For a brief moment in the spring of 2020, as doctors were forced to temporarily halt elective procedures and it was becoming clear that we’d all be staying at home in sweatpants a lot longer than we’d initially thought, we wondered if the desire for cosmetic procedures would wane. But after analyzing the behavioral trends of U.S. consumers on RealSelf over the past year and speaking to doctors across the country, it’s clear that people are just as interested as ever in plastic surgery and aesthetics.
The most popular procedures over the past year, in terms of the ones people research and ultimately get, remain the same as in prior years—breast augmentations, Brazilian butt lifts, tummy tucks, rhinoplasties, eyelid surgeries, and facelifts aren’t going out of style anytime soon.
But when we look at what’s trending—the procedures with the most significant increase in consumer interest* from 2019 to 2020—some surprises emerge. Above-the-neck skin rejuvenation treatments using radiofrequency, platelet-rich plasma, and microneedling are getting significantly more attention nationwide, while some niche procedures, like areola reduction surgery, are seeing an uptick in specific metro areas.
Below, we break down the biggest trends of the past year: up-and-coming treatments, the procedures consumers have the most questions about, the most-read reviews, and more. And we share insights from top plastic surgeons about how they expect to see these trends play out in their own practices in 2021.
*Top procedures and other trends are measured by page views in 2020. To find out which procedures real patients give the highest Worth It Ratings, check out our 2021 Most Worth It Ranking.
The most researched cosmetic procedures: women vs. men
Maybe men and women aren’t so different after all. Rhinoplasty, tummy tuck, and Brazilian butt lift landed in the top three most researched procedures for each, though Dr. Lawrence Iteld, a board-certified plastic surgeon in Chicago, notes that men typically seek out tummy tucks and BBLs for completely different reasons. “I probably see a handful [of men for tummy tucks] per year, and it’s only one or two who are not bariatric patients,” he says. Those exceptions are often trans males, who desire a “a more washboard abdomen.” Women, on the other hand, frequently seek out the muscle-and-skin-tightening surgery after childbirth, often as part of a mommy makeover.
BBLs are “definitely becoming more popular, especially in the gay community and among trans females,” says Dr. Iteld. Within the gay population, he sees a split between those living with HIV who are experiencing gluteal and/or leg atrophy after decades of antiretroviral use and those interested in butt enhancement simply for aesthetic reasons.
The top 5 trending cosmetic procedures
With the exception of Aqualyx, an injectable that dissolves small pockets of fat and is most commonly used in Europe to treat a double chin (it’s similar to Kybella but hasn’t received FDA approval in the U.S. yet), the procedures with the greatest year-over-year increase in interest are all geared toward facial skin rejuvenation. All five trending procedures are noninvasive, with an average cost below $2,000.
The plasma pen (which isn’t without its critics), Morpheus8 (a type of radiofrequency microneedling), and the Vampire Facial (a combination of microneedling and topical PRP) take very different approaches, but their end goals are the same: firmer skin, increased collagen and elastin production, more even tone and texture, and less noticeable pores and fine lines.
Growing interest in this category is no surprise, says Christine Ross, RN, who performs skin rejuvenation treatments at New York City board-certified facial plastic surgeon Dr. Steven Pearlman’s office. “We are seeing an influx of patients wanting skin tightening. Patients say it’s due to looking at themselves all day on Zoom calls, which is making them more critical of their faces. We are also getting more complaints of ‘tech neck,’ the horizontal lines that form along the neck from looking down at devices constantly.” To target these issues and improve overall skin health and appearance, Ross recommends a Morpheus8 series—three treatments, spaced four weeks apart—for best results.
Top 5 trending procedures by major metro area
Los Angeles
Morpheus8 and plasma pen top the L.A. list, followed by the deep plane facelift, the most effective solution for significant facial sagging and deep wrinkling; hip augmentation, which typically involves fat transfer, implants, or injectable fillers in order to deliver a more hourglass shape and smooth out hip dips; and areola reduction surgery.
Dr. Urmen Desai, a board-certified plastic surgeon in Beverly Hills, California, says the latter has become “more popular than ever” in the past year. “I see many patients in my Beverly Hills practice requesting areola reduction surgery, alone or in conjunction with a breast lift or breast reduction. Many patients end up having enlarged areolas after breastfeeding or if they have large, pendulous breasts. Areola reduction shrinks the diameter of the areola, giving a more proportional appearance as compared to the overall breast size. I anticipate that the interest in this procedure will continue in 2021,” he notes.
New York City
New Yorkers’ biggest concerns are around hair loss, skin rejuvenation, and volume loss. Dr. David Shafer, a board-certified plastic surgeon in New York City, reports an increase in patients wanting hair treatments in the past year (like so many other providers, he credits video conferencing with bringing our insecurities to the forefront) and says his most popular solution is PRP microinjections in the scalp follicles, to stimulate hair growth.
Chemical peels, he says, are “tried-and-true treatments” for addressing uneven texture and pigmentation on all skin types, while Retin-A, a topical tretinoin prescription, “is one of the most effective ingredients … for reducing fine lines, stimulating collagen at the biochemical level.”
As for the “workhorse of cosmetic practices”? That’s a hyaluronic acid filler, like Juvéderm, says Dr. Shafer. Dermal fillers can lift cheeks, augment chins, volumize lips, smooth out creases, and more, and “they have the added benefit of reversibility, so if someone doesn’t like their results—very unlikely—it is possible to ‘melt’ the filler and return to baseline.”
Chicago
In the Windy City, there’s high demand for surgical body procedures that require a fairly significant amount of downtime as well as hair loss treatments and more minimally invasive procedures, like chin liposuction.
Dr. Ramsen Azizi, a board-certified plastic surgeon in Chicago, says, “I have found a big boost in people looking for BBL and BBL revisions during COVID-19 and quarantine times. The biggest reason I have heard from patients is, the usual two-to-three-week recovery for these procedures that was hard to do [before] is now much easier while working from home.” He adds that having more time to research procedures and more expendable income due to not taking vacations or dining out also helps convince people to finally get the surgery they’ve been thinking about for years.
“Mommy makeover is interesting because it brings all the social factors [of the pandemic year] together,” says Dr. Iteld. “Moms suddenly have a little more discretionary income, and there’s a lot less running around with the kids. You don’t have to get them to school, home from school, to baseball and soccer, so you can recover more easily. And if their partners are working from home too, they’ve got some extra help and built-in daycare.” Because mommy makeovers involve more than one procedure (a tummy tuck, liposuction, and a breast lift or augmentation are a common combo) and are so customizable to the individual patient’s needs, downtime tends to be lengthy—anywhere from two to four weeks.
Chin liposuction is trending, for the obvious reason, as well. “The computer camera has a wide field of view, with a small aperture lens that blows out the central portion of the face and highlights everything in the middle. You just see your double chin a little more, even people who don’t have a lot of double chin. Most of these cameras are positioned low, so you’re looking down at them instead of straight [on], with your chin up,” explains Dr. Iteld.
Dallas
Morpheus8 seems to be having its best year across the board, but Texans are also showing greater interest in breast implants, BBL revision surgery, FaceTite (a skin tightening treatment that harnesses the power of radiofrequency energy), and tumescent liposuction.
The most traditional liposuction technique of the many now available, tumescent actually refers to the anesthetic fluid used—a combination of lidocaine; epinephrine; and a vasoconstrictor, to shrink blood vessels and reduce bruising. It’s a popular procedure that can be done in an outpatient surgical facility. Dr. Peter Malouf, a board-certified dermatologist in Fort Worth, Texas, believes liposuction is trending in his practice “due to pandemic-related issues, such as weight gain, a sedentary lifestyle, increased time off from work and activities, and more opportunity to recover from procedures now than pre-pandemic.”
Atlanta
Dr. Carmen Kavali, a board-certified plastic surgeon in Atlanta, isn’t surprised by the data that shows surgical procedures dominating over noninvasive treatments in her city. She reports that facelifts, mommy makeovers, and Brazilian butt lift revisions have all been extremely popular in her practice lately. “There’s been a surge in facelifts over the past eight months. People come into my office and literally say they can’t stand to look at their faces on Zoom for another day and want me to get rid of the loose skin and sagging jawlines,” she says.
The rise in Brazilian butt lift revision, according to Dr. Kavali, is due to the simple fact that “there are a lot of BBLs being done, and not all are done well. I think we’re going to start seeing a trend toward less dramatic buttock fullness and more natural proportions, which will drive more women to have their buttocks revised.”
