This Cosmetic Procedure Just Overtook Breast Augmentation As #1 in America

Updated: Feb. 16, 2023

Nope, it's not BOTOX! A board-certified plastic surgeon reflects on what happened when our healthy love of curves met Zoom culture: A nostalgic treatment made a comeback.

Over 30 million Americans got some type of cosmetic procedure done in 2021. These ranged from BOTOX injections to rhinoplasty to full-body reconstructions, according to data from the International Society of Aesthetic Plastic Surgery (ISAPS). This was up 19% from the year prior…and in 2023, a new procedure that’s not so new has claimed the top spot. So what’s changed? And, why?

Plastic surgery trends are linked with which body types are currently in style, says Gary S. Berger MD, FACS, a board-certified plastic surgeon with Sono Bello.

Body types tend to follow trends just like clothing does—which is an admittedly strange thing to say about the bodies we’re all born in—but it is true that certain looks become more, or less, desirable based on popular culture. For example, Sir Mix-a-Lot’s 1992 proclaimed love for big butts in “Baby Got Back” was one factor that shifted the skinny, often fake-breasted look of the 1980s to celebrate the curvier female figure.

Now, in 2023, according to the most recent survey data from ISAPS, the trends in cosmetic procedures have shifted yet again. For many years, the most popular plastic surgery in the world was breast augmentation. Today, the number-one most-requested plastic surgery procedure is another nostalgic mainstay: It’s liposuction.

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Changing your body type through surgery

It makes sense: In an era when more women are focused on healthy eating and exercise, we’re empowered to embrace more of what we love about our bodies. So, big breasts have started to rank lower in desirability than a healthy butt.

However, that can get a little complicated in the age of Zoom meetings, when for at least a small portion of the day, we’re staring at our own faces with enough time to examine what we might change about ourselves. The increase in “tech neck” can expedite gravity’s effect on, say, a double-chin, but attempting to spot-reduce with exercise doesn’t work.

Liposuction, however, is a procedure that offers the best of both worlds. You can get a smaller, more toned body part without appearing overly “done” or giving up those beautiful curves you’ve come to love.

“There are a lot of factors for the increase in popularity in lipo,” says Dr. Berger. “It has a faster recovery time and is more affordable than breast augmentation, making it available to more people. And more people, of more diverse backgrounds, are looking for ways to feel better about themselves.”

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What is liposuction, exactly?

Liposuction is an outpatient surgical procedure that uses suction to remove fat from specific areas of the body. Dr. Berger says the most common target for liposuction is the abdomen and waist, in both men and women. A typical liposuction procedure takes about two hours in the office, and patients recover at home.

“Under the umbrella of lipo, there are multiple methods that combine science and artistry that plastic surgeons can use to contour the body for a desired appearance,” Dr. Berger says.

How much weight can you lose with liposuction?

“Liposuction should always be done for shape only,” says Dr. Berger. “Though some patients may use it to jumpstart themselves to a healthier lifestyle, it is never a good replacement for diet and exercise.”

Still curious? This plastic surgeon says the safe limit for liposuction removal in one surgery is about five liters, which equates to 11 pounds.

How painful is liposuction?

Out of all the cosmetic procedures, lipo is one of the least painful, says Dr. Berger. “My patients tell me that it feels like going back to the gym for the first time in a while—achy and sore, but not significantly painful,” he says.

Will the fat come back?

Liposuction generally isn’t permanent. Many liposuction patients experience normal weight fluctuations, but that doesn’t mean the procedure didn’t work, Dr. Berger says.

“There is an oft-repeated myth that having liposuction will cause the fat to migrate somewhere else. However, if a patient gains significant weight after having had liposuction, the body distribution pattern of that weight may be different than before surgery, leading to the illusion that the person had ‘surgery on my stomach and all the fat moved to my arms,’ for example,” he explains.

You can have lipo repeatedly, including in the same spot, if there’s still residual fat or if you’ve gained weight, he adds.

How much does liposuction typically cost?

According to the American Society of Plastic Surgeons, the average cost for liposuction in the US is $3,637. Costs for liposuction vary widely based on where you live, where the procedure is performed (a medical spa vs. a doctor’s office vs. a hospital), what type of liposuction you want, and how much fat is being removed. Note that this total doesn’t usually include other fees, like the anesthesia or operating room facilities.

What are the negatives of liposuction?

There are some risks associated with getting lipo—the most common being an aesthetically unappealing result. For instance, some people may end up with lumpy spots, changes in skin texture, or asymmetry. Also, says Dr. Berger, be aware that liposuction can’t get rid of cellulite, stretch marks or loose skin.

“Skin that has been stretched out from large weight changes or pregnancy may not improve or return to being smoother without some form of skin removal surgery as well,” he says.

Less common liposuction risks include numbness, swelling, infection, fat embolism, heart or kidney problems, and lidocaine toxicity (from the numbing agent used).

The bottom (pun intended!) line: While the questions around self-esteem and plastic surgery will probably always be debated, if liposuction can help you achieve a contoured body that will make you feel better, it’s a tried-and-true procedure, as long as you’re aware of what you might expect.

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