American Academy of Facial Plastic and Reconstructive Surgery 26 Membership Survey: Trends in Facial Plastic Surgery February 27 AAFPRS 31 South Henry Street Alexandria, VA 22314 Phone: (73) 299-9291 Web site: www.facemd.org Referrals: (8) 332-FACE
Table of Contents Introduction... 3 Major Findings.. 4 Detailed Findings. 7 26 Overall s and Trends. 8 26 s In Selected Procedures.. 11 Patients By Gender...... 13 Patients By Age. 18 Location of Procedures 19 Average Fees.... 2 Multiple Facial Procedures. 21 Past Year Trends.. 22 Procedures by Ethnicity. 23 Future of Plastic Surgery..... 24 Board Certification Status..... 25 Appendix.... 26 26 vs. 25 s in Selected Procedures (Zeros Included) Patients By Gender (Zeros Included) Patients By Age (Zeros Included) 2
Introduction Objectives The objective of this research is to provide statistics and insights for facial plastic surgery. This study also provides trend information regarding the frequency of both reconstructive and cosmetic surgery the results are compared to similar studies conducted since 2. Study Method A self-administered questionnaire was sent to 1,336 members and fellows of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), including those board certified by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS). Since 24, only ABFPRS certified members received the survey, so to trend accurately, only answers from those Surgeons who are ABFPRS certified are being reported (N = 118 26/N=145 25). Overall, 193 completed surveys were returned, representing a 15 response rate. All data tabulations were conducted by ICR in Media, PA. Reading Notes The base sizes are noted for each question. In some cases, the base sizes are less than the total (N=118 ABFPRS certified Surgeons) since some surgeons performed zero procedures (for a specific procedure) in 26. It was necessary to report zero suppressed findings since data obtained prior to 2 were reported this way. These cases are noted. Where percentages add to more than 1, it is due to either a multiple response question, or rounding to the nearest percent. Where percentages add up to less than 1, this is due to the exclusion of don t know and no answer. In some cases, physicians incorrectly entered data. In some cases questions were changed slightly from year to year to obtain more accurate data. As a result, we are not able to provide trend information since 2 for these questions. And, most importantly, any projections based on these results must be made with extreme caution. The base sizes are small (N=118) resulting in significant margins of error around the data. About AAFPRS The AAFPRS is the world s largest association of facial plastic and reconstructive surgeons with approximately 2,8 members whose cosmetic and reconstructive surgery focuses on the face, head and neck. Academy fellows are board-certified and subscribe to a code of ethics. In addition, the AAFPRS provides consumers with free information and brochures and a list of qualified facial plastic surgeons in their area by visiting the AAFPRS Web site www.facemd.org. Contact Information For more information, or to schedule an interview with an AAFPRS spokesperson, please contact Rita Magness at AAFPRS, rcmagness@aafprs.org or (73) 299-9291, x227. 3
Major Findings ABFPRS certified surgeons report performing an average of 865 facial cosmetic surgical, cosmetic non-surgical, and reconstructive procedures per surgeon in 26 (see page 8). This proportion is up by 34 since 25, and similarly increased since 2 (+39). Increases from 2 are primarily attributable to the increase in cosmetic non-surgical procedures among women (+69) and men (+91). The increase in cosmetic surgical procedures since 25 are mainly attributable to an increase among men (+59), and also women (+44). Compared to 1999, Hispanic (+37), African American (+43), and Asian-American (+28) cosmetic surgical patients increased (see page 9). The proportion of Caucasian cosmetic surgical patients is similar to that in 1999, only increased by 2. In the past year there has been little change among Hispanic, African American, and Caucasian cosmetic surgical patients; Asian American cosmetic surgical patients have decreased since 25 (-19). In 26, the most popular cosmetic surgical procedures were blepharoplasty (58 procedures per surgeon, on average), rhinoplasty (54 procedures), and Rhytidectomy/plasty (53 procedures). The most common cosmetic non-surgical procedures were Botox (384 procedures), microdermabrasion (264 procedures), Hyaluronic acid (169 procedures), and chemical peels (162 procedures) (see pages 1-12). The most notable increases in number of procedures from 25 to 26 are lip augmentations, collagen and