In the world of modern social media, it doesn’t take long to find yourself in a situation in which you’ve accidentally convinced the Instagram algorithm that all you’ll want to look at for the foreseeable future is women who are so beautiful it’s startling. And it doesn’t take long to start to recognize the parts of yourself that don’t quite match up with their beauty. Nose not quite as rounded, skin not quite as taut, lips not quite as full. Maybe one of those things really sticks with you, or maybe it’s already been with you for quite a while now. In most cases, you don’t really know if the women in the posts you see are using filters, or if they’ve had cosmetic procedures, or if they’re naturally just flawless. But…does it really matter? Even if you knew, would it really change how you feel? You just want to feel beautiful. Maybe you, like millions of other American women, have considered cosmetic surgery, too.

Can I ask you a personal question?

👁️ Eyebrow-raising trends

Last year, the American Society of Plastic Surgeons (ASPS), “the world's largest plastic surgery organization representing 92 percent of all board-certified plastic surgeons in the United States,” released its latest dataset covering the state of cosmetic procedures in the U.S. In 2022, there were 26.2 million surgical and minimally invasive cosmetic and reconstructive procedures, a 19% increase from pre-pandemic levels reported in 2019. And numbers were up across the board. Within the surgical category, breast augmentation increased 4%, blepharoplasty (eyelid surgery) 13%, liposuction 23%, breast lifts 30%, and abdominoplasty (tummy tuck) 37%.

But the scale of surgical cosmetic procedures, totaling 1.5 million, paled in comparison to that of minimally invasive cosmetic procedures, which accounted for 23.7 million procedures. Among them, neuromodulator injections (aka Botox) were the most popular (8.7 million total), up a staggering 73% from 2019. As women in their 20s and 30s now strive to minimize the appearance of aging earlier than ever, “barely-there” aka “preventative” aka “baby” Botox has surged. Hyaluronic acid fillers followed Botox at 4.8 million procedures, and saw a similar increase of 70%. While men have experienced a significant rise in cosmetic procedures relative to their 2019 levels, women still unsurprisingly account for roughly 9 in 10 cosmetic procedures (though just 2 in 10 plastic surgeons), with women under the age of 45 driving the demand in recent years. So what’s behind these trends? 

Double-edged social media

When it comes to rising rates of cosmetic procedures, nothing seems to be a more prominent driver than influencers on social media. In one report, the ASPS attributed skyrocketing rates of lip filler usage to the “Kylie Effect”, referring to “Kylie Jenner’s transition from thin-lipped teenager to full-pouted beauty icon [that] arguably spurred the initial wave of lip augmentation interest.” Research recently published in the Aesthetic Surgery Journal “observed a significant increase in public interest in both surgical and nonsurgical aesthetic procedures after Instagram gained popularity in the April of 2012.” Other surveys found that 44% of Gen Z and 30% of Millennials reported having learned about cosmetic procedures via social media.

The more we see ourselves on screens, the more these trends seem to be amplified. And during no time in history did we stare endlessly at ourselves on screens more than we did throughout the COVID-19 pandemic. The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) appropriately dubbed the post-pandemic surge in cosmetic procedures the “Zoom Boom,” and found that nearly 80% of facial plastic surgeons agreed that “looking better in selfies” was an increasingly prominent driver of cosmetic procedures. Another group of researchers published findings illustrating that before and after the COVID-19 pandemic, there was “a statistically significant change in number of participants that: followed social media accounts showing results of cosmetic procedures; had thought about having a cosmetic procedure done; had discussed cosmetic procedures with a physician, dermatologist, or other; and believed that a cosmetic procedure would help their self-esteem.”

Many plastic surgeons have become familiar with the experience of patients not just bringing photos of celebrities to their consultations, but of bringing photos of their filtered selves as inspiration. With regard to filters, the ASPS states that the “disparity between filtered images and reality can lead patients to aspire to unattainable results, setting them up for disappointment and dissatisfaction.” With regard to social media trends, it states that “patients may request treatments or surgeries based on these trends without fully understanding the risks, limitations or appropriateness for their specific case.”

But on the other hand, many in the field also point to social media as a major source of education and de-stigmatization of cosmetic procedures. Some influencers use their platforms to shed light on their experience with different procedures, the risks, and the results. Many surgeons say their patients are more informed than ever, while patients say learning about the landscape of possible cosmetic procedures through social media has made them less intimidated by the process. In fact, one survey of over 2000 American adults found that 31% of people felt that “more celebrities and influencers talking about their cosmetic procedure on social media” had contributed to increasingly positive attitudes towards the topic, while 48% also felt there was a “greater societal focus on self-care and feeling confident.”

Satisfaction, sentiment, costs & more

Despite the complicated relationship between modern social media and cosmetic procedures, one thing seems to be pretty clear about those who ultimately choose to pursue such changes: they’re overwhelmingly satisfied with their choice. One study that evaluated 228 individuals in the months following their aesthetic plastic surgery found that “over 84% were satisfied or very satisfied with the aesthetic result, 85% would undergo the same treatment again and 94% of the patients would further recommend their operation.” Online site RealSelf, which aims to provide online resources for those considering cosmetic procedures as well as aggregate reviews and satisfaction rates, shows average “worth it” ratings of over 90% across thousands of reviews for each of the following procedures, just to name a few: Botox, facelift, rhinoplasty, breast augmentation, and eyelid surgery.

