The latest plastic surgery stats are out!

The American Society of Plastic Surgeons (ASPS) released their annual report on plastic surgery procedures this past week.

According to ASPS, 13.1 million cosmetic plastic surgery procedures, including both minimally-invasive or surgical categories, were performed in the United States in 2010, up 5 percent from 2009.

"The economy is showing signs of improvement and financially, things seem a little better for people this year," said ASPS President Phillip Haeck, MD. "There's some pent-up demand for cosmetic surgical procedures. People have waited a couple of years or more to have procedures, until their finances were at least somewhat back in order", said Dr. Haeck.

Cosmetic surgical procedures increased 2 percent, with nearly 1.6 million procedures in 2010. The top five surgical procedures were:
• Breast augmentation (296,000)
• Nose reshaping (252,000)
• Eyelid surgery (209,000)
• Liposuction (203,000)
• Tummy tuck (116,000)

Interestingly, people are having more facelift surgeries, with a rise of 9 percent in 2010, with nearly 113,000 procedures. Facelifts have not experienced growth since 2007.

Breast augmentations increased 2 percent over the previous year, remaining the most popular cosmetic surgical procedure. Silicone implants are being used in 60% of all breast augmentations nationally. In our practice, this figure is more like 75%.

All surgical body contouring procedures also experienced growth in 2010 - breast lifts (up 3 percent), lower body lifts (up 9 percent), upper arm lifts (up 5 percent), and thigh lifts (up 8 percent). Many of those procedures are being requested following massive weight loss.

Cosmetic minimally-invasive procedures increased 5 percent, with nearly 11.6 million procedures in 2010. The top five minimally-invasive procedures were:
• Botulinum toxin type A (5.4 million)
• Soft tissue fillers (1.8 million)
• Chemical peel (1.1 million)
• Laser hair removal (938,000)
• Microdermabrasion (825,000)

"Injectables have remained robust despite the economy," said Dr. Haeck. "Botox® and Dysport® injections are up 12 percent, while, interestingly, fat injections are up 14 percent, which could reflect how a patient's own fat is being used in more creative ways to rejuvenate the face and body."

Breast reconstruction is up 8 percent in 2010 and is new to the top five reconstructive procedures. I'm glad to see that efforts in educating breast cancer survivors about their reconstructive options are helping.

The report can be viewed in more detail here.

Get more out of Sculptra...

Here's a neat little trick, courtesy of Dr. Laurie Casas, which was presented at the "hot topics" part of the ASPS meeting in Toronto: Sculptra users can get a better result if they combine the injectable treatment with the use of Retin-A cream.

Dr. Casas explained that, since both products work by stimulating collagen, it made sense to try them together to see if a synergistic (additive) effect would happen. Her study found that the combination worked especially well for patients younger than age 55, and particularly well for those patients getting Sculptra in the cheeks and mid-facial areas.

Often the patients found that they required less Sculptra product to achieve the desired result, when they used the Retin-A cream. Another money saving tip for you from PSB- the Plastic Surgery Blog!

Plastic Surgery 2010

The biggest meeting in Plastic Surgery, the American Society of Plastic Surgeons (ASPS) annual meeting, "Plastic Surgery 2010" will be in Toronto, starting in about 2 weeks. And yours truly will be there, with about 5,000 other surgeons, medical personnel, exhibitors and industry representatives in the field of plastic surgery. To quote the late Ed Sullivan, it's a really big show.

Even though it's called the "American" Society of Plastic Surgeons, there's actually a very large degree of international participation from our European and Canadian surgery colleagues, which is very eye-opening and helpful. We'll be hearing about new techniques, checking out the effectiveness of new devices, and learning about up and coming trends from around the world. The ASPS meeting covers not only cosmetic surgery, but also all the other subspecialties of plastic surgery: reconstructive surgery, microsurgery, cranio-facial, hand and burn surgery are all well represented.

I'll be attending the cosmetically-oriented sessions, including the ever-popular "Hot Topics in Plastic Surgery", a panel on Breast Augmentation through Fat Grafting, and a number of teaching courses.

Not to worry, I'll be blogging about it all, the good, the bad, and the ugly.

ASAPS 2010: the Laser Lipo Backlash

I just returned from the Aesthetic Society's annual meeting, held just outside Washington, D.C. As usual, ASAPS put on another top quality, well-organized session, with a wide selection of first-rate surgeons from around the world. The next series of blog posts will feature new stories from the meeting.

Up first: The Disappointment of Laser Liposuction.