poly-llactic acid. Comparing to 22, the most significant increases in procedures are as follows: Botox (+221), microdermabrasion (199), lip augmentations (+119), laser resurfacing (+112), and rhytidectomy/plasty (+15). The following are notable changes from 24 (see page 13): Overall Increases (since 25): Increases among Women and Men (since 25): Lip augmentations (up by 167) - Microdermabrasion in men (up by 234) Collagen (up by 133) - Fat injections in men ( up by 145) Poly-L-lactic acid (up by 114) - Lip augmentations in women (up by 145)* - Poly-L-lactic acid in women (up by 118) Overall Decreases (since 25): Laser resurfacing (down by 18) * Caution: Lip augmentations up in men since 25 (up by 627*), however the average number of procedures was very low in 25 (about 1 procedure per physician on average) and 26 (about 8 procedures). 4
Major Findings, continued Women continue to be the most likely candidates for facial plastic surgery 77 of all surgical procedures and 81 of all non-surgical procedures are performed on women (see page 8). Men and women are almost evenly split in terms of reconstructive procedures. The most common cosmetic surgical procedures undergone by women are blepharoplasty (average of 47 procedures per surgeon that performed at least one procedure in 26), rhytidectomy / rhytidoplasty (46 procedures), lip augmentations (39 procedures), rhinoplasty (36 procedures), and ablative skin resurfacing (33 procedures). The most common non-surgical cosmetic procedures among women are Botox (335 procedures in 26), microdermabrasion (23 procedures), chemical peels (139 procedures), and hyaluronic acid injections (139 procedures) (see pages 14 and 16). Among male patients, microdermabrasion (73 procedures in 26), Botox (52 procedures), hair transplants (39 procedures), chemical peels (32 procedures), hyaluronic acid injections (22 procedures), and rhinoplasty (19 procedures) are the most common procedures (see pages 15 and 17). Surgeons estimate that approximately one out of every two (53) procedures performed in 26 took place at private offices, and three in ten (28) at a free-standing surgical center. About one out of every six procedures (16) were performed at hospitals, and much fewer at a medical spa (2) (see page 19). Rhytidectomy/rhytidoplasty commands the highest average fee per procedure ($6894, on average), followed by hair transplants ($6126), rhinoplasty ($4829), and forehead lifts ($3685) (see page 2). More than one-half of patients (56) have had multiple facial procedures in the same year (see page 21). 5
Major Findings, continued According to these surgeons, the latest trends seen in their offices in 26 are patients being more educated about plastic surgery (86 agree), patients being given plastic surgery as a gift (49), patients traveling abroad for plastic surgery and then coming in with complications and re-do s (48), teens undergoing cosmetic surgery (48), and couples undergoing cosmetic surgery together (47). In 26 among four different popular cosmetic surgeries, African Americans were most predisposed to have received rhinoplasty (62), as were Hispanics (53). Asian Americans were most likely to have received blepharoplasty (44), while Caucasians were slightly more likely to have received blepharoplasty (32) and then rhinoplasty (29). Surgeons feel that the future holds more filler introductions into the market (96) and patient safety as a continued focal point in cosmetic surgery (94). They also foresee in increase in cosmetic surgery for ethnic populations (85). Most (85) surgeons indicated they are ABOto certified (American Board of Otolaryngology). Three in five (61) are ABFPRS certified (American Board of Facial Plastic and Reconstructive Surgery). 6
Detailed Findings 7
26 Overall s and Trends Average Number of Procedures Per Surgeon 459 41 359 274 262 186 132 12 Cosmetic - Surgical Cosmetic - Non-surgical 334 347 Reconstructive 35 284 266 244 234 175 121 117 17 122 26 25 24 23 22 21 2 Women 26 25 24 23 22 21 2 Change Since 2 Change Since 25 Category: Cosmetic Surgical Cosmetic Non-surgical Reconstructive 212 373 67 147 287 53 25 344 198 265 62 247 289 63 13 36 5 186 221 62 +14 +69 +8 +44 +3 +26 Men 26 25 24 23 22 21 2 Change Since 2 Change Since 25 Category: Cosmetic Surgical Cosmetic Non-surgical Reconstructive 62 86 65 39 72 49 57 66 46 4 59 37 45 54 45 41 57 48 45 6 +29 +91 +8 +59 +19 +33 Q5. Please estimate the total number of procedures you have performed in 26. Base: N=118 ABFPRS certified Members = Data not available for reconstructive procedures. Surgeons responding zero to any procedure category are NOT included above. 8
