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Global Plastic Surgery Survey Highlights Significant Changes in Aesthetic Procedures During Pandemic


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The International Society of Aesthetic Plastic Surgery (ISAPS) released the results of its annual Global Survey on Aesthetic/Cosmetic Procedures, which showcased the impact of the COVID-19 pandemic on aesthetic plastic surgery procedures worldwide throughout 2020. 

Among the Highlights: 

  • Plastic surgery procedures for aesthetic purposes decreased by 10.9 percent overall in 2020, with 77.8 percent of surgeons globally experiencing temporary practice closures during the COVID-19 pandemic. 
  • Nonsurgical procedures (primarily fillers and hair removal treatments) continued to increase, but by lower proportions than seen in previous years (5.7 percent in 2020, compared to 7.6 percent in 2019). This resulted in an overall decrease of 1.8 percent for all procedures.  

“This downward trend is in line with our survey findings of lower patient demand due to safety and financial concerns during the COVID-19 pandemic,” says Arturo Ramirez-Montañana, M.D., chair of ISAPS’ Global Survey Committee. “At the same time, many of us have also experienced an increase in demand due to patients’ increased flexibility, the opportunity for a more private recovery and, particularly for facial procedures, the so-called ‘Zoom effect.’ This has limited the impact of COVID-19 on overall procedures.”

Aesthetic Procedures

The most common surgical procedures worldwide remained the same during 2020, with breast augmentation making up 16 percent of all procedures, liposuction 15.1 percent, eyelid surgery 12.1 percent, rhinoplasty 8.4 percent, and abdominoplasty 7.6 percent. 

The top five nonsurgical procedures also remained consistent: botulinum toxin (43.2 percent of all nonsurgical procedures), hyaluronic acid (28.1 percent), hair removal (12.8 percent), nonsurgical fat reduction (3.9 percent), and photo rejuvenation (3.6 percent). Around 85 percent of nonsurgical procedures were performed on women.

Despite the overall reduction in surgeries, rhinoplasty and brow-lift surgeries continued to increase, and nonsurgical facial rejuvenation showed a 13.9 percent increase compared to a decrease in both 2019 and 2018. 

Overall, nonsurgical procedures increased, except for botulinum toxin, hyaluronic acid, and micro-ablative resurfacing (decreasing by 0.9 percent, 6.1 percent, and 11.3 percent, respectively). 

The most common surgical procedures in men continue to be eyelid surgery, liposuction, gynecomastia (enlarged breast tissue), rhinoplasty, and ear surgery. 

Looking at the age distribution for different procedures, 19 to 34-year-olds made up the highest proportion of those undergoing rhinoplasty (67.9 percent) while 35 to 50-year-olds accounted for the majority of botulinum toxin procedures (50.2 percent).  

At the time of this survey, only 45 percent of surgeons had seen a return to pre-pandemic patient volume. “Despite the terrible pandemic we are living through, it seems that most aesthetic plastic surgeons are getting back to near-normal practice, and I am optimistic about 2021, both for the plastic surgery industry and for surgical and nonsurgical procedures,” says Ramirez-Montañana.

Country Statistics

The U.S. saw an increase in both surgical and nonsurgical procedures, consolidating its position as the number one country for surgical procedures performed worldwide (14.7 percent of total surgical procedures) and taking the lead from Brazil with the most nonsurgical procedures performed worldwide (22.1 percent of total nonsurgical procedures).

  • The top 10 countries for procedures in 2020 were the U.S., Brazil, Germany, Japan, Turkey, Mexico, Argentina, Italy, Russia, and India, followed by Spain, Greece, Colombia, and Thailand. 
  • Mexico, Turkey, and Colombia saw the highest proportion of foreign patients: 28.2 percent, 25.8 percent, and 21.8 percent, respectively in 2020. Thailand, which held the number one position last year, was fourth highest at 20.9 percent. 
  • Hospitals continue to be the primary facility where surgical procedures are performed (43.8 percent worldwide), apart from the U.S. where office facilities (45 percent of procedures) and free-standing surgical centers (34.3 percent) are more commonly used.
About The Author

Julie is the co-founder of Well Defined and a longtime influencer and advocate in the wellness world. Along with her work at Well Defined, she is an executive recruiter and marketing specialist for Hutchinson Consulting. She is also a consultant and content strategist for numerous wellness brands. She is the former editor-in-chief and publisher of American Spa and was named a 2019 Folio Top Woman in Media in the Industry Trailblazers category and a 2018 winner of ISPA’s Innovate Award. She is also a seasoned journalist, specializing in spa, travel, health, fitness, wellness, sustainability, and beauty. She has been published in Departures,, E! Online,, Insider’s Guide to Spas, Luxury Travel Advisor, Marin Magazine, Ocean Home, Smart Meetings, Spa Asia, and Travel Agent.