Despite the marketing hype by the laser manufacturers, surgeons are now coming forward saying that they're just not seeing the hoped-for improvement in results with laser liposuction, compared to standard liposuction methods. The excitement phase, seen when any new technology comes along, is probably over - to be replaced by a more honest, pragmatic assessment phase.

Dr. Jeff Kenkel, laser guru from UT Southwestern, probably said it best with a very honest assessment, "I really wanted to believe in the lasers, and I kept on trying them...", but then he showed us his clinical results, which showed very little, if any, skin tightening. He admitted there wasn't a single surgical result obtained with the laser that he couldn't have been obtained with standard liposuction.

So far, there's very little good science at this point in 2010 to back up the claims that the manufacturers were making in 2007. That's not to say that laser lipo is without some merit - it's just not the magic wand that many promoters have claimed it is. Research is still ongoing, and surgeons like Dr. Barry diBernardino are working hard to present scientifically valid data, not just opinion and "hand-waving", like we've seen in the past.

Many surgeons in the audience felt like the manufacturers really need to show more solid scientific research, before making sales claims. Others of us felt it was really up to us not be conned by preliminary results and sub-standard studies, and to demand better from the manufacturers and the news media.

Of interest, the best lipo results I saw at the whole meeting were done by Dr. Simeon Wall, Jr., of Louisiana. His secret: a three-step liposuction method done with... power-assisted liposuction. No laser, no magic gadget - just a great technique with the tools we already have.

Once again, it's the carpenter, not the hammer used.

ASAPS 2010: stay tuned

Yes, readers - it's that time of year again, when the best aesthetic plastic surgeons in the world congregate for their annual meeting.

ASAPS 2010 will be held in Washington, D.C., starting in about a week. The latest and greatest, what's hot and what's not, and what actually works in cosmetic plastic surgery will be up for discussion....just the sort of stuff we love here at PSB: the plastic surgery blog!

I'll be attending, listening, learning and questioning. When I get back, I'll have a full report for everyone....stay tuned.

Plastic Surgery Predictions for 2010

Remember the old Johnny Carson sketch, "The Great Karnak"? Well, these predictions may prove to be about as accurate, but here goes...

1. Botox vs. Dysport. So far, this corporate shoot-out has been pretty low-key. But I expect the marketing and tug-of-war between the two corporate behemoths to increase significantly in 2010, as people (both patients and physicians) become more comfortable with Dysport. IMO, there's plenty of room for both in the ever-expanding non-surgical market. Of course, the real game changer is Revance Therapeutics' topical formulation - Botox cream. But that's probably a few years away yet.

2. Market Consolidation. I expect two forms of market consolidation in 2010, continuing what we were seeing in the rough economic waters of 2009. Smaller product lines will either drop out, or be absorbed by larger corporations. Mergers and buyouts of small to mid-size aesthetic companies will continue, as we've seen in the laser industry in 2009.

3. Increasing regulation of medi-spas. It's taken a while, but regulators at the State level are beginning to wise up that medi-spas are doing treatments and procedures that until recently, were only done in physicians' offices or surgery centers. So, they should have similar safety regulations and oversight. The recent med-spa related liposuction death in Florida has added fuel to this fire.

4. Pragmatism towards current minimally-invasive procedures. When ever any new technology is introduced, there are 3 phases: an excitement / hype phase, a reassessment phase, and the final "here's-the real-deal" phase. I'm hopeful that in 2010, we'll be approaching the pragmatic phase about laser-assisted liposuction (LAL), and that we'll see more good science about the degree of skin tightening that LAL really produces.

5. Continued interest in fat grafting. Especially once the technology for turbo-charging fat grafts with stem cells gets approved by the FDA, this is the next "big thing" in both aesthetic plastic and reconstructive surgery.

6. Will the "gummy-bear" breast implants arrive in 2010? Maybe in the second half of the year. The real question is whether American women will accept the trade-offs of larger incisions and the "super-firm" feeling of the implant for a possibly lower contracture rate and lower rate of gel migration. I think textured, standard gel implants will undergo a surge in popularity - especially for revisional cases.

7. More "me-too" products. Whether it's in the injectable filler, botox, or laser arena, I think companies will try to introduce their spin on currently existing products, to gain a share in the lucrative cosmetic market. There will be more HA fillers, more fractional lasers, more liposuction devices - each touting that their product is "just as good as Brand X". (The FDA 401 (k) equivalency process encourages imitation, rather than innovation.) This will, of course, be more confusing for consumers. If the new products don't catch on rapidly, I suspect, prediction # 2 will take place, and the product will sink out of sight, more rapidly than before. Better then, to stay with the tried-and-true / market leaders.

That's all Dr. F. has for now. Happy New Year, everybody!