26 Overall s and Trends 1 Percentage of Patients By Ethnic Group in 26 8 6 Cosmetic 4 2 Caucasian Hispanic Asian American African American Other Percentage of Patients By Ethnic Group Caucasian Hispanic African-American Asian-American 26 1999 Change Since 1999 26 1999 Change Since 1999 26 1999 Change Since 2 26 1999 Change Since 1999 Category: Cosmetic 77.6 75.8 +2.4 8.6 6.3 +36.5 5. 3.5 +42.9 7.6 6. +26.7 26 Change 25 Since 25 26 Change Since 25 26 25 Change 25 Since 25 26 25 Change Since 25 Category: Cosmetic 77.6 83.8-7.4 8.6 9.2 +6.5 5. 6.2-19.4 7.6 7.1 +7. Q1. Please estimate the following percentages of your patients by race/ethnicity. Base: N=118 ABFPRS certified Members 9
26 s and Trends in Selected Procedures Average Number of Procedures Performed Per Surgeon 26 25 Change 26 vs. 25 24 Change 26 vs. 24 23 Change 26 vs. 23 22 Change 26 vs. 22 Blepharoplasty 57.5 55.7 3 66.5-14 68.9-17 77.5-26 Botox 384. 315.6 22 355. 8 171.8 124 119.7 221 Implants^ Calcium Hydroxyapetite, PMMA beads** 18. 49.9 9.8 46.3 84 8 -- -- -- -- -- -- Chemical Peels 162. 125.6 29 134.4 21 11.6 47 84.9 91 Chin Augmentation Collagen/Cosmoderm/ Cosmoplast** 14.2 4.1 1.6 17.2 34 133 12.4 15 -- 14.1 1 -- 11.1 28 -- Fat Injections 37.4 28.1 33 18. 18 57.4-35 19.7 89 Forehead Lift 24.4 2.3 2 26.2-7 3. -19 19.6 25 Hair Transplant 44. 37.3 18 32.3 36 -- -- Hyaluronic Acid** 168.9 122.7 38 -- -- -- Laser Resurfacing*** 39. 47.8-18 31.7 23 49.9-22 18.4 112 Lip Augmentation 39.5 14.8 167 22.9 73 21.5 84 18. 119 Microdermabrasion 264. 188.9 4 161.3 64 167.9 57 88.2 199 Otoplasty 6.9 5.1 35 5.5 26 9.5-27 4.9 41 Poly-L-Lactic Acid** 52. 24.3 114 -- -- -- Rhinoplasty 53.5 48.9 9 54.3-2 52.9 1 71.7-25 Rhytidectomy/Rhytidoplasty 52.8 38. 39 4.5 3 37.4 41 25.7 15 Scar Revision 17.7 18.7-5 17.1 4 37.5-53 15.5 14 ** In 24, these procedures were included in Filler Injections *** Starting in 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7. Please estimate the number of procedures, the average cost per procedure, and the percentage of male/female patients receiving each procedure. Base: N=118 ABFPRS certified Members Surgeons responding zero to any procedure category are NOT included above. 1
26 s in Selected Surgical Procedures Average Number of Procedures Performed Per Surgeon 2 4 6 8 1 12 14 16 18 Blepharoplasty Rhinoplasty Rhytidectomy/plasty Hair Transplant Lip Augmentation Laser Resurfacing*** 57.5 53.5 52.8 44. 39.5 39. Forehead Lift Implants Scar Revision Chin Augmentation Otoplasty 24.4 18. 17.7 14.2 6.9 *** Starting in 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7. Please estimate the number of procedures, the average cost per procedure, and the percentage of male/female patients receiving each procedure. Base: N=118 ABFPRS certified Members Surgeons responding zero to any procedure category are NOT included above. 11
26 s in Selected Minimally Invasive Procedures Average Number of Procedures Performed Per Surgeon 5 1 15 2 25 3 35 4 Botox 384. Microdermabrasion 264. Hyaluronic Acid** 168.9 Chemical Peels 162. Poly-L-Lactic Acid** 52 Calcium Hydroxyapetite, PMMA beads** 49.9 Collagen/Cosmoderm/Cosmoplast** 4.1 Fat Injections 37.4 ** In 24, these procedures were included in Filler Injections Q7. Please estimate the number of procedures, the average cost per procedure, and the percentage of male/female patients receiving each procedure. Base: N=118 ABFPRS certified Members Surgeons responding zero to any procedure category are NOT included above. 12
Patients By Gender Average Number of Procedures Performed Per Surgeon -- Zeros Excluded -- Women Men 26 25 Change 26 25 Change 26 25 Change Blepharoplasty 57.5 55.7 +3 47. 48.1-2.3 1.1 8.8 14.8 Botox 384. 315.6 +22 319.8 274.8 16.48 51.8 51.4.8 Implants ^ 18. 9.8 +84 15.3 8.1 88.9 4.8 3.1 54.8 Calcium Hydroxyapetite PMMA beads** 49.9 46.3 +8 28.5 42.7-33.3 1.5 6.5 61.5 Chemical Peels 162. 125.6 +29 11.9 115.6-4.1 32.4 17.5 85.1 Chin Augmentation 14.2 1.6 +34 1.1 8.5 18.8 5.7 3.3 72.7 Collagen/ Cosmoderm/Cosmoplast** 4.1 17.2 +133 18.4 15.7 17.2 9.1 5. 82. Fat Injections 37.4 28.1 +33 33.2 26.8 23.9 1.8 4.4 145.5 Forehead Lift 24.4 2.3 +2 22.1 18.5 19.5 4.8 3.4 41.2 Hair Transplant 44. 37.3 +18 14.1 8.3 69.9 38.9 39.6 6.3 Hyaluronic Acid** 168.9 122.7 +38 138.7 112.5 23.3 21.7 14.3 51.7 Laser Resurfacing*** 39. 47.8-18 27.7 33. -16.1 9.6 24.3-6.5 Lip Augmentation 39.5 14.8 +167 39.2 16. 145. 8. 1.1 627.3 Microdermabrasion 264. 188.9 +4 229.9 179.5 28.1 73.4 22. 233.6 Otoplasty 6.9 5.1 +35 4.1 3. 36.7 3.7 2.9 27.6 Poly-l Lactic Acid** 52. 24.3 +114 27.9 12.8 118. 15.8 23.3-32.2 Rhinoplasty 53.5 48.9 +9 3.4 33.9-1.3 19.1 15.8 2.9 Rhytidectomy /Rhytidoplasty 52.8 38. +39 46.2 34. 35.9 7.9 5.4 46.3 Scar Revision 17.7 18.7-5 12.1 1. 21. 