men and women in 2001. Many of these could be legitimate, certainly, but how many of these surgeries were borne out of teenage insecurities?
Percent Change in Plastic Surgery Treatments for Women, 1998-2001
These procedures — which are usually out of pocket costs for the patient — are not cheap either. A facelift is the most expensive of the common procedures, with the national average physician fee running roughly $5,000. Breast augmentation averages $3,043. Nose reshaping is $2,947. The prices remained fairly constant over the period, with some procedures becoming less expensive as the treatment is perfected. A chemical peel suddenly starts to sound like a bargain at $516, about half of what it cost in 1998.
New treatments are being discovered all the time. Botox became the most popular procedure in 2001, after the FDA approved the drug for cosmetic use. Botox is short for botulism toxin, the substance that causes botulism, a potentially fatal form of food poisoning. (It is administered in small enough doses so that it is fairly harmless). This "facelift in a syringe" has given birth to Botox parties, where a group of women (and sometimes men) get together, witness a demonstration, and then have the procedure performed on each of them. Botox does reduce wrinkles, true, but it only lasts a few months, and the $300 to 1,000 treatments can add up. Also, the drug can paralyze the nerves in the forehead, potentially diminishing the user's range of facial expressions. You can't frown, look surprised or squint, but, hey …. you look ten years younger.
In any discussion of who is a suitable plastic surgery candidate, some version of this line invariably appears: patient must be in good physical and emotional health. That last point is a good qualifier. Why do we get our tummies tucked, and our love handles zapped and a new jaw? Just to be beautiful and young? To help in the competition for mates? Many patients profess to being pleased with their new and improved physical selves. Great. But how many expect their new face to grant them a new life?
Source: Data come from the American Society of Plastic Surgeons, located at http://www.plasticsurgery.org.
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