The American Society of Plastic Surgeons publishes the most widely cited procedural-volume dataset in US aesthetic medicine. The 2023 report — covering procedures performed by ASPS-member board-certified plastic surgeons — records over 1.5 million cosmetic surgical procedures and millions more minimally invasive treatments.
But the headline numbers require context. ASPS changed its data-capture methodology between 2020 and 2022, which means direct year-over-year comparisons across that boundary overstate real growth. The procedure mix, however, tells a clear and consistent story: minimally invasive treatments have moved from roughly 85% of volume in 2020 to over 90% in 2023, neuromodulator injections alone now exceed 9 million annual procedures, and body-contouring surgery is rising alongside GLP-1–driven weight loss.
This article breaks down the 2023 procedure data by volume, category, and growth rate — and explains what the trends mean for patients weighing treatment options and for providers planning capital and staffing.
The data source
The ASPS procedural statistics are compiled annually from member-surgeon surveys, Board of Plastic Surgery certification records, and a billing-code–based capture methodology expanded in 2022. The numbers represent procedures performed by board-certified plastic surgeons in the United States; they do not include procedures performed by dermatologists, facial plastic surgeons, or non-physician injectors in med spas.
The dataset analyzed here covers 2020, 2022, and 2023. ASPS did not publish a 2021 report. The 2020 data reflects the COVID-19 downturn, when elective procedure volumes dropped significantly before recovering.
In 2024, an independent analysis published in Cureus found that ASPS-reported total procedural volume across cosmetic surgical, minimally invasive, and reconstructive categories reached 30.9 million procedures in 2024, with minimally invasive procedures accounting for 91.5% of that total.
The surgical-to-nonsurgical shift in one table
| Category | 2020 volume | Share | 2023 volume (est.) | Share |
|---|---|---|---|---|
| Cosmetic surgical | 2,314,720 | 14.8% | ~1,437,000 | ~5–6% |
| Minimally invasive | 13,281,235 | 85.2% | ~24+ million | ~93–94% |
Sources: ASPS 2020 and 2023 Plastic Surgery Statistics Reports.
The surgical share has been declining for over a decade. In 2020, surgical procedures still represented 14.8% of total cosmetic volume. By 2023, that share dropped to roughly 5–6% — partly driven by methodology changes that capture more minimally invasive activity, and partly by genuine demand shifts toward injectables and energy-based devices that require no operating room.
Top procedures by volume (2023)
Minimally invasive
| Procedure | 2023 volume | YoY change |
|---|---|---|
| Neuromodulator injection (Botox, Dysport, Xeomin, Jeuveau, Daxxify) | 9,480,949 | +9% |
| Hyaluronic acid fillers (Juvéderm, Restylane families) | 5,294,603 | +8% |
| Skin resurfacing (chemical peels, laser, dermabrasion) | 3,501,696 | +5% |
| Skin treatment / combination laser (laser hair removal, IPL, etc.) | 3,101,772 | +6% |
| Lip augmentation (injectable materials) | 1,439,291 | +4% |
| Non-hyaluronic acid fillers (Sculptra, Radiesse, Bellafill, Renuva) | 924,549 | +8% |
| Noninvasive fat reduