Spending on Cosmetic Procedures Exceeds $12 Billion in the US in 2014: ASAPS Report

Aesthetic Procedures | Surgical | Non Surgical | Altamonte Springs FLConstant innovation in the field of cosmetic surgery and non-surgical aesthetic procedures has helped make these procedures more predictable, effective, and affordable. Each year millions of new American patients as well as repeat patients continue to seek treatments to enhance their physical appearance and reduce the signs of aging.

Board certified plastic surgeon, Dr. Thomas Fiala, provides stellar, acute, and fascinating cosmetic procedures. Dr. Fiala believes in adopting a holistic approach to every cosmetic treatment, and focuses on delivering results in the least invasive and a healthy manner. He receives patients from Orlando, Altamonte Springs, FL for a wide range of aesthetic surgery and non-surgical procedures.

Increased Acceptance of Aesthetic Procedures

The American Society for Aesthetic Plastic Surgery (ASAPS) has brought out its 18th annual multi-specialty data report that provides useful insights about the growing demand for aesthetic procedures in the country. As per the report, Americans spent over $12 billion on invasive and non-invasive cosmetic procedures in 2014.

One of the encouraging findings of the report was that aesthetic procedures are gaining popularity among men on a wider scale. In the last five years, the number of men opting for cosmetic surgery and non-surgical treatments has jumped by as much as 43%.

The topmost procedures in terms of year on year growth are buttock augmentation (up 86%), labiaplasty (up 49%), and non-surgical fat reduction (up 42%).

Most Popular Cosmetic Surgery Procedures

The most popular cosmetic surgery procedures for men and women combined in 2014 included the following:

  • Liposuction (342,494 procedures)
  • Breast Augmentation (286,694 procedures)
  • Eyelid Surgery (165,714 procedures)
  • Tummy Tuck (164,021 procedures)
  • Nose Surgery (145,909 procedures)

Liposuction can be performed both as a standalone surgery and in combination with other procedures for more effective outcomes. Improve qualities in breast implants have led to a greater popularity of breast augmentation procedure over the years. Abdominoplasty, eyelid surgery, and rhinoplasty continue to be listed among most requested procedures.

Most Popular Non-surgical Cosmetic Treatments

The most popular non-surgical cosmetic procedures for both men and women combined included the following in 2014:

  •     Botulinum Toxin (3,588,218 procedures)
  •     Hyaluronic Acid Based Fillers (1,696,621 procedures)
  •     Hair Removal (828,480 procedures)
  •     Chemical Peel (484,053 procedures)
  •     Microdermabrasion (417,034 procedures)

FDA approved Botulinum Toxin injectable treatments to reduce aging signs from the face topped the list of non-surgical procedures with nearly 3.6 million treatments in 2014. Hyaluronic fillers such as Juvederm and Restylane, and laser hair removal, chemical peel treatment, and microdermabrasion have also emerged as in-demand procedures.


Growth in Male Cosmetic Procedures

According to the ASAPS records, the number of men’s procedures since 2010 has gone up as follows:

Cosmetic Surgeries

  •     Blepharoplasty (up 34%)
  •     Male Breast Reduction (up 33%)
  •     Facelift (up 44%)

Non-Surgical Procedures

  • Botulinum Toxin (up 84%)
  • Hyaluronic Acid Based Fillers (up 94%)
  • Nonsurgical skin tightening (up 37%)
  • Intense Pulsed Light (up 44%)

The future bodes well for both surgical and non-surgical cosmetic procedures, considering the past and present market trends. Just think how sunny these numbers would be if the economy was not in a recession as well. If there more jobs for people, and there easily could be, this industry would only be looking brighter.


Plastic Surgery Practice

Plastic Surgeon Orlando FLDr. Thomas Fiala is a double board certified plastic surgeon providing state of the art reconstructive and cosmetic surgery procedures. Dr. Fiala’s practice is founded on the belief that each patient’s need for aesthetics is unique, and every surgical or non-surgical procedure must be customized to meet that need. Patient satisfaction is the prime goal at Dr. Fiala’s plastic surgery practice in Florida, and every process and procedure at the practice centers around this goal only.

The practice is equipped with advanced surgical technologies, and Dr. Fiala and his experienced team make the best use of the latest and proven surgical techniques and procedures to deliver the highest satisfaction levels for each patient. Patients in Orlando, Altamonte Springs, FL, and other areas have an opportunity to receive treatments at Dr. Fiala’s practice.

