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The Most Common Cosmetic Surgery in 2011 Was …

Cosmetic Surgery Sees Increase in 2011, While Botox and Other Minimally Invasive Procedures

By Denise Mann WebMD Health News Reviewed by Laura J. Martin, MD March 20, 2012 —

Almost 9.2 million cosmetic procedures were performed in the United States in 2011, and Americans spent nearly $10 billion on cosmetic procedures last year. These are some of the key findings in the new statistics from the American Society for Aesthetic Plastic Surgery (ASAPS). Cosmetic surgical procedures increased almost 1% since 2010, while minimally invasive procedures decreased almost 2% in the same time period. This is the 15th year the ASAPS has tracked plastic surgery. Since 1997, cosmetic procedures have increased 197% for men and women combined — and there have been some changes over the years. “Surgery seems to be slowly coming back,” says ASAPS President Jeffrey M. Kenkel, MD. He is a professor and vice chairman of the department of plastic surgery at the University of Texas Southwestern Medical Center in Dallas.

Noninvasive procedures such as injectables do have a role, but individuals are looking for more durable results, says Kenkel. One of the reasons that the numbers are creeping up is that people need to stay in the work force longer, which means that they must compete with their younger counterparts for the same jobs, he says.

Liposuction topped the list of most popular plastic surgeries in 2011, and injections of botulinum toxin type A (including Botox and Dysport) ranked as the top nonsurgical procedures, the new statistics show.

According to the new statistics, the top five surgical procedures in 2011 were:

  • Liposuction
  • Breast augmentation
  • Abdominoplasty (tummy tuck)
  • Eyelid surgery
  • Breast lift

Fully two-thirds of women opting for breast augmentation with implants chose silicone-filled breast implants in 2011. Kenkel says this shows that women and plastic surgeons are becoming more comfortable with the safety of these implants. Due to safety concerns, there was a 14-year ban on the use of silicone breast implants. This ban was lifted in 2006. In a further nod confirming the safety of these implants, the FDA recently approved a new silicone-gel breast implant from Sientra, making it the third company to market these implants in the U.S.

In 2011, the top five minimally invasive procedures were:

  • Botulinum toxin type A Hyaluronic acid-based fillers (for treatment of wrinkles)
  • Laser hair removal
  • Microdermabrasion
  • Intense pulsed light (IPL) treatments (for treatment of skin redness and uneven skin tone)

Women had almost 8.4 million cosmetic procedures in 2011, and men had almost 800,000. The number of cosmetic procedures for men increased over 121% from 1997, which was the year that ASAPS first started tracking these statistics. The new statistics were based on questionnaires sent to dermatologists, otolaryngologists, and plastic surgeons. More than 1,100 doctors returned the questionnaires. The final sample included responses from 420 plastic surgeons, 384 dermatologists, and 211 otolaryngologists.

A brief history of breast enlargements

By Claire Bowes & Cordelia Hebblethwaite -BBC World Service

In search of a bigger bust

Design for a breast protector, 1864. US patent number 43321. Inventor Eleanor M MarshallInjected: Paraffin was tried in the 1890s, but quickly dropped because it leaked to other parts of the body

Transplanted: In the 1920s and 1930s doctors tried moving fat from other parts of the body to the breast

Inserted: Polyurethane, cartilage, sponges, wood and even glass balls, were all tried in the 1950s

Non-surgical solutions: Vacuum pumps, suction devices, a multitude of lotions and potions, and padded or inflatable bras

Source: Inventing Beauty by Teresa Riordan

Composite of images about the history of breast implants and those who inspired women to want bigger bosoms - including patent drawing for bust-developing device 1929, US patent number 1795073, inventor Peggy Bbowh

It was spring 1962 when Timmie Jean Lindsey, a mother-of-six lay down on the operating table at Jefferson Davis hospital in Houston, Texas.

Over the next two hours, she went from a B to a C cup, in an operation that made history.

“I thought they came out just perfect… They felt soft and just like real breasts,” says Lindsey now aged 80.

“I don’t think I got the full results of them until I went out in public and men on the street would whistle at me.”

Though the operation boosted her self-confidence – and she enjoyed the extra attention – she had never planned to have a breast augmentation.

Lindsey had been to hospital to get a tattoo removed from her breasts, and it was then that doctors asked if she would consider volunteering for this first-of-its-kind operation.

“I was more concerned about getting my ears pinned back… My ears stood out like Dumbo! And they said ‘Oh we’ll do that too.'” So a deal was struck.

The surgeons were two ambitious pioneers, Frank Gerow and Thomas Cronin.