7.1 7.8-9. **In 24, these procedures were included in Filler Injections ***Starting in 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^New in 25 Q7.Please estimate the number of procedures, the average cost per procedure, and the percentage of male/female patients receiving each procedure. Base: N=118 ABFPRS certified Members (Surgeons responding zero to any procedure category are NOT included above) Note: The average number of procedures for MEN and WOMEN do not add to the TOTAL numbers. When analyzing the number of procedures on MEN, there was a certain number of surgeons that performed zero procedures in 24. The number of surgeons that performed zero procedures on WOMEN is a different number. Finally, when looking at the total, a surgeon would be excluded only if they performed zero procedures in 24 on either men or women, which is highly unlikely. 13
Patients By Gender - Surgical Procedures Average Number of Procedures Performed Per Surgeon -- Women -- 2 4 6 8 1 Blepharoplasty Rhytidectomy/plasty Lip Augmentation Rhinoplasty Laser Resurfacing*** 47. 46.2 39.2 36.3 32.8 Forehead Lift Implants Hair Transplant Scar Revision Chin Augmentation Otoplasty 22.1 15.3 14.1 12.1 1.1 4.1 *** Starting in 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7. Please estimate the number of procedures, the average cost per procedure, and the percentage of male/female patients receiving each procedure. Base: N=118 ABFPRS certified Members Surgeons responding zero to any procedure category are NOT included above. 14
Patients By Gender - Surgical Procedures Average Number of Procedures Performed Per Surgeon -- Men -- 1 2 3 4 5 6 7 8 9 1 Hair Transplant 38.9 Rhinoplasty 19.1 Blepharoplasty Laser Resurfacing*** Lip Augmentation Rhytidectomy/plasty Scar Revision Chin Augmentation Forehead Lift Implants Otoplasty 1.1 9.6 8 7.9 7.1 5.7 4.8 4.8 3.7 *** Starting in 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7. Please estimate the number of procedures, the average cost per procedure, and the percentage of male/female patients receiving each procedure. Base: N=118 ABFPRS certified Members Surgeons responding zero to any procedure category are NOT included above. 15
Patients By Gender Minimally Invasive Procedures Average Number of Procedures Performed Per Surgeon -- Women -- 5 1 15 2 25 3 35 4 Botox 335.1 Microdermabrasion 229.9 Chemical Peels 138.7 Hyaluronic Acid** 138.7 Poly-L-Lactic Acid** 52. Collagen/Cosmoderm/Cosmoplast** 4.7 Calcium Hydroxyapetite, PMMA beads** 39.7 Fat Injections 34.1 ** In 24, these procedures were included in Filler Injections Q7. Please estimate the number of procedures, the average cost per procedure, and the percentage of male/female patients receiving each procedure. Base: N=118 ABFPRS certified Members Surgeons responding zero to any procedure category are NOT included above. 16
Patients By Gender Minimally Invasive Procedures Average Number of Procedures Performed Per Surgeon -- Men -- 1 2 3 4 5 6 7 8 Microdermabrasion 73.4 Botox 51.8 Chemical Peels 32.4 Hyaluronic Acid** 21.7 Poly-L-Lactic Acid** 15.8 Fat Injections 1.8 Calcium Hydroxyapetite, PMMA beads** 1.5 Collagen/Cosmoderm/Cosmoplast** 9.1 ** In 24, these procedures were included in Filler Injections Q7. Please estimate the number of procedures, the average cost per procedure, and the percentage of male/female patients receiving each procedure. Base: N=118 ABFPRS certified Members Surgeons responding zero to any procedure category are NOT included above. 17
Patients By Age Numbers by age group depicted on this table are based on the number of procedures reported by age group. Average Number of Procedures Performed Per Surgeon --Zeros Excluded-- 26 Under 21 22-4 41-6 61+ Blepharoplasty 57.5 16.1 14.5 32.8 14.2 Botox 384 43.2 133.1 198.8 72.2 Brow Lift 18.9 5.3 6.1 14.8 7.9 Chemical Peels 162. 6.4 61.5 77.7 37. Facelift 52.8 -- 9.7 35.1 15.9 Filler Injections 296.3 35.8 134. 157.8 71.7 Rhinoplasty 53.5 13.2 27.8 13.8 7.1 ** In 24, Filler Injections included five specific procedures rolled up into a net, including: Calcium Hydroxyapatite, Collagen Injections, Hyaluronic Acid injections, Poly-L-Lactic Acid Injections, and Poly Methyl Methacrylate Injections; for in 25 & 26 these were asked separately Q7/Q8. Please estimate the number of procedures, the average cost per procedure, and the percentage of male/female patients receiving each procedure. Base: N=118 ABFPRS certified Members; Surgeons responding zero are NOT included Note: The average number of procedures for each age group do not add to the TOTAL numbers. The number of surgeons that performed zero procedures is a different number for each age group -- therefore, the base sizes vary. Finally, when looking at the total, a surgeon would be excluded only if they performed zero procedures in 25 on all age groups. 18