About Dr. Fiala

Dr. Fiala is a well-known and highly experienced plastic surgeon for a wide range of procedures, including breast augmentation, breast lift, breast reduction, breast revision, body lift, facelift, eyelid lift, forehead lift, rhinoplasty, tummy tuck, liposuction, mommy makeover, and other procedures. He is also the medical director of Fiala Aesthetics Medical Spa, which is a leading med spa for some of the most effective and advanced non-surgical cosmetic and anti-aging procedures.

Dr. Fiala launched his plastic surgery practice in downtown Orlando more than 16 years ago, and since then has remained completed dedicated to his mission of transforming the lives of his patients through safe and effective reconstructive and cosmetic surgery procedures. He is the recipient of the prestigious “RealSelf 100” award as recognition for his contributions to the field of cosmetic surgery and non-surgical treatments.

Procedures Offered

A comprehensive range of plastic and cosmetic surgery procedures for the breast, body, and face are provided at Dr. Fiala’s practice in Florida. Patients have the advantage to avail of various non-surgical procedures as well at Fiala Aesthetics Medical Spa, which runs on the same high standards as maintained at Dr. Fiala’s plastic surgery practice.

Procedures for the Face

Facial plastic surgery is one of the most effective ways to reduce the signs of aging from the face, and improve facial profile and aesthetics. Dr. Fiala offers full and partial facelift procedures, nose surgery or rhinoplasty, brow lift eyelid lift, otoplasty or ear surgery, chin augmentation, cheek augmentation, lip augmentation, and other procedures for the face.

Procedures for the Body

Surgical procedures to improve body contours are provided at Dr. Fiala’s practice. These procedures may be recommended to patients who are keen to reduce stubborn fat pockets from certain areas of the body, or are bothered by conditions such as skin laxity and cellulite. Tummy tuck, arm lift, thigh lift, buttock lift, liposuction and body lift are popular body procedures available at the practice.

Procedures for the Breast

Breast surgery procedures have become highly popular in the United States. Dr. Fiala’s plastic surgery practice is equipped to provide state of the art treatments such as breast augmentation, breast reduction, breast lift, breast augmentation with lift, and male breast reduction.

For more information of the treatments and procedures offered at this Orlando Medical Spa by Dr. Thomas Fiala please contact us at (407) 339-3222(407) 339-3222 or visit www.plasticsurgeryinflorida.com ; http://coolsculptinginorlando.com/

Every year, we look forward to seeing the statistics from ASAPS.  They act as a barometer, refelcting the total volume of procedures in the U.S., and also help us to identify trends in what’s popular, and what’s not.

Here are some highlights from their report.

1.  If you combine the surgical and nonsurgical cosmetic procedures, there were over 9 million procedures performed in the United States in 2011. Surgical procedures accounted for 18% of the total number of procedures and nonsurgical procedures made up 82% of the total number of procedures.  Women had 91% of the total. The number of cosmetic procedures for women has increased over 208% since 1997.

2.  From 2010-2011, there was almost a 13% increase in the total number of liposuction procedures, with over 300,000 procedures performed. For the first time in three years, lipoplasty has surpassed breast augmentation, returning as the most popular cosmetic surgical procedure in the United States.

3.  The top five cosmetic surgical procedures in 2011 were:
–  liposuction (325,332 procedures)
–  breast augmentation (316,848 procedures)
–  abdominoplasty (149,410 procedures)
–  blepharoplasty (147,540 procedures)
–  breast lift (127,054 procedures).
It’s interesting to note that rhinoplasty, which used to be a top 5 procedure, is no longer present.

4.   The top five nonsurgical cosmetic procedures in 2011 were:
–  Botox (2,619,739 procedures)
–  filler injections with restylane, juvederm (1,206,186 procedures)
–  laser hair removal (919,802 procedures);
–  microdermabrasion (499,427 procedures)
–  IPL laser treatment (439,161 procedures).

No surprises here.  Botox and fillers remain popular on the minimally invasive side of things, while breast augmentation, liposuction and tummy tucks are still very popular on the surgical side.

