The International Society of Aesthetic Plastic Surgery (ISAPS) released the results of its annual Global Survey on Aesthetic/Cosmetic Procedures, showing a 19.3% overall increase in procedures performed by plastic surgeons in 2021, with more than 12.8 million surgical and 17.5 million non-surgical, procedures performed worldwide.


The 19.3% increase shows recovery from 2020 (which saw an overall drop of -1.8% in all procedures and -10.9% in surgical procedures due to the impact of COVID-19 on global practice). 

The report shows a continuing rise in Aesthetic Surgery, with a 33.3% increase over the last four years.

Both surgical and non-surgical procedures showed increases since the last survey (18.5% and 19.9%, respectively), with a significant increase of 54.4% in non-surgical procedures in the last four years.

Aesthetic Procedures

Liposuction was the most common cosmetic surgical procedure in 2021, with more than 1.9 million procedures and a 24.8% increase, overtaking breast augmentation (+3.8%). The top five most popular surgical procedures remain liposuction, breast augmentation, eyelid surgery, rhinoplasty, and abdominoplasty. The top five non-surgical procedures are botulinum toxin, hyaluronic acid, hair removal, skin tightening, and fat reduction.

Breast augmentation remains the most common surgical procedure for women, with only a slight increase of +0.5% in the last four years. By contrast, surgery to remove implants increased by 22.6% (+49.6% in the last four years), and breast lifts by 31.4% in the last year.

Face and head procedures increased by 14.8%, with eyelid surgery being the most common procedure and the most popular surgical procedure among men. Thigh lift showed the highest growth for all surgical procedures (+53.1%). Buttock lifts and buttock augmentation have also increased by 45.7% and 40.5%, respectively, since 2017.

The other most common surgical procedures in women remain liposuction and eyelid surgery. Among men, the other top two are gynecomastia (increasing notably) and liposuction.

According to Dr. Gianluca Campiglio, Global Survey Editor and plastic surgeon in Italy, “These data clearly reflect the experience of recovery from the previous year’s negative impact of COVID-19 on aesthetic procedures and numbers now exceed the pre-pandemic ones. We noticed an interesting increase in surgical procedures related to so called “body contouring”, such as liposuction, which is now ranked as the most common procedure, ahead of breast augmentation for the first time in many years, and also a similar emerging trend for abdominoplasty, thigh lift and buttock augmentation. The lower increase in breast augmentation, and related increase in implant removals, also reflects our experience following publication of reports on BIA-ALCL in the preceding year.”

Most breast augmentations (53.1% of the total) and rhinoplasties (63.7%) took place in 19–34-year-olds, whereas botulinum toxin injectables were most popular among those aged 35–50 (47.2% of the total).

Botulinum toxin remains the most common non-surgical procedure for both men and women and across all age groups, with more than seven million procedures performed by plastic surgeons worldwide. This also becomes the most common aesthetic procedure in patients aged 18 years or younger, overtaking rhinoplasty in previous years.

There has been a notable increase in hyaluronic acid injections (+30.3%), and Dr. Campiglio reflects that this may relate to the growing use of this product in other parts of the body, such as the buttock.

Country Statistics

Once again, the USA performed the most procedures worldwide (24.1% of the total), with 30.4% of all non-surgical procedures and 15.5% of all surgical procedures, followed by Brazil (8.9%) and Japan (5.7%). The USA and Brazil are estimated to have the most plastic surgeons, with more than 30% of the world’s total. Asian countries follow with China in third place, Japan in fourth, and South Korea in fifth. 

Surgical procedures continue to be performed primarily in hospitals (43.5% worldwide) or office facilities (35.6%).