Globalisation and other trends in cosmetic surgery

Dr Renalto Saltz MD, FACS is the President of the International Society of Aesthetic Plastic Surgery (ISAPS), the world’s leading organisation for information on aesthetic plastic surgery with access to over 3,200 board-certified aesthetic plastic surgeons in 103 countries. As a global forum for the exchange of ideas and knowledge, ISAPS contributes to the advancement of aesthetic plastic surgery procedures by holding over 30 courses and symposia around the world each year and educating its members on new procedures, techniques and options in aesthetic and reconstructive plastic surgery. ISAPS is also a champion for global patient safety, as unfortunately many aesthetic procedures around the world are performed by unlicensed physicians, or those lacking the proper training. ISAPS provides the public, media and government authorities with much needed resources and materials on understanding aesthetic procedures, how to choose the best surgeon, and global cosmetic surgery trends based on its annual independent international study on cosmetic procedures.


Q: In choosing plastic surgery, Western patients tend to choose butt and breast augmentation, while Asians mostly undergo eye and jaw surgeries. Could you discuss how plastic surgery trends differ worldwide and why?

A: Although that was common in the past, preferences and tastes changed a long time ago. Today we do not see an “aesthetic cultural divide” anymore but instead a very uniform view of “beauty,” which I think is the result of Hollywood’s beauty ideals and the influence of the internet. When you see today’s modern standards of beauty, they do not represent one country, one culture, or one race like they used to. The most beautiful faces and bodies, in both men and women, are now a mixture of many traces of beauty found in the most diverse corners of the globe. For example, the traditional beautiful large butts and smaller breasts of South Americans have now been replaced by the larger breasts seen more commonly in North American women, while the traditional small North American butts are now often requested to be made bigger like those more commonly requested in Latin America, or popular celebrities like Jennifer Lopez and Kim Kardashian. This same trend is happening in Asia and other parts of the world. 


Q: Plastic surgery is becoming more common and accepted among men, with butt implants, facelifts and breast reductions being some of the top trends. In your opinion, why is the demand for cosmetic surgery increasing among men?

A: Although women continue to drive the demand for cosmetic surgery, making up 86.2 percent of procedures worldwide, men now account for almost 14 percent. Some of the most popular procedures for men include eyelid surgery, gynaecomastia (breast reduction), liposuction and hair transplants. The old taboos are disappearing – by this I mean the stigma associated with men seeking cosmetic procedures to make themselves look better. Today’s modern men (metrosexuals) are taking advantage of the many options available for looking and feeling better. In addition, the baby boomer generation has both money and the highest longevity compared to previous generations. As healthy and wealthy individuals, they can therefore afford to undergo any number of procedures to make themselves look good compared to men in the past. This in turn has pushed the industry and us surgeons to constantly come up with new technologies to match their desire to remain young and attractive, and the industry and aesthetic surgeons around the world have responded.


Q: Some reports suggest that a growing number of teenagers, especially young girls, are opting for cosmetic surgery. Have you seen such a trend? Do you believe cosmetic surgery might have detrimental effects on teenagers and therefore should be strictly regulated?

A: The trend does exist but our data shows that it is not that widespread. At the end of the day, the decision on whether to perform a surgical or non-surgical treatment should be determined by the board certified aesthetic surgeon in consultation with the patient or the patient’s parents if he or she is a minor. Common sense, ethics, and attention to patient safety are the key ingredients for a successful outcome.


Q: Many patients travel in order to seek cosmetic treatments overseas. What are some of the top destinations around the world and why do people choose them? Can you discuss the risks associated with travelling abroad for plastic surgery and how they can be minimised?

A: The top destinations for plastic surgery span across six continents and include Brazil, Canada, China, Costa Rica, India, Iran, Malaysia, Mexico, Poland, Singapore, South Africa, Switzerland, Thailand, Turkey, the U.S. and Venezuela. Currently, South Korea is the number-one plastic surgery destination in the world, holding nearly a quarter of the global plastic surgery market share – meaning that currently one out of four patients who travel abroad for cosmetic procedures is opting to have them in South Korea. Of course, top-quality aesthetic plastic surgeons practice all over the world, but as you may well know, many doctors, and not just plastic surgeons, offer cosmetic surgery. This is why it is critical to understand the specific level of aesthetic training, expertise, and commitment to patient safety your chosen doctor possesses.

Public education by the media is also necessary to help prevent the many complications and fatalities that can be related to medical tourism as the majority of people who seek to have procedures performed outside of their home country usually do so for financial reasons and can be lured by very low cosmetic surgery prices – meantime the surgery is not being performed by a board certified-plastic surgeon, or in some instances, not by a surgeon at all, or in an accredited hospital facility (I am sure you have heard the horror stories of procedures being performed in hotel rooms and garages etc). To minimise certain risks, choose the right surgeons and find out what each surgeon’s training and background is. When in doubt, you can consult ISAPS’ member list of board-certified aesthetic plastic surgeons, all of whom must adhere to a rigorous review process.

In addition to knowing the basic facts about your surgeon, you should establish a doctor-patient relationship ahead of time. A solid doctor-patient relationship must include comfortably discussing the sensitive subject of safety, as well as developing a plan in case something goes wrong during or post-surgery, such as unsatisfied results. Make sure to discuss other possible complications, recovery, and aftercare with your doctor in advance of any travel, which includes complications from post-surgery travel or long-haul flights. ISAPS offers the most comprehensive guide to helping you plan your medical travel anywhere in the world.

Dr Renato Saltz MD, FACS, President, International Society of Aesthetic Plastic Surgery (ISAPS)

This story was originally published in the Global Health and Travel issue of October 2017