It was Gerow who had first come up with the plan for a new kind of breast implant.

“Frank Gerow squeezed a plastic blood bag and remarked how much it felt like a woman’s breast,” says Teresa Riordan, author of Inventing Beauty: A History of the Innovations that have Made Us Beautiful.

“And he had this ‘Aha!’ moment, where he first conceived of the silicone breast implant.”

The first guinea pig for the silicone implant was a dog named Esmeralda. The basic principle behind the prototype was simple.

“A rocket achieves lift off with lift and thrust – same thing in breast augmentation,” says Thomas Biggs, who was working with Gerow and Cronin in 1962 as a junior resident in plastic surgery.

“I was in charge of the dog. The implant was inserted under the skin and left for a couple of weeks, until she chewed at her stitches and it had to be removed.”

The operation was deemed a success and Gerow declared that the implants were “as harmless as water”. Soon after, the medical team began looking for women to try out the implants.

Timmie Jean Lindsey has only a hazy recollection of her operation day.

“As I came back from surgery there was just a lot of weight on my chest – like something heavy had been sitting there.”

“That was about it – after maybe three or four days the pain part of it had let up.”

The doctors were pleased with their work. But, at the time, Biggs had no idea quite what they had on their hands.

“Sure it was a little bit exciting, but if I’d had a mirror to the future I’d have been dumbstruck,” he says.

“I was not wise enough to realise the magnitude of it.”

The significance began to hit home when Cronin presented the work at the International Society of Plastic Surgeons in Washington DC in 1963. “The plastic surgery world was absolutely set on fire with enthusiasm,” says Biggs.

The time seemed right. 1950s America had seen a whole swathe of cultural influences come together around the ideal of a larger breast.

It was the decade in which Playboy magazine and Barbie launched, and film stars played a big role too.


The busty look of Marilyn Monroe and Jane Russell and also Dior’s New Look of 1957, really emphasised this curvy silhouette, and got women thinking about augmenting their breasts,” says Teresa Riordan.

“Falsies” – basically stuffed bras – were popular, but increasingly women wanted something more.

Through the years, all manner of approaches had been tried to increase breast size. In the 1950s, doctors started inserting sponge implants into women’s breasts. Some allege that Marilyn Monroe had this operation, though this is hotly contested.

Monroe biographer Anthony Summers says people he interviewed for his book, who knew her well – including Billy Travilla, who was both her dressmaker and one of her lovers – said she had no reason at all to have any breast enhancement.

“The filmmaker Billy Wilder described Monroe’s bosom as, ‘a miracle of shape, density and an apparent lack of gravity,'” he says.

The sponge technique worked well at first, but did not last – the sponges soon shrank, and became “hard as baseballs” says Biggs.

Silicone was also a material of the moment. “There was a post-war American fascination with all things plastic and artificial,” says Riordan.

It is not in the US, though, that the silicone was first used for breast enlargement, but in Japan, where it was tried out by prostitutes.

Eager to do better trade with the occupying US forces, who they presumed preferred a larger chest, they experimented by injecting silicone – stolen from the docks of Yokohama – direct into the breast.

These injections turned out to have a nasty side-effect known as “silicone rot”, in which gangrene set in around the injection site.

The early silicone breast implants pioneered in the US fortunately avoided this hitch, but were not entirely problem-free.

Hematoma, where blood collects in a swelling, was one early difficulty. There were cases of infections too, and also “fibrous capsular contractions” where a scar would form, making the implant hard.

“We are not worshipping what we had 50 years ago, because that’s history,” says Biggs.

There have been many advances over the decades, like 3D-imaging, and implants that are increasingly rupture-proof – and the range has widened.

“In the early days, we only had four choices or sizes – large, medium, small and petite. Now we have over 450 choices,” says Biggs.

Around the world, breast enlargement is now the second-most popular cosmetic surgery operation, after liposuction (the removal of fat). In many countries – including the UK – it is the most popular operation.

It’s not only used by women who want to perfect their body shape but also by patients who have undergone mastectomy as a result of breast cancer. This was something Gerow and Cronin envisaged from the start, and one of their motives for developing the operation.

For many years, Timmie Jean Lindsey kept fairly quiet about her breast enlargement – one boyfriend never knew for example, and it was only decades later that she told many of her friends and family about it.

Fifty years on she remains delighted with the results, though there is no stopping the passing of time, she says.

“You would think they would stay real perky, but no – they are just like a regular breasts, they begin to sag over the years. That surprised me. I figured they’d just stay where they were.”

But she still very happy with the little piece of history she carries inside her body.

“It’s kind of awesome to know that I was first,” she says.

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