The number of cosmetic procedures climbed to more than 10.2 million last year, most of them office-based, minimally invasive cosmetic fixes such as Botox injections.
The number of traditional plastic surgeries declined by 5 percent over the last five years, while minimally invasive cosmetic procedures jumped by 53 percent over the past five years, according to a report from the American Society of Plastic Surgeons.
The most commonly performed surgical procedure last year was liposuction, according to the report, with 323,605 being performed. But the number of these procedures, in which a surgeon inserts a wand that sucks fat out of a patient's body, was about a thousand fewer than the previous year and down 9 percent from the 354,015 procedures done in 2000.
The rest of the top five cosmetic surgery procedures in 2005:
# Nose reshaping -- 298,413
# Breast augmentation -- 291,350
# Eyelid lifts -- 230,697
# Tummy tucks -- 134,746
The 3.8 million Botox injections given last year were almost five times the number performed in 2000, according to the report, and a million more than in 2004. Surgeons collectively billed almost $1.4 billion for Botox treatments last year.
The other top minimally invasive procedures:
# Chemical peel -- 1,033,581
# Microdermabrasion -- 837,711
# Laser hair removal -- 782,732
# Sclerotherapy -- 589,768
But the so-called "hot" procedures such as vaginal rejuvenation, pectoral implants, buttock implants and calf augmentation were little more than a blip on the plastic surgery radar. Only 793 vaginal rejuvenation procedures were done in 2005, the first year for which data were available. Likewise, there were only 206 pectoral implants and 337 calf augmentations done last year.
They are "simply are not being performed in large numbers," said Dr. Bruce Cunningham of the University of Minnesota in Minneapolis, the ASPS president.
Cosmetic surgery remains medicine mainly for white women, according to the report. Of all patients, 77 percent were white and roughly 90 percent were women. Fifty-one percent of all cosmetic surgery patients and 69 percent of patients who get minimally invasive procedures were 51 and older. Cunningham's group compiles the yearly report using an online national database for plastic surgery procedures called Tracking Operations and Outcomes for Plastic Surgeons. It combines that with a survey of 17,000 board-certified physicians in specialties most likely to perform plastic surgery.
Plastic surgeons also do reconstructive surgery to remove damage from trauma or disease. The most-performed reconstructive procedure last year was tumor removal at more than 3.9 million, but this was down 15 percent from 2004. Scar revisions (181,000), hand surgery (172,000) and breast reduction (114,000) are also common. More than 29,000 animal-bite repair surgeries were done in 2005, down 35 percent from 2004.