Location of Procedures Percentage of Procedures By Location 6 4 2 Private office Hospital Free-standing surgical center Medical spa 55 53 49 45 44 35 3 28 28 26 24 25 19 18 16 41 28 31 2 2 2 26 25 24 23 22 21 Q2. Please estimate the percentage of procedures (surgical and non-surgical) you performed in each of the following locations during 26. Base: N=118 ABFPRS certified Members = All trend data not available for medical spa since data only collected since 24. 19
Average Fees Average Cost ($) Per Procedure (in 26 and 25) 26 25 Change $ $ Blepharoplasty 3163 311 5. Botox 435 464-6.3 Implants^ 2763 2523 9.5 Calcium Hydroxyapetite, PMMA beads** 95 16-1. Chemical Peels 339 385-11.9 Chin Augmentation 2297 265 11.2 Collagen/Cosmoderm/ Cosmoplast** 464 438 5.9 Fat Injections 1838 1656 11. Forehead Lift 3685 3621 1.8 Hair Transplant 6126 5537 1.6 Hyaluronic Acid** 628 581 8.1 Laser Resurfacing*** 2236 2259-1. Lip Augmentation 1838 1869-1.7 Microdermabrasion 164 132 24.2 Otoplasty 3114 35 2.1 Poly-L-Lactic Acid** 14 166-2.4 Rhinoplasty 4829 4296 12.4 Rhytidectomy/Rhytidoplasty 6894 6622 4.1 Scar Revision 1327 1245 6.6 ** In 24, these procedures were included in Filler Injections *** Starting in 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7. Please estimate the number of procedures, the average cost per procedure, and the percentage of male/female patients receiving each procedure. Base: N=118 ABFPRS certified Members (26); 145 ABFPRS certified Members (25) Surgeons responding zero to any procedure category are NOT included above. 2
Multiple Facial Procedures Surveyed surgeons estimate that just over one-half of their patients (56) have had multiple facial procedures in the same year, slightly more than in 25. 8 Percentage of Patients With Multiple Facial Procedures In The Same Year 6 56 51 54 49 47 4 28 34 2 26 25 24 23 22 21 2 Q3. Please estimate the percentage of your patients on whom you performed multiple facial procedures (at the same time or during the course of the same year). Base: N=145 ABFPRS certified Members 21
Past Year Trends Most surveyed surgeons say they have seen an increase in patient knowledge regarding plastic surgery in the past year. Approximately one-half have seen patients given plastic surgery as a gift, patient traveling abroad to undergo cosmetic surgery and then coming into their practice with complications or re-do s, teens undergoing cosmetic surgery, and/or couples undergoing surgery together. Trends in Past Year Patients are more educated about plastic surgery, different procedures available, patient safety 86 Plastic surgery as gift 49 Patients traveling abroad to undergo cosmetic surgery and coming into your practice with complications/re-do's 48 Teens undergoing cosmetic surgery 48 Couples undergoing surgery together 47 Mothers/daughters undergoing together 24 Patients requesting a celebrity facial feature 23 1 2 3 4 5 6 7 8 9 1 Q9. Have you seen any of the following trends in your office in 26? Base: N=118 ABFPRS certified Members 22
Procedures by Ethnicity Considering four popular cosmetic surgery procedures, African Americans are most likely getting Rhinoplasty (62), as are Hispanics (53). Asian-Americans are most likely receiving Blepharoplasty (44), while Caucasians are more evenly split between Blepharopolasty and Rhinoplasty (32 and 29). 8 Most Performed Facial Cosmetic Surgery By Ethnic Groups Rhinoplasty Blepharoplasty 6 62 Facelift Chin augmentation 53 44 4 32 29 27 2 22 3 Caucasian 1 5 African- American 1 3 Asian-American 1 7 2 Hispanic Q4. Which facial cosmetic surgical procedures is most performed among Base: N=118 ABFPRS certified Members 23
Future of Plastic Surgery The vast majority of surgeons predict that more fillers will be introduced into the market and patient safety will continue to be a focal point in cosmetic surgery. Most also feel that cosmetic surgery procedures will increase among ethnic populations. What Does the Future Hold for Plastic Surgery? Patient safety will continue to be a focal point in cosmetic surgery More fillers will be introduced to the market Cosmetic surgery will increase for ethnic populations 94 89 92 96 93 9 85 8 76 More surgeons will offer wellness and lifestyle techniques for patients 71 72 79 Reality television popularity will subside Medical Spas will become more popular 52 56 48 51 54 Other None of these 3 4 4 2 3 4 26 25 24 2 4 6 8 1 Q6. What does the future hold for plastic surgery? Base: N=118 ABFPRS certified Members 24
Board Certification Status More than four in five (85) surgeons responding are ABOto certified, while three in five (61) are ABFPRS certified. Board Certification Status 26 ABOto 85 ABFPRS 61 Other 11 No answer 1 1 2 3 4 5 6 7 8 9 Q1. Please check your current board certification status: Base: N=193 Respondents 25
