Cosmetic Craze by Nathan Johnson The Internet and quicker, easier procedures are fueling our appetite for cosmetic surgery print article      send to a friend

Cosmetic surgery is booming in this country.  Statistics vary, but consider these numbers: over the past decade or so, cosmetic surgery procedures have increased nearly eight-fold. The top three procedures-liposuction, breast augmentation, and eyelid enhancement-grew in popularity by over two hundred percent last year alone. 

"There is absolutely no doubt that there has been a huge increase-an exponential increase and interest-in cosmetic surgery," says Brian Kinney, MD, spokesperson for the American Society of Plastic Surgeons (ASPS). "If you look back 10 years, just plastic surgeons were doing cosmetic surgery.  Now all kinds of people are doing it." These days, other specialists such as dermatologists and otolaryngologists (ear, nose and throat specialists) are also taking part in cosmetic surgery.

 Increase among men

The statistical rise in cosmetic procedures is not just part of some proliferation of wealthy grandmothers on Rodeo Drive.  The growing popularity of these procedures spans a broad demographic, from spry 25 year-old women going in for preventive procedures to middle aged men trying to compete with them in the workplace.  

The most remarkable development in cosmetic surgery may, in fact, be its growing popularity among these men (see related article in this issue).  "There's clearly a change in men's attitudes," Dr. Kinney explains. "Ten to fifteen years ago it used to be a thing where men would think 'that's kind of a thing for women.'  Now men are doing lipo, hair grafts, rhinoplasty, eyelid surgery. There's clearly been a change and men are clearly more involved and less concerned about whether someone might find out that they had something done."

As a result of this attitude change, many industry experts believe that men may some day constitute a larger portion of cosmetic surgery recipients.  "Right now, about 9% of cosmetic surgery patients are men," says Dr. Douglas Dedo, MD, president of the American Academy of Cosmetic Surgery.  But because of the continually evolving perception of cosmetic surgery, Dr. Dedo predicts the trend will persist with men.  "You'll hear women talking about things they've had done, but recently one of our doctors reported that one of his patients was telling his friends that he had liposuction! That's pretty unheard of (among men).  However, this is becoming more and more common."

Cosmetic surgery in general has become more accepted among the public, according to Dr. Dedo, and men have been brought along for the ride. "I think [the idea of] men being concerned about their looks has only recently been seen as okay. I think it's becoming more acceptable for men themselves, so I think I would look to see more men [going in for cosmetic surgery procedures] in the future."  

The face of the future

What then, does the future hold?

Liposuction, for one, will surely continue to dominate. Statistics released by the ASPS in July confirm that the most popular of cosmetic procedures just got more popular, surging at least 34 percent over the past 2 years, with some reputable organizations putting these numbers much higher.

Why all the hoopla over liposuction, you ask?  While an already weighty 29 percent of Americans were considered to be heavy or obese 20 years ago, now that number is about 62 percent!  This despite the fact that we have what Dr. Kinney calls an exercise-oriented culture. "We are the heaviest country in the world and we're heavier than we've ever been in history," he emphasizes.  "People are eating more, eating out more, they're eating junk food, they're eating fast food, and they're not exercising enough, so clearly people are becoming more overweight. A lot of people who are unable or unwilling to modify their behavior are turning to liposuction to be the substitute." Ultimately this strategy is anything but a solution, because those who have liposuction without modifying their diet or exercise pattern will gain all the fat extracted through the procedure.

Because of increased public demand and the loss of stigma associated with procedures like liposuction, the numbers we're seeing now are likely to increase in the coming years.  "If you look back at surveys 15 years ago a small percentage of men and perhaps 40-50 percent of women said they might do something to change themselves," says Dr. Kinney.  "And now the numbers are overwhelmingly high. Something like 80 or 90 % of women and 60 or 70 % of men recently said they would do something to 'make themselves better.'"

Much of this willingness to consider new things will depend on the proliferation of the so-called "lunchtime procedures" like microdermabrasion and botox injections, where even a busy, ten-hour-a-day worker can drop by the doctor's office and come out refreshed and ready to go an hour later. 

Dr. Dedo believes that these quick, mostly skincare related fix-me-ups are the wave of the future. As he explains, "I think that one of the things we're seeing is that once someone tries [these quick procedures], whether it's botox or dermabrasion or a light chemical peel, they're so impressed with the results that they're going to keep going back."

Space age cosmetics

Dr. Kinney, who was recently named chairman of the new ASPS technology committee and serves as a medical advisor to Surgery.com, has a more futuristic forecast.  He sees the Internet-a development that has revolutionized the way people manage their own health care needs by providing them with more practical medical information--as a sign of things to come. "What would you have done 15 years ago if you wanted to learn about rhinoplasty?" he asks. "You might go to a medical library and start looking through journals that were pretty dry and not particularly informative. There wasn't much information. Now that the info is widely available, you can really come up to speed quickly on your realm of choices.  And I think that makes a lot of difference."

Dr. Kinney uses the ever-popular liposuction to illustrate his Jetsonesque predictions. "Let's say a patient wants to know about liposuction. Currently, you can go to various web sites, and you can also interactively communicate with doctors. There are also various reality shows that tell you what it's like in the operating room. I believe that this interactivity, the e-mail feedback, the before and after pictures of surgery, and the accessibility--not only of info but of medical professionals--have really driven [the growth of cosmetic surgery].

"If you look forward another five or ten years," Dr. Kinney continues, "you may see video conferencing and telemedicine via the Internet, and eventually remote exams where there's a robotic arm in one city and the doctor in another examining a patient. Those kind of things-along with satellite or Internet links to personal broadcasts for patients who are interested in particular topics, for example--will start appearing on websites within a couple of years when the technology becomes inexpensive enough. It exists now. I think those are going to be very important."

According to Dr. Kinney, communication will encourage patients to pursue treatments they may not have been comfortable with before. People are already starting to get accustomed to appearing on the Internet, for all the world to see.  This was not always the case.  "When I was first starting to do my web pages," he says, "I only used pictures of breast augmentation and liposuction patients and the reason was because these were the only procedures that allowed you to avoid identifying who the patient was." 

But while it's taken a while for those in their golden years to come around, younger generations have no problem with, say, having their newly sculpted nose posted online.  As Dr. Kinney puts it, "you have this entire population of  people 25 and younger, or even 30 or younger, who almost don't know the world without an Internet."

Eventually, Dr. Kinney's forecast sees a stage he likens to "ubiquitous computing," with Internet access everywhere.  People will view cosmetic surgery much like they currently view working out at the gym or going to the salon to have their hair and nails done.  "When we talk about convergence, when we talk about technologies," he explains, "you could almost say that that's somewhat happening here-that there will be a convergence. It's seen as an extension of just improving yourself."

Drs. Kinney and Dedo do not agree with this perception, and stress that cosmetic surgery is the last thing we should trivialize.  Both emphasize the importance of viewing the object of the current cosmetic craze for exactly what it is-surgery.  "This is [not] like buying makeup.this is surgery," says Dr. Kinney.  "This is an operation, you go to sleep.  There are risks, there are benefits, but it is still surgery.  While we're doing better at it, we also have to be careful that we don't confuse things."

So while Americans may be flocking to improve themselves, this is not an invitation to treat cosmetic surgery like a trip to the beauty parlor.  So venture, if you feel so inclined, into the cosmetic world of the future, but beware of the risks involved.