By Henk Giele
In its article ‘UK plastic surgery statistics 2012: brows up, breasts down’, The Guardian reported that 39,000 women underwent cosmetic plastic surgery in 2012: nearly 10,000 breast augments, 4,000 reductions, 5,000 facelifts, 3,000 nose jobs and 3,000 tummy tucks.
Even men got in on the act with 4,102 men reported to have had cosmetic surgery. However, men had no recorded breast augmentations, but did have 107 tummy tucks, and 642 breast reductions. The report went on to say that this represented a 6% rise on the previous year and a similar rise was seen every year since 2009. At this rate we will run out of patients soon enough!
However, these facts have to be interpreted with care as Daily Mail reported there were 95,000 cosmetic or aesthetic plastic surgical procedures in the UK in 2011, half of them being non-invasive cosmetic treatments such as Botox, fillers, dental treatments and even hair treatments. The UK came 16th, with 3.5 people per 1,000 per year having a cosmetic procedure. Surprisingly, South Korea topped the rank with 13.5 people per thousand. It is important to keep in mind that these figures are based on self-reporting surveys rather than official statistics. Given that cosmetic plastic surgery operates on the fringes of normal medicine and surgery, is not funded by national health services or insurance companies, and can be performed by anybody not necessarily a skilled doctor, let alone a surgeon or a plastic surgeon at that, the figures are likely to be massively underestimated.
There is of course a benefit in the cosmetic surgical societies and their members in inflating the figures in order to normalize the concept of cosmetic surgery in the belief that if it becomes normal that will reduce the threshold of acceptance of potential patients and thus increase the numbers further.
So does this mean that cosmetic plastic surgery is on the increase?
One would expect that cosmetic plastic surgery, which adds value to the body, would be an indulgence funded by disposable income and thus, in times of austerity and belt-tightening, the rates of such surgery would decrease.
However, if the above-mentioned reports are to be believed, cosmetic plastic surgery rates are dramatically increasing. Perhaps, the weight loss and skin excess are now associated with the belt-tightening and driving business? Or are they driven by views such as those attributed to Professor Ruth Holliday from Leeds University saying that ‘getting a boob job is a way of getting status for people who don’t have any status selling coffee to the public’.
Forgive me, but the last time I looked having bigger breasts did not make you a better professional. Such comments and media reports on how common cosmetic surgery has become normalize the surgery and increase the readiness for patients to talk about it, thus creating a virtuous feedback circle. Except that the virtuous part of it is highly debatable.
Undoubtedly, every year new procedures are developing and gaining popularity. Most recently labiaplasty has been the talk of the town, and the number of people talking about it and doing it has increased considerably. On the down side, personal communication with cosmetic plastic surgeons suggests that cosmetic procedures are on the decrease, at least in their practices. But perhaps the patients are avoiding private practitioners and seeking the chains or groups that offer standardized services such as no fee consultations and standard pricing. Such groups do seem to be much more prevalent in the UK than in the god-fatherland of plastic surgery the United States where individual surgeon practices with their individual reputations are the norm.
Increasing or decreasing? It is impossible to know, but my guess is that the acceptance of cosmetic plastic surgery is getting more and more widespread as is the scope of the procedures available and the scope of potential problems correctible. Gone are the days when clinics had to have separate doors and waiting rooms so that patients could hide. Now it is almost as if patients wish to flaunt it, especially the breast enlargements. Celebrities no longer lie about it; they tweet, blog or vlog every gritty detail. There are even TV series about the good, the bad and the ugly aspects of the surgery, driven by voyeurism and public interest. There is no doubt that cosmetic plastic surgery, and the patients they treat are becoming increasingly popular. And every time someone else writes about their experience, it becomes more and more normal.
Henk Giele is a Consultant Plastic and Reconstructive surgeon at the Oxford University Hospitals NHS Trust. He is also a consultant in hand surgery, and cosmetic surgery. Originally from Australia, he took a post at the Radcliffe Infirmary in Oxford in 1997. Henk came to the UK having had posts in various regions of Australia and also France. He is a member of many medical associations, including the British Association of Plastic, Reconstructive and Aesthetic Surgeons, and is widely published in books and journals. Along with Oliver Cassell, he is the author of Plastic and Reconstructive Surgery.
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Image credits: Amir Karam Fat Transfer Facelift, by BestInPlastics, and Gynecomastia with Liposuction by David Andrew Copeland, via Wikimedia Commons.