Appendix 26
26 vs. 25 s in Selected Procedures Average Number of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 26 Projected * Rank of 25 Projected * Rank of Blepharoplasty 56.4 186 5 55.7 54.3 186 5 55.7 Botox 38.4 61 1 315.6 3.5 61 1 315.6 Implants^ Calcium Hydroxyapetite, PMMA beads** 15. 3. 146 5 18 8 9.8 46.3 7.3 25. 146 5 18 8 9.8 46.3 Chemical Peels 127.2 24 3 125.6 1.2 24 3 125.6 Chin Augmentation Collagen/Cosmoderm/ Cosmoplast** 13.2 21.2 186 22 17 15 1.6 17.2 9.3 1.1 186 22 17 15 1.6 17.2 Fat Injections 21.3 3589 11 28.1 17.9 3589 11 28.1 Forehead Lift 22.7 372 13 2.3 18.6 372 13 2.3 Hair Transplant 12.6 234 1 37.3 11.7 234 1 37.3 Hyaluronic Acid** 163.9 2134 4 122.7 16.7 2134 4 122.7 Laser Resurfacing*** 34.9 798 7 47.8 39.9 798 7 47.8 Lip Augmentation 22.4 162 16 14.8 8.1 162 16 14.8 Microdermabrasion 148.5 2292 2 188.9 114.6 2292 2 188.9 Otoplasty 6.6 96 19 5.1 4.8 96 19 5.1 Poly-L-Lactic Acid** 21.8 188 12 24.3 9.4 188 12 24.3 Rhinoplasty 53.5 97 6 48.9 48.5 97 6 48.9 Rhytidectomy/Rhytidoplasty 5.9 698 9 38. 34.9 698 9 38. Scar Revision 16.3 332 14 18.7 16.6 332 14 18.7 ** In 24, these procedures were included in Filler Injections *** In 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=118 ABFPRS certified members (26); 145 AAFPRS certified Members (25) * Projections should be used with caution the survey respondents were based on a non-random, pre-selected basis. Based on 2, active AAFPRS members. 27
Patients By Gender Average Number of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 26 Women Rank Of Men Rank Of Blepharoplasty 56.4 45.6 11 8.9 9.3 9 16.5 Botox 38.4 331.7 1 87.2 47.6 1 12.5 Implants^ Calcium Hydroxyapetite, PMMA beads** 15. 3. 12.3 22.9 12 4 82. 76.3 2.9 4.3 8 14 19.3 14.3 Chemical Peels 127.2 18.4 6 85.2 16.2 15 12.7 Chin Augmentation Collagen/Cosmoderm/ Cosmoplast** 13.2 21.2 9.2 2.3 13 7 69.7 96.2 4.3 1.6 7 13 32.6 7.5 Fat Injections 21.3 18.4 2 86.4 3.1 18 14.6 Forehead Lift 22.7 2.3 8 89.4 3.2 11 14.1 Hair Transplant 12.6 2.5 19 19.8 1.3 1 81.7 Hyaluronic Acid** 163.9 134.1 5 81.8 15.2 17 9.3 Laser Resurfacing*** 34.9 29.1 14 83.4 6. 5 17.2 Lip Augmentation 22.4 22. 1 98.2.7 18 3.1 Microdermabrasion 148.5 119.5 3 8.5 3.3 16 2.4 Otoplasty 6.6 3.8 16 57.6 3. 3 45.5 Poly-L-Lactic Acid** 21.8 18.7 18 85.8 4.2 2 19.3 Rhinoplasty 53.5 36.3 15 67.9 18.4 6 34.4 Rhytidectomy/Rhytidoplasty 5.9 44.4 9 87.2 6.3 12 12.4 Scar Revision 16.3 11.1 17 68.1 6.1 4 37.4 ** In 24, these procedures were included in Filler Injections *** Starting in 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=118 ABFPRS certified Members in 26 28
Patients By Gender Average Number of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 26 25 24 WomenWomenWomen 23 26 25 24 Women 23 Men 26 Men 25 Men 24 Men 23 Blepharoplasty 56.4 54.3 65.2 56.3 45.6 46.5 53.1 45.6 9.3 8. 12.2 1.7 Botox 38.4 3.5 343.6 137.1 331.7 261.1 292.4 124.2 47.6 44.2 51.3 12.9 Implants^ Calcium Hydroxyapetite, PMMA beads** 15. 3. 7.3 25. 12.3 22.9 6. 22.9 2.9 4.3 1.3 2.4 Chemical Peels 127.2 1.2 11.2 67. 18.4 91.5 1.7 61.7 16.2 9.3 9.7 5.3 Chin Augmentation Collagen/Cosmoderm/ Cosmoplast** 13.2 21.2 9.3 1.1 11.9 1.7 9.2 2.4 7.2 9.2 8.9 8.2 4.3 1.6 2.1 1.1 3.1 2.5 Fat Injections 21.3 17.9 9.8 2.5 18.4 16.8 8.9 19.3 3.1 1.3 1. 1.2 Forehead Lift 22.7 18.6 25.1 21.2 2.3 16.7 21.8 18.2 3.2 2.1 3.3 3. Hair Transplant 12.6 11.7 1. 2.5 1.6.9 1.3 1.2 9.2 Hyaluronic Acid** 163.9 16.7 134.1 97.5 15.2 9.3 Laser Resurfacing*** 34.9 39.9 29.2 25.2 29.1 27.4 26.7 23.1 6. 13.7 2.7 2.1 Lip Augmentation 22.4 8.1 16.4 11.7 22. 8.2 16.4 11.2.7.1.2.5 Microdermabrasion 148.5 114.6 18.4 69.3 119.5 16.4 97.3 64.3 3.3 1.5 11.2 5. Otoplasty 6.6 4.8 5.4 6.4 3.8 2.5 2.8 3.6 3. 2.4 2.7 2.9 Poly-L-Lactic Acid** 21.8 9.4 18.7 4.5 4.2 4.9 Rhinoplasty 53.5 48.5 53.7 44.2 36.3 33.3 35.8 29.7 18.4 15.4 18. 14.4 Rhytidectomy/Rhytidoplasty 5.9 34.9 39.6 3.5 44.4 31.2 34.5 25.7 6.3 3.9 5.3 4.8 Scar Revision 16.3 16.6 16.3 22. 11.1 8.6 9.8 12.3 6.1 6.2 6.8 9.7 ** In 24, these procedures were included in Filler Injections *** Starting in 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=118 ABFPRS certified Members (26), 145 ABFPRS certified Members (25); 17 AAFPRS Members (24); 19 members in 23; 97 members in 22 29