The drug Aromasin appears to cut the odds of breast cancer by 65 percent in high-risk postmenopausal women, new research has found. Unlike other anti-estrogen drugs like tamoxifen, Aromasin doesn’t seem to have an increased risk of uterine cancer or blood clots.Aromasin, an aromatase inhibitor, is currently approved for early breast cancer patients, but is not FDA approved as a preventative medication. Currently, the medication costs $300-400 per month, but will soon be available in generic form. Hopefully, the price will drop.

The new placebo-controlled study, conducted by Canada’s NCIC Clinical Trials Group with partial support from Pfizer, involved 4,560 women from Canada, the U.S., France and Spain with a median age of 62.5 years. The women were all post-menopausal and had at least one other risk factor for breast cancer.

After three years, researchers observed 11 invasive breast cancers in the women receiving Aromasin, compared with 32 in the group receiving the placebo, for a 65% reduction. There were also fewer precancerous lesions in the group receiving the drug.

“This may add another potential drug for these women,” said Dr. Jennifer Litton, a breast medical oncologist with the University of Texas M.D. Anderson Cancer Center in Houston. “Hot flashes, joint stiffness were more pronounced but it [Aromasin] doesn’t have the blood clot and uterine cancer risk.”

Here are my choices for the “Hot Topics” presented at the Boston ASAPS meeting:
1. “Stem Cell Facelift” – Dr. Peter Rubin reviewed the literature on the so-called Stem Cell facelift. It turns out that there really is no consistent technique for this method. Many advertised “stem cell facelifts” are simply regular facelifts with regular fat grafting and don’t involve any extra stem-cell work at all. Furthermore, to date, there is NO DATA that this technique is superior to facelift with standard fat grafting. Summary: as of today, the stem cell facelift can either be considered unproven and under development, or if you are a little more cynical, it might just be “marketing hype”.

2. Biofilms & breast implant contracture – as we’ve discussed here before, evidence continues to accumulate that there is a link between bacteria, which go on to form a slimy biofilm, and later development of a hard, contracted breast implant. Australian surgeon Dr. Anand Diva presented data from an animal study, showing that in their experimental model, once a biofilm was formed, that 80% of the animals went on to form a capsule around their implant. Furthermore, when an antibiotic-impregnated mesh was placed in the pocket with the implant, there were zero contractures, despite purposely contaminating the pocket with a dose of bacteria. The mesh, made by a company called TyRx, is currently in studies as a method to prevent infections around cardiac pacemakers. So far, no human studies have been done with breast implants and this mesh – but it’s clearly very interesting and exciting.

3. High Intensity Frequency Ultrasound (HIFU) – Dr. Mark Jewell presented his data on the Liposonix machine, which is claimed to reduce abdominal fat without invasive surgery or injections, but just an external treatment which focuses ultrasonic energy on the fat. It turns out that it works….but there are some limitations. In their study of 180 patients, an average reduction of 2.5 cm (1″) in abdominal circumference was seen after only one treatment. Some patients (good responders) had more than a 3 cm reduction in circumference. Treatment pain was rated as “none or mild” in 67%. Again, this machine is not FDA approved yet…but it’s available in Europe. Hopefully, we’ll get it one of these days!

Lots of cool stuff….more to come. It’s also been nice to catch up with friends from Boston and from Ann Arbor.

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.

Plastic Surgery advice site RealSelf.com keeps a consumer-generated list of procedures, rated by whether or not the consumer felt they were “worth it” or not. (link) While it’s not scientific, it’s a good reflection of how consumers feel about things.

Here are the top five plastic surgery procedures (most worth it), as of today:

#1) “mommy make-over” – 94% approval
#2) lower body lift – 93% approval
#3) tummy tuck – 90% approval
#4) breast implant revision – 89% approval
#5) breast reduction – 87% approval

(Editors note: gastric bypass was rated tops overall, but since it’s a bariatric surgery operation, I didn’t put it on this list.)

List below are some of the “least worth it” procedures, according to the users of Realself.com

#138) “portrait” skin resurfacing – 11% approval
#137) thread lift – 22% approval
#136) blue peel – 25%
#135) ProFractional Laser – 25% approval
#134) silicone injections
#131) VelaShape – 28% approval
#128) Zerona fat reduction – 32% approval

No surprises in this rogues’ gallery. Although we used to use the Blue Peel, we now prefer the VI Peel. Works just as well for light to medium strength peeling, and you don’t have a blue tinge to your skin for the first few days!

