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The American Society of Plastic Surgeons' procedural statistics: what they really mean.

Annually, the American Society of Plastic Surgeons (ASPS) collects procedural statistics and tracks trends in both reconstructive and cosmetic plastic surgery. Recently released statistics for 2002 indicate that surgical numbers remained stable.1 The ASPS statistics indicate that more than 1.6 million patients underwent a cosmetic surgical procedure in 2002, a 1 percent increase over the previous year. A total of 4.9 million nonsurgical procedures were performed, which is a 15 percent decline from the past year; however, there was a 31 percent surge in the use of botulinum toxin type A. Plastic surgeons performed more than 6 million reconstructive procedures, representing an 8 percent increase. While the numbers for women remained unchanged, procedures performed on men increased 3 percent. These numbers show us that, despite the environment, economy, terrorists, and war, individuals are willing to set high priorities to look as good as they feel and to invest in themselves via cosmetic procedures. The top cosmetic surgery procedures for 2002 were nasal reshaping, liposuction, breast augmentation, eyelid surgery, and face lifts (Fig. 1). The 35to 50-yearold age group had more than 2.9 million surgical and nonsurgical procedures performed. This group represents 45 percent of all cosmetic procedures. For this group, liposuction remained the number one cosmetic surgical procedure, while botulinum toxin type A injections were the top nonsurgical procedure. In the second largest age group, the 19to 34-year-olds who represent 24 percent of cosmetic patients, breast augmentation was the leading cosmetic surgical procedure and microdermabrasion was the top nonsurgical procedure. In reconstructive surgery, 2002 statistics show that the top reconstructive procedure remained tumor removal, with an increase of 10 percent (Fig. 2). The largest decrease was in breast implant removal for reconstructive patients, down 18 percent from the previous year. The fact that plastic surgeons performed more than 6 million reconstructive procedures in 2002 exemplifies the fact that reconstructive surgery remains a strong, viable, and essential aspect of plastic surgery. Gender trends for 2002 show 5.6 million cosmetic surgery procedures for women compared with 1 million for men. The top surgical procedures for women were breast augmentation, liposuction, nose reshaping, eyelid surgery, and face lifts. Whereas augmentation remains the most popular procedure for women ever since statistics have been kept, the top nonsurgical procedures for women remain injections of botulinum toxin type A, chemical peels, microdermabrasion, sclerotherapy, and laser hair removal (Fig. 3). This is in contrast to nonsurgical procedures for men, where injections of botulinum toxin type A were second to chemical peels, followed by microdermabrasion, laser hair removal, and collagen injections. The top surgical procedure for men was nasal reshaping, followed by liposuction, eyelid surgery, hair transplantation, and ear surgery (Fig. 4). A look at age trends in nonsurgical procedures showed that collagen injections in-