26 vs. 25 s in Selected Procedures Average Number of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 26 Projected * Rank of 25 Projected * Rank of Blepharoplasty 56.4 1128 5 55.7 54.3 186 5 55.7 Botox 38.4 768 1 315.6 3.5 61 1 315.6 Implants^ Calcium Hydroxyapetite, PMMA beads** 15. 3. 3 6 18 9 9.8 46.3 7.3 25. 146 5 18 9 9.8 46.3 Chemical Peels 127.2 2544 4 125.6 1.2 24 4 125.6 Chin Augmentation Collagen/Cosmoderm/ Cosmoplast** 13.2 21.2 264 424 16 14 1.6 17.2 9.3 1.1 186 22 16 14 1.6 17.2 Fat Injections 21.3 426 11 28.1 17.9 358 11 28.1 Forehead Lift 22.7 454 1 2.3 18.6 372 1 2.3 Hair Transplant 12.6 252 13 37.3 11.7 234 13 37.3 Hyaluronic Acid** 163.9 3278 3 122.7 16.7 2134 3 122.7 Laser Resurfacing*** 34.9 698 7 47.8 39.9 798 7 47.8 Lip Augmentation 22.4 448 17 14.8 8.1 162 17 14.8 Microdermabrasion 148.5 297 2 188.9 114.6 2292 2 188.9 Otoplasty 6.6 132 19 5.1 4.8 96 19 5.1 Poly-L-Lactic Acid** 21.8 436 15 24.3 9.4 188 15 24.3 Rhinoplasty 53.5 17 6 48.9 48.5 97 6 48.9 Rhytidectomy/Rhytidoplasty 5.9 118 8 38. 34.9 698 8 38. Scar Revision 16.3 326 12 18.7 16.6 332 12 18.7 ** In 24, these procedures were included in Filler Injections *** In 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=118 ABFPRS certified members (26); 145 AAFPRS certified Members (25) * Projections should be used with caution the survey respondents were based on a non-random, pre-selected basis. Based on 2, active AAFPRS members. 3
Patients By Age (26) Percentages on this table are based on the percentages reported by age group for the year 26. Average Percentage of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 26 Under 21 22-4 41-6 61+ Blepharoplasty 57.5 2.2 22.1 54.7 21.1 Botox 384. 1.4 33.1 5.4 15. Brow Lift 19..5 15.3 58.2 25.9 Chemical Peels 162. 8.5 32.4 41.7 17.5 Facelift 52.8. 7.9 65. 27.1 Filler Injections 296.3 1.2 36.4 45.1 17.2 Rhinoplasty 53.5 21.6 49.9 23.2 5.3 ** In 24, these procedures were included in Filler Injections *** In 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7/8. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=118 ABFPRS certified Members; Surgeons responding zero are included Note: Some age fields were left blank, resulting in columns that may not add to the total # of patients 31
Patients By Age (25) Percentages on this table are based on the percentages reported by age group for the year 25. Average Percentage of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 25 Under 21 22-4 41-6 61+ Blepharoplasty 54.3 2. 18.7 55.1 24.2 Botox 3.5.4 3.7 53.7 15.1 Brow Lift 18.6. 9. 59.7 31.3 Chemical Peels 1.2 5.2 29.2 47.1 18.5 Facelift 34.9. 2.8 59.6 37.5 Filler Injections 1.6 32.9 47.6 17.9 Rhinoplasty 48.5 2.4 51.3 23.4 5. ** In 24, these procedures were included in Filler Injections *** In 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion ^ New in 25 Q7/8. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=118 ABFPRS certified Members; Surgeons responding zero are included Note: Some age fields were left blank, resulting in columns that may not add to the total # of patients 32
Patients By Age (24) Percentages on this table are based on the percentages reported by age group for the year 24. Average Percentage of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 24 Under 2 2-39 4-59 6-79 8+ Blepharoplasty 65.2 2. 15.2 55.1 26.6 1. Botox 343.6.2 33.7 47.2 18.8.1 Brow Lift 25.1.5 1.6 59.4 27.6 1.8 Chemical Peels 11.2 5. 25.8 46.3 22.2.7 Facelift 39.6.8 4. 58.2 35.3 1.7 Filler Injections 131.3.8 26.9 51. 2.8.5 Rhinoplasty 53.7 18.6 47.1 27.7 6.6. ** In 24, Filler Injections included five specific procedures rolled up into a net, including: Calcium Hydroxyapatite Injections, Collagen Injections, Hyaluronic Acid Injection, Poly-L-Lactic Acid Injections, and Poly Methyl Methacrylate Injections *** In 24, Laser Resurfacing was asked as Ablative Skin Resurfacing which includes: deep peels, laser, and dermabrasion Q1. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=17 AAFPRS Members; Surgeons responding zero are included Note: Some age fields were left blank, resulting in columns that may not add to the total # of patients 33
Patients By Age (23) Percent of total on this table represents totals for each specific procedure for the year 23. Average Number of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 23 Under 2 of of of of 2-39 4-59 6-79 8 + of Blepharoplasty 56.3.3.5 7.8 13.9 29.1 51.7 17.3 3.7 1.7 3. Botox 137.1.. 36.8 26.8 73.1 53.3 26.6 19.4.6.4 Chemical Peels 67. 4.7 7. 17.7 26.4 32.1 47.9 12.3 18.4.2.3 Chin Augmentation 1.7.6 5.6 3.6 33.6 5.7 53.3.9 8.4.. Facial/Neck Liposuction 22.1.2.9 3.1 14. 12.7 57.5 6.1 27.6.1.5 Fat Injections 2.5.. 3.5 17.1 9.8 47.8 7.1 34.6.. Filler Injections 7.5.3.4 15.8 22.4 35.2 49.9 19. 27..2.3 Forehead Lift 21.2.. 1.2 5.7 14.1 66.5 5.9 27.8.1.5 IPL Laser Resurfacing 23.5.3 1.3 5.2 22.1 14.1 6. 3.8 16.2.. Laser Resurfacing 25.2.. 4.5 17.9 13.6 54. 7.1 28.2.. Lip Augmentation 11.7.1.9 3.4 29.1 5.8 49.6 2.3 19.7.1.9 Microdermabrasion 69.3 9.3 13.4 23.8 34.3 28.9 41.7 7.2 1.4.1.1 Otoplasty 6.4 4.1 64.1 1.6 25..7 1.9.1 1.6.. Rhinoplasty 44.2 7.5 17. 2.2 45.7 14.1 31.9 2.3 5.2.1.2 Rhytidectomy/Rhytidoplasty 3.5.2.7 2.2 7.2 17.4 57. 1.6 34.8.2.7 Scar Revision 22. 3.8 17.3 8.4 38.2 7.9 35.9 1.7 7.7.1.5 638.2 31.4 4.9 158.8 24.9 314.3 49.2 13.3 2.4 3.5.5 Q6. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=19 AAFPRS Members; Surgeons responding zero are included Note: Some age fields were left blank, resulting in columns that may not add to the total # of patients 34