Now’s the time, says Dr. Ruth Celestin, a board-certified plastic surgeon in Riverdale, Georgia. “The no-sitting post-op period is much more feasible in a WFH environment. If you’re in an office, surrounded by colleagues, in a cubicle, or have to walk through a gauntlet of offices in order to get to your workspace, toting a giant BBL pillow after your procedure is not exactly discreet. I’ve had people who said they’ve wanted to do a BBL for years but couldn’t stomach [having] the long-term no-sitting aspect of recovery basically ‘ratting them out’ at work!”
South Florida
“As you would expect in Miami, procedures such as breast augmentations, breast lifts, and mommy makeovers are in high demand,” says Dr. Nirmal Nathan, a board-certified plastic surgeon in the city.
Breast implants remain popular, of course, but breast augmentation may be the trending search term at the moment because, he notes, “there is a significant percentage of my younger patients who are looking for a more natural look, with fat grafting.” The added benefit of a fat transfer breast augmentation is that the liposuction harvesting transforms the waist and abdomen at the same time, he says, adding that “the patient-satisfaction rate with fat grafting for breast augmentation and lifting is quite high.”
Top 5 most discussed topics
These are the procedures RealSelf members and doctors couldn’t stop talking about.
1. Rhinoplasty
RealSelf members asked 2,321 questions about rhinoplasty over the past year, and doctors on the site provided 9,910 answers. The most viewed nose job question asked about steroid injections after revision rhinoplasty, to reduce swelling during recovery.
2. Brazilian butt lift
RealSelf members asked 1,170 questions about Brazilian butt lifts, and doctors gave 7,300 answers. The most viewed BBL question came from a 5’5” woman weighing 200 pounds who wanted to know if she would be a good candidate for the procedure.
3. Eyelid surgery
RealSelf members asked 862 questions about eyelid surgery, and doctors responded with 2,769 answers. The most viewed question asked when stitches should be removed post-surgery in order to reduce scarring.
4. Dermal fillers
RealSelf members asked 834 questions about dermal fillers, and doctors provided 3,799 answers. The most viewed filler question asked about whether tear-trough or midcheek filler would best solve the issue of “looking permanently tired.”
5. Liposuction
RealSelf members asked 722 questions about liposuction, and doctors gave them 5,984 answers. The most viewed lipo question asked how long one should wait to get liposuction after a tattoo.
The most popular RealSelf member reviews
Honest, personal, and detailed reviews help our community make smart, confident decisions about cosmetic procedures. Here are the most viewed reviews from over the past year, for the most popular procedures.
The top breast augmentation review
“I am so lucky to have such a talented doctor. I am wearing a 32DD now, but that is a really hard size to find. My nipples are still sensitive but not painfully sensitive, so that’s nice! Under, my breasts are still numb, but it’s slowly going away … All in all, they feel like they are mine and I’ve always had them. It’s such a wonderful feeling!” —@DallasShellBell
The top mommy makeover review
“My life has changed so much since this surgery. I have confidence I never had before. I can grab a pair of pants or a shirt without trying it on (which works really well during covid, btw) and I know whatever I choose is going to fit. Before, I would try things on and leave depressed every time.” —@Aquagirl17
The top facelift review
“I want to share my before and after pics because people should know this surgery is worth it. I chose four weeks of downtime and enjoyed seeing the transformation daily! … I was surprised I healed so rapidly. I am grateful for my experience and decision to improve myself. My children (3) were happy I still look like their mom but younger.” —@Fearless761313
The top Brazilian butt lift review
“I am currently about eight weeks post-op now. Overall, I am happy with my results and my experience. I only gave [my doctor] four stars because I wish it was a little bit bigger, but he did listen to what I said (which was ‘natural and not too dramatic’) … However, everyone tells me how much they like it because it’s natural and my waist and hip ratio go [together] very well.” —@daisyy92
The top tummy tuck review
“I’m a little concerned about the swelling. Am I being impatient? I wear my girdle for 8–10 hours a day… not sure what I’m doing wrong. Once I take the girdle off, the swelling is there within a few minutes. I also take arnica for the swelling. For exercise, I was doing some at-home boot camp workouts, but I recently stopped because of the discomfort. Any suggestions would be lovely.” —@lisarowan
To learn more about some of the trending procedures in this report and to find out which procedures real patients give the highest Worth It Ratings, check out our 2021 Most Worth It Ranking.
