It’s time to retire the myth that cosmetic and elective treatments are only for the rich and famous in markets like Beverly Hills. That’s according to a new analysis by RealSelf, which reveals the U.S. metro areas with the most plastic surgeons and medaesthetic providers per capita. For the analysis, only areas with a population of 1 million and above were included.

What did it find? People nationwide have ample access to plastic surgeons and medaesthetic providers, and they’re taking advantage of it to book procedures from breast augmentation to Botox.


Plastic surgery moves mainstream

While some may think plastic surgery is only for affluent women on the coasts, the reality is that more people in markets nationwide are exploring the benefits of plastic surgery.

Looking at metro areas with the highest concentration of plastic surgeons, Miami topped the list with 8.3 plastic surgeons per 100,000 residents, while Los Angeles came in at No. 2 with 7.6 plastic surgeons per capita. Interestingly, New Orleans came in at No. 3 with 7.4 plastic surgeons per 100,000 residents.

Top 10 Metro Areas for Plastic Surgeons per Capita
The top 10 metro areas with the most plastic surgeons per capita

“Plastic surgery treatments will always be the gold standard because, despite some downtime, they offer more predictable results,” says Dr. Jules Walters, a New Orleans plastic surgeon. “In my practice, cosmetic breast surgery, mommy makeovers, BBLs [Brazilian butt lifts], and rhinoplasty are the most requested plastic surgery procedures.”

Salt Lake City is also an intriguing market for plastic surgery. Coming in at No. 5, it remains one of the strongest markets in the country. While the city is more socially and politically conservative, it’s also home to many women, especially younger women, who are looking to reclaim their bodies after having kids.

“Mommy makeover procedures are very popular in Utah, as many women who’ve had multiple children want to regain their pre-pregnancy bodies to participate in the active lifestyle here,” says Dr. Renato Saltz, a plastic surgeon in Salt Lake City.

As always, Texas and California hold top spots in our plastic surgeons per capita report. These states have thriving metro areas, and their populations take beauty seriously. California has four cities in the top 10: Los Angeles (2) with 7.6 plastic surgeons per 100,000 residents, San Jose (6) with 6.4, San Francisco (7) with 6.3, and San Diego (8) with 5.9. Austin, Texas, takes the No. 4 spot with 6.7 plastic surgeons per 100,000 residents.


Medaesthetic practices on the rise

Another emerging trend among plastic surgeons? Adding medspas to their practices. It makes sense, as a growing number of consumers are interested in minimally invasive treatments.

According to the American Society of Plastic Surgeons, in 2017 nonsurgical procedures outpaced surgical ones at a rate of 8:1 with a total of 17.5 million aesthetic procedures reported.

“Consumer demand for medical aesthetic treatments is growing as new technologies and treatment options have made aesthetics more accessible to a wider audience,” said Dr. Lara Devgan, RealSelf Chief Medical Officer and board-certified plastic surgeon. “As a result, many plastic surgeons, including myself, have expanded treatment offerings or added medical spas to meet the growing needs of our patients. As innovation and medical advancements continue to disrupt this market, I expect consumer interest to grow and expand beyond major metros into suburbs and other smaller markets.”

For the first time, RealSelf also looked at the number of medaesthetic providers per 100,000 people in U.S. markets over 1 million in population. RealSelf data shows that people nationwide have even greater access to medaesthetic and nonsurgical providers and are discovering the benefits of toxins (Botox, Dysport), injectable fillers (Juvederm, Restylane), and non-surgical treatments (lasers, radiofrequency, etc.) to help them look more refreshed without the downtime of a surgical procedure.

Top 10 Metros for Medaesthetic Providers

Top 10 medaesthetic metros

Just as with plastic surgeons, Miami is the U.S. metro area with the most medaesthetic providers per capita, at 10.9 per 100,000 people.

Dr. Leonard Hochstein, a plastic surgeon in Miami, says that while he focuses on the surgical side of his business, he has also recognized the importance of building a medaesthetic practice.

“I concentrate on surgery, which is what I enjoy doing the most,” Dr. Hochstein says. “For this reason, we established Hochstein MedSpa. We take pride in having the most established, top providers in their fields who deliver the best treatments to our patients who want nonsurgical procedures.”

Sunny Southern California is also a hot spot for medaesthetic providers, with Los Angeles at No. 2 with 10.3 providers per capita, and San Diego (3) at 9.6.  

Dr. Brent Moelleken, a plastic surgeon in Beverly Hills, says that plastic surgery still accounts for half his business, but he has also expanded his practice with a medspa to accommodate the growing demand for medaesthetic services.

“While minimally invasive treatments, such as lasers and radiofrequency treatments, have greatly increased, there are many patients who still need more long-lasting, permanent treatments that only surgeries can provide,” Dr. Moelleken says. “So, the number of surgeries has risen as well. In Beverly Hills, patients are interested in what is new and different!”


Tech hubs are hotbeds for medaesthetic growth

The demand for more natural-looking treatments with less downtime is on the rise in cities known for their active, outdoorsy populations that are also driven by the tech industry.

Five out of the top 10 metro areas for medaesthetic providers per capita are also known for being centers of technology: Seattle, San Francisco, Austin, San Jose, and Denver, respectively.

Seattle leads the tech pack at No. 4, with 9.3 providers per 100,000 residents. San Francisco takes the No. 5 spot with 9.2, followed by Austin (6) with 9.1, San Jose (7) with 8.9, and Denver (9) with 8.6.

“We perform significantly more nonsurgical than surgical procedures today,” says Dr. Wayne Larrabee, a facial plastic surgeon in Seattle. “We operate three days a week and perform about two surgical procedures per day, but perform an average of 30 medaesthetic procedures per day among our physicians, nurse injectors, and aestheticians.”

Dr. Johnny Franco, a plastic surgeon in Austin, Texas, says that he plans to double the size of his medspa in 2019 to keep up with growing demand for medaesthetic treatments. “The number of requests for non-invasive treatments has increased tremendously,” he says. “Patients want treatments that will enhance their appearance, but minimize their downtime.”

Dr. David Mabrie, a facial plastic surgeon in San Francisco, says that medaesthetic treatments now account for 98 percent of his business.

“The San Francisco Bay Area has always been home to urban professionals who want to look their best, and my practice has increasingly attracted these industry leaders,” Dr. Mabrie says. “As the tech business areas expand their borders from Silicon Valley to the East Bay and within the City of San Francisco, our tech industry patient base continues to grow.

“I believe that awareness of nonsurgical treatment options plays a bigger role than affluence,” he adds. “Nonsurgical rejuvenation and enhancement can refresh the face in two visits with little to no downtime, making it convenient to incorporate into a busy lifestyle. Looking your best has never been so easy.”

As breakthroughs in science and beauty continue, medaesthetics will continue to be a fascinating market to watch. For now, if you are looking for a trusted provider in your area, RealSelf can help. Find an expert in your area.

Top 25 Metros with the Most Plastic Surgeons per Capita


































A note about methodology: To calculate providers per capita, RealSelf first calculated the number of plastic surgeons and medaesthetic providers in a metro area. For the purposes of this analysis, RealSelf defined metro areas according to the United States Office of Management and Budget Core Based Statistical Area (CBSA) definitions, released in 2010. Both metropolitan and micropolitan areas were included. Plastic surgeons and medaesthetic providers were assigned to an area based on the ZIP code of their primary office location. Population data was calculated by adding the 2017 U.S. Census Bureau population estimates for individual counties within a CBSA. For the purposes of the list above, only areas with a population 1 million and above were included.