Patients By Age (22) Percent of total on this table represents totals for each specific procedure for the year 22. Average Number of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 22 Under 2 of of of of 2-39 4-59 6-79 8 + of Blepharoplasty Botox Cheek Augmentation Chemical Peels Chin Augmentation Facial Fracture Facial/Neck Liposuction Fat Injections Filler Injections Forehead Lift Hair Transplant IPL Laser Resurfacing Laser Hair Removal Laser Resurfacing Lip Augmentation Microdermabrasion Nasal Fracture Otoplasty Rhinoplasty Rhytidectomy/Rhytidoplasty Scar Revision Skin Cancer Reconstruction Skin Graft 43.5 69.1 2.5 29.8 5.5 5.4 7. 3.2 31.7 1.5 2.7 2.9 5.8 7. 5.4 22.7 24.7 2.6 4.5 15.1 7. 31.5 8.8 1.8 1.4. 7.9.6.9.3..2.6...4.1.2 1.1 2.1 1.4 6.4.5.2.1 4 2 27 11 17 4 1 6 7 1 4 5 9 54 16 3 1 1 Q6. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=97 AAFPRS Members; Surgeons responding zero are included Note: Some age fields were left blank, resulting in columns that may not add to the total # of patients 3.5 23.6.9 8.4 2.2.2 2.2.4 13.2.8.8.1.3 1.3 2. 7.7 1.9.7 18.3 1.2.2 2.1.1 384.9 26.2 6.8 92.1 23.9 149.6 38.9 64.4 16.7 1.7 2.8 8 34 36 28 4 4 31 13 42 8 3 3 5 19 37 34 8 27 45 8 3 7 1 22. 36.1 1.1 1.1 2..1 3.2 1.9 15.8 6.2 1.5.1.2 3.4 2.4 11.4.1.4 13.1 8.9.1 9.4.1 51 52 44 34 36 2 46 59 5 59 56 3 3 49 44 5.4 15 32 59 1 3 1 15. 7.9.5 3.4.7. 1.2.9 2.5 3..5.1. 2.2.8 2.6.. 2.6 4.4.1 15.7.3 34 11 2 11 13 17 28 8 29 19 3 31 15 11 6 29 1 5 3 1.1.1.1.2.4 8.7.1 3 2.3.5 3 28 1 35
Patients By Age (21) Percent of total on this table represents totals for each specific procedure for the year 21. Average Number of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 21 Under 2 of of of of 2-39 4-59 6-79 8 + of Blepharoplasty 49.7.6 1 7.2 14 26.8 54 14.5 29.3 1 Botox 67. 2.1 3 17.7 26 36.6 55 1.6 16 Cheek Augmentation 3..7 23 1.8 6.6 2 Chemical Peels 36.8 4.1 11 1.5 29 15.5 42 6.6 18 Chin Augmentation 8.1.7 9 2.5 31 3.4 42 1.5 19 Facial/Neck Liposuction 1.3.1 1 2.6 25 5.1 5 2.5 24 Fat Injections 5. 1.1 22 2.8 56 1. 2 Filler Injections 31.5.6 2 7.9 25 17.7 56 5.2 17 Forehead Lift 13.1.2 2 1.4 11 7.2 55 4.3 33 Hair Transplant 7.2.3 4 2.4 33 3.6 5.8 11 Laser Resurfacing 13.5.2 1 2.5 19 6.9 51 3.8 28 Lip Augmentation 5.7.2 4 2.6 46 2.8 49.9 16 Microdermabrasion 23.3 5.3 23 5.6 24 9.3 4 3. 13 Otoplasty 4.1 2. 49 1.2 29.6 15.2 5 Rhinoplasty 34.7 5.8 17 15.6 45 11. 32 2.3 7 Rhytidectomy/Rhytidoplasty 2.9.4 2 1.2 6 11.7 56 7.4 35.2 1 Skin Cancer Reconstruction 28..9 3 1.6 6 8.1 29 14.1 5 3.4 12 Facial Fracture 2.2.7 32.1 5 Nasal Fracture 21.4 2.5 12 1.9 9 Scar Revision 4.8.2 4.1 2.1 2.1 2 Skin Graft 8.1.4 5.2 2.3 4 398.4 27.3 6.9 86.4 21.7 171.2 43. 79.7 2. 3.9 1 Q6. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=18 AAFPRS Members; Surgeons responding zero are included Note: Some age fields were left blank, resulting in columns that may not add to the total # of patients 36
Patients By Age (2) Percent of total on this table represents totals for each specific procedure for the year 2. Average Number of Procedures Performed Per Surgeon -- Surgeons Responding Zero Included -- 2 Under 2 of of of of 2-39 4-59 6-79 8 + of Blepharoplasty 62.3 7.4 12 27.5 44 17. 27 1.4 17 Botox 38..1 11.2 29 2.5 54 6.2 16 Cheek Augmentation 3.4.1 3 1.2 35 1.5 44.6 18 Chemical Peels 45.5 3.5 8 12.6 28 18.6 41 9.8 22.9 2 Chin Augmentation 1.6 1.2 11 3.7 34 4.3 4 1.6 15 Facial/Neck Liposuction 9.8.3 3 2.4 24 5. 51 2.1 21 Fat Injections 4.8.1 2.8 17 2.3 49 1.4 3.1 2 Filler Injections 27.4.2 1 8.1 3 14.6 53 4.3 16.1 1 Forehead Lift 12.2 1.2 1 7. 58 3.9 32 Hair Transplant 3..8 27 1.7 57.5 17 Laser Resurfacing 12.3.1 1 2.4 2 5.9 49 3.7 31 Lip Augmentation 6.6.4 5 2.7 36 3.4 45 1. 13 Microdermabrasion 4. 1.4 3 11.6 29 2.1 5 7. 17 Otoplasty 4.3 2.5 58 1.3 3.5 12 Rhinoplasty 39.9 6.2 16 17.6 44 13.7 34 2.5 6 Rhytidectomy/Rhytidoplasty 19.1.5 3 11.8 62 6.7 35.1 1 Skin Cancer Reconstruction 28.7.1 1.7 6 8.8 31 13.5 47 4.7 16 368.7 16.2 4.4 87.2 23.7 167.2 45.3 81.8 22.2 16.3 4.4 Q6. Please estimate the total costs associated with each procedure and the specific number of patients in each age group receiving each procedure. Base: N=18 AAFPRS Members; Surgeons responding zero are included 37