I’m now participating in the discussion panels over at RealSelf.com, answering common patient questions. Hopefully, prospective patients will find these answers helpful, in addition to all the educational material on our own website. Here’s the link…

Q & A with Thomas Fiala, MD:

View all answers from Thomas Fiala, MD on RealSelf.com

A recent Washington Post article (link here) discusses the phenomenon of getting plastic surgery to feel better after a break-up or divorce. While that certainly does happen, the obvious concern for me as a surgeon is that people would be potentially making big, life-changing decisions about undergoing surgery while they still may be pretty emotional or stressed. It’s certainly better to let a little time go by. “I’ll show him who’s hot” is perhaps not the best reason to have surgery!

We also see the flip side of things – people in shaky relationships who separate sometime after the plastic surgery is completed. It’s usually a case of a lady who suddenly feels a whole lot better about herself, and who realizes she has choices and options she didn’t think she had before. Or maybe she feels that she doesn’t have to put up with certain situations any more…

Sometimes the shot of self-confidence that plastic surgery brings can have unexpected consequences!

You’ve heard about stem-cell enhanced fat grafts for rejuvenating the face and the hands…but here’s a new & very cool idea: stem cells to fix an ailing heart.

Here’s the concept: Do some liposuction, and isolate out the small percentage of fat-derived stem cells from the rest of the fat enzymatically. Take these stem cells, and inject them (carefully!) into the heart muscle. The stem-cells then go on to repair the damaged heart muscle, hopefully helping the heart function better, and improving the patient’s symptoms and quality of life.

In the United States, more than one million patients have a severe form of heart disease, known as “no-option chronic myocardial ischemia” with a 10 year mortality rate exceeding 20% and an annual healthcare cost of more than $10 billion. If the idea works, it would be a huge step forward for these patients.

A recent multi-center, 27 patient, double-blind, placebo-controlled European study known as “PRECISE“, looked at this very idea, and the results were recently presented at the American Heart Association meeting. And they are very promising. The patients selected really had no other option, other than cardiac transplantation. As part of the procedure, a small amount of fat tissue was removed with liposuction from each patient’s abdomen. The stem cells were then extracted, and injected into the muscle of the left ventricle.

The researchers found that the stem-cell treated patients not only had a lower cardiac mortality rate over the course of the study, but that they could perform more physical activity after the treatment, and that the heart had a higher functional capacity and better maximum oxygen consumption (reflecting a higher work capacity) when compared to untreated control patients.

Impression: very exciting stuff! Sure it’s a small study, but if it pans out in larger trials, this could be a major breakthrough. Soon, maybe we’ll be seeing the plastic surgeon helping out some CCU (coronary care unit) patients with liposuction for stem-cell harvesting.

Macrolane is an injectable hyaluronic gel product from Q-Med, the makers of Restylane, which is available in Europe, but not in North America yet. Over there, Macrolane has been tried for body contouring applications, including breast augmentation – hence the catch-phrase “boob jab” for an injection of Macrolane to the breast.

In this month’s Plastic and Reconstructive Surgery online is a preliminary publication (ahead of print) of a study from Sweden, looking at a 12 month study of 24 women who had Macrolane VRF30 injected into their breasts for cosmetic augmentation purposes. (Click here for abstract)

Twenty-four women (average age = 37 years) were treated. The Macrolane VRF30 gel, up to 100 cc per side, was injected in the subglandular position with the aid of local anesthesia. Since Macrolane is slowly absorbed by the body, it was fully expected that the results would change over time: at six months post-injection, 83% were pleased with the improvement, and at 12 months, 69% were still considered improved.

While there were no major complications or systemic issues, capsular contracture around the injected material was still the most commonly reported adverse effect, with 25% of patients reporting undesirable breast firmness due to this problem.

The authors concluded that this gel is worthy of further study, and may be an option for patients that want non-surgical improvement of breast volume. Personally, I find the reported 25% incidence of capsular contracture to be a lot higher than I would like to see.

Speaking of HA gels, I’ve often wondered: why not make a breast implant that is filled with a hyaluronic gel, instead of saline or silicone? Might give the feel of a silicone gel implant, but be easy to clean up in case of deflation. Hmmm…..You read it here first, at PSB!

Happy Halloween!!

Plastic Surgery In Florida