August 11th, 2010
11:53 AM ET

World's top nips-tucks: Tummies, breasts, eyes

U.S.A. reigns supreme... in the world of plastic surgery.

The United States has the most number of plastic surgeons and total surgical procedures, according to a survey from The International Society of Aesthetic Plastic Surgery.

Americans spend about $11 billion a year to nip, tuck, reduce, enlarge, inject and shape their bodies. That preoccupation with improving tummies, breasts, noses and faces isn't isolated to the United States. Beauty procedures are popular in Brazil (who comes in at a close No. 2) and Asian countries such as China (No. 3) and India (No. 4).

The top two procedures for these four countries are liposuction and breast augmentation. See the rankings here.

Dr. Foad Nahai, president of ISAPS, recalled traveling to Brazil 20 years ago when the popular procedures there were to shape and lift breasts. The Brazilian women then weren't interested in enlargement, he said. But now, breast augmentation is the second most popular procedure in Brazil, according to the survey.

It's fair to say that the increasingly popular procedures around the world seek to mimic Western features, but they vary regionally and have their own ethnic twist, said Nahai, who practices in Atlanta, Georgia.

He said he asked plastic surgeons in a Thai conference what the most common procedures were in that country. The Thai doctors said it was blepharoplasty, in which fat is removed from the eyelid to give a more defined crease, and rhinoplasty that inserts silicone in the bridge of the nose to give more prominence.

The surge of surgeries in China and India could be a product of economic growth, Nahai said.

“As the economy booms, I’m sure there’s now a middle class in both countries. There are lots of disposable income and people choose to spend it on cosmetic enhancements,” he said.

Recession no barrier to cosmetic procedures

The biennial survey by the organization was conducted by a U.S. research firm as surveys were sent to 20,000 members. The various national societies of plastic surgeons also provided some estimates. The overall survey portion of this research holds a standard error of plus or minus 4.24 percentage points at a 95 percent level of confidence.

Here are the 2009 top 10 surgeries in the world:

1. Liposuction 1,607,979
2. Breast augmentation 1,454,317
3. Blepharoplasty (eyelid surgery) 1,153,756
4. Rhinoplasty (nose surgery) 799,521
5. Abdominoplasty (tummy tuck) 622,022
6. Breast reduction 509,396
7. Breast lift 487,993
8. Facelift 401,902
9. Gynecomastia (male breast reduction) 250,984
10. Otoplasty (ear surgery) 226,017

soundoff (32 Responses)
  1. Mike Knight

    The story ignores one of the most common American cosmetic procedures of all: non-religious male circumcision. Despite not being endorsed as a therapeutic procedure by the American Medical Association, male circumcision is still performed almost routinely by many American hospitals. Although there are attempts to justify the procedure, it was actually championed by John Harvey Kellogg simply as a method of discouraging masturbation. Given the nature of the procedure, it is difficult for many countries to understand why the US campaigns against female circumcision in some third world countries, while permitting a procedure in male babies that is surgically just as brutal – without allowing the child to make their own decision when they reach adulthood.

    August 11, 2010 at 14:46 | Report abuse | Reply
    • Eternal Response


      Female circumcision is a means of removing pleasure from females during intercourse. It is a means of controlling a population. Male circumcision does not have an affect on the performance of or pleasure from. It was started before modern hygiene as a hygienic method. While it is no longer necessary, there are still women that agree it is more pleasant in appearance.

      It is like facial hair, or the lack thereof. It is preference, nothing more.

      August 11, 2010 at 15:11 | Report abuse |
    • AC

      I agree with you that male circumcision is done for looks and is a needless silly procedure. But female circumcision is more along the lines of female castration. It's far more damaging, far more painful and limits a females future pleasure. Men still do quite fine without their foreskins.

      August 11, 2010 at 17:03 | Report abuse |
    • Michael Guarnieri

      While it may be true that male circumcision is done for primarily cosmetic or cultural reasons in the United
      States, it has emerged as one of the most effective population-level ways of reducing transmission of HIV in developing countries. Multiple well-conducted studies have shown a greater than 50% reduction in female to male transmission among circumcised males. Fewer infected males, in turn, leads to less reciprocal transmission back to females. There are few single interventions that exist today that are this effective against HIV transmission.

      August 11, 2010 at 17:26 | Report abuse |
    • aroth

      As a circumcised male I can assure you that the procedure in no way "discourages masturbation" (or otherwise interferes with normal sexual function). Comparing it to female "circumcision", which involves the complete removal of a functional sexual organ, is ridiculous. Saying that the two are "just as brutal" is equally ridiculous. If other nations have difficulty understanding the difference between removing a flap of skin that is nonfunctional and nonessential to sexual enjoyment and removing a complete sexual organ, then that's their problem, not ours.

      August 11, 2010 at 19:32 | Report abuse |
    • LiberalIsNotA4LetterWord

      Yea male circumcision is a cosmetic procedure, I'll see ya there. Its a purely hygenic thing to do. I would never allow for any male childern I had not to be circumcised just like I myself was circumcised. In all honesty if I wasn't circumcised I'd probably have it done as an adult. You're the same people who think Big Pharmaceuticals are only out to control the populace (and I'm not saying there isn't corruption and profiteering but let's drop the conspiracy theory stuff) and vaccinations are linked to autism and are unnecessary. I'll take my chances with these things since time and time again they've helped me throughout life.

      August 11, 2010 at 22:43 | Report abuse |
    • garyM

      What! Male circumcision is completely irrelevant. While I don't recall the exact reason for its popularity in the U.S., it has lately been advocated as a form of reducing the likelihood of HIV in countries like Africa. In the U.S. it has been such a routine procedure for decades that you must elect not to have it instead of the other way around.