Amongst women, not only has satisfaction around cosmetic procedures been remarkably high, but positive sentiment has also risen. In a recent survey by RealSelf, 32% of women associated plastic surgery with self-improvement, 31% with empowered personal choice, and 30% with confidence building. However, stigma still remains, particularly amongst men: male respondents were most likely to categorize plastic surgery as fake (35%), vain (29%), dangerous (27%), and financially wasteful (27%). Yes, we are also rolling our eyes right now (...and restraining ourselves from using the remainder of this piece to psychoanalyze the collective male brain and the irony that eludes it).

Leaving the judgment and condescension of a statement like “financially wasteful” behind, we’d be remiss not to discuss the costs of cosmetic surgery as a major factor for those considering them. Across the board, cosmetic procedures are not cheap by any measure. According to the ASPS, all common forms of face and body cosmetic surgical procedures cost, on average, somewhere between $3k and $10k. Minimally invasive cosmetic procedures, while less expensive, are rarely one-time occurrences for patients. Botox, for example, needs to be refreshed every 3 to 6 months and costs roughly $500 per treatment. Lip filler also typically requires biannual treatments for maintenance and can run you $750 per treatment. In other words, five years of two treatments per year of each Botox and lip filler would likely rack up a $12.5k bill. (For a thorough breakdown of costs for each type of procedure, check out this resource from the ASPS.) Not surprisingly, the global cosmetic surgery market is huge. In 2023, it was valued at $57.67B. By 2032, that number is projected to balloon to $81.66B.

For many, these costs simply make cosmetic procedures unaccessible. And it’s reflected in the numbers. RealSelf found that “while 24% of the general population reported having had some form of cosmetic procedure, the percentage increases to 40% when only looking at respondents who make more than $150k annually.” And while wealthier clientele can shell out the cash to meet these prices and achieve their beauty goals, steep costs of cosmetic procedures have driven many to pursue medical tourism. In other countries such as Mexico or Costa Rica, patients may find doctors able to perform their desired procedures at lower costs. But this can also come with significant risk. Travel on long flights combined with surgery increases rates of complications like pulmonary embolism and blood clots, while the situation also fundamentally complicates proper follow-up care and exposes patients to medical standards and qualifications that may differ from that of the United States. It goes without saying that health comes above all else, so it’s critical to do your own research and evaluation of the costs and benefits of cosmetic procedures prior to making the decision for yourself.

Let us know what you think by voting in our poll and leaving an anonymous comment.

💭 Our Your two cents

Another week, another very complicated NTP topic. And to make matters trickier, neither of us have had personal experience with cosmetic surgery to date. Since the beginning of NTP, we’ve been wanting to find ways to incorporate the stories and perspectives of our readers in addition to our own… because NTP is about starting conversations, not just listening to ourselves talk. So this week, we figured you might be better off hearing from someone who can actually speak to this topic from personal experience. Without further ado, here’s one of our readers who can do exactly that. ;)

So yeah, we couldn’t have said it better if we tried. What I’ve always found so difficult about the topic of cosmetic surgery is that it forces us to confront the fact that society can sometimes make us feel as though we aren’t good enough. And that sucks. I wish it wasn’t that way. But it is. And as our anonymous NTP reader-writer so gracefully implies, who are we to weigh in on the choices someone else makes in order to feel beautiful? After all, you know yourself best… you don’t know someone else best. And if we’re lucky, a little less judgment from a whole lot of us might ultimately go a long way.  

P.S. If you’d ever like to share anonymously about any topic that might fit into a future NTP, or if you just liked this week’s guest post, send us a message and let us know. We’d absolutely love to hear from you. :)

💃 The girls have spoken

Last week, we dove into the financial gender gap that doesn’t always get the hype that the gender pay gap gets, but is every bit as important: the gender wealth gap. We asked ourselves So…why don’t we invest more? and took a closer look at the ways in which investing being labeled as risky and masculine have affected us when it comes to making investments of our own. We also tried to break down how such decisions can produce compounding financial outcomes over time. In our poll, we were thrilled to see that 85% of you reported making investments of your own already, while the remaining 15% do invest but only through your employee-sponsored 401K plans or are planning to get started soon. But we also heard from you that even though you are walking the walk, at times it can still be very intimidating, very confusing, and very imposter-syndrome-inducing. Which we can totally relate to. But with some effort, who knows – maybe the latest earnings reports might be the hot topic of our next wine night. I bet that there, they probably won’t be so scary after all.

💌 Up Next

That’s all for today! If you liked this edition of Not That Personal, we think one of your friends probably will too – refer one (or two or three) below. ;)

Have something to say? We’d love to hear it – reply to this email or leave an anonymous comment here. :) 

Up next? ​​So…how much do you spend on friends’ weddings?

💖 S & J