      August 12, 2010 at 00:38 | Report abuse |
    • P

      Mike is right in that the argument is often made in nations that practice female circumcision that we circumcise our males. Meanwhile Michael is right in that circumcision reduces HIV transmission, but fails to note that this is due to the ease of tearing the foreskin during dry vaginal intercourse (a very confusing preference when having sex with prostitutes). And while there is a huge difference between male circumcision and female circumcision, in both intention and result, what good news can be found is that studies show that the majority of the clitoris is located below the skin level, is generally undamaged during the barbaric procedure, and many thus mutilated women are still able to achieve orgasm during masturbation.
      As per the article, what I found most interesting is that eyelid procedures are more common than nose jobs. But if the idea is to "mimic Western features" than I guess I shouldn't be surprised. My wife, who is Vietnamese, has kittens every time she sees an Asian woman who has had her eyes done to look rounder.

      August 12, 2010 at 00:39 | Report abuse |
    • Alan

      Mike Knight, male circumcision is actually a very useful procedure and it prevents penile cancers and serves multiple hygenic purposes-such as those to prevent penile infections. I would recomment all males get circumcised for these very reasons.

      August 12, 2010 at 10:43 | Report abuse |
    • angryStudent

      so female circumcision (depending on which thrid world country your willing to look at) is where they take a young girl, sew up her vagina and then cut it open every time her husband wants to have sex. After intercourse she is re-sewn back up. I wonder why the US doesn't want female circumcision in our country.

      August 13, 2010 at 08:58 | Report abuse |
  2. Diane

    Male circumcision may be a cosmetic preference, but as a society we don't allow men to make that decision themselves – we thrust it upon them as infants. And, removing the foreskin DOES remove the largest part of the penis for sexual pleasure. Men who are circumcised just don't realize what they are missing out on.

    August 11, 2010 at 15:24 | Report abuse | Reply
    • bob

      how would you know?

      August 11, 2010 at 19:56 | Report abuse |
    • J-Pap

      I dunno how you circumcised fellows make a good pull. Glad to be natural!!!

      August 11, 2010 at 23:48 | Report abuse |
    • angryStudent

      as a woman, i prefer circumcisized. hmmm.... that's how they pull it off.

      August 13, 2010 at 08:59 | Report abuse |
  3. Alex

    Eternal Response,

    If circumcision was performed to discourage masturbation, how does that NOT affect pleasure derived from "manipulation"? And as for it being a preference, you're exactly right. WOMEN can pick and choose what they prefer in a penis. Men can't. Because unlike facial hair, what's gone ain't growing back.

    August 11, 2010 at 15:46 | Report abuse | Reply
    • J-Pap

      Yeah exactly, If I don't like big nasty lips that hang on a girls pus, I'll choose another girl. Same goes for girls with guys. To each their own. I"m just glad I have the choice.

      August 11, 2010 at 23:50 | Report abuse |
  4. Jenna

    The conclusion is misleading. If we're going by head count alone, obviously nations with huge populations such as China, India, and the USA are going to be pushed to the top. The real conclusion should be drawn from the percentage of the population that undergoes plastic surgery. Brazil would be #1 by a landslide. 3824 plastic surgeons for a country with a population of less than 200 million, versus 5700 for the USA's 300 million+ population, and 4250 for China's 1.5 billion people. You do the math – Brazil and South Korea should be at the top of the list.

    August 11, 2010 at 17:44 | Report abuse | Reply
    • Charles

      I was just about to post the same thing. Unless the numbers are per capita, they don't really tell you anything.

      August 11, 2010 at 19:02 | Report abuse |
    • aroth

      Actually, if you do the math based upon the numbers you provided, you get 20 surgeons per million people in Brazil, and 18.6 surgeons per million people in the U.S.. A 7% difference is far from being "a landslide".

      August 11, 2010 at 19:20 | Report abuse |
    • Alex

      I did do the math. Even using the numbers you state the ratios are comparable between the US and Brazil both close to 1 per 50,000, certainly not a "landslide."

      August 11, 2010 at 19:21 | Report abuse |
    • Steff

      Here are the per capita numbers, which have much more meaning than raw statistics. It turns out that the highest rate of plastic surgery occurs in South Korea, which is really no surprise to anyone familiar with cosmetic care in Asia.

      The calculations can be found at http://www.asianplasticsurgeryguide.com/news10-2/081003_south-korea-highest.html

      August 21, 2010 at 23:13 | Report abuse |
  5. kazz

    screw all this crap

    August 11, 2010 at 18:02 | Report abuse | Reply
  6. aroth

    Exercise is at least as effective as most of the procedures listed. And it's a lot less expensive, too.

    August 11, 2010 at 19:21 | Report abuse | Reply
    • Brett

      I recommend Hockey as a great exercise which will alter the look of your nose and face.

      August 11, 2010 at 20:23 | Report abuse |
  7. Marco

    Aroth, what the hell is wrong with you. That is the dumbest thing I've ever heard. Tell me how exercise is as effective as a breast aug, nose job, facelift, eyelid,ear surgery etc, etc....

    August 11, 2010 at 20:51 | Report abuse | Reply
  8. Dammika K

    I wonder if the numbers for breast augmentation are compiled with breast reconstruction for women who have had a full mastectomy due to cancer. I ask because I'm curious as to what rate breast cancer strikes in the U.S. as compared to the rest of the world. And to those who have battled with cancer...I pray you stay strong.

    August 12, 2010 at 00:10 | Report abuse | Reply
  9. Beth

    I am looking to find some options for the top dr.'s in the world that specialize in breast augmentations. I am curious to know where most of the victoria secret models had theirs done

    October 6, 2012 at 14:04 | Report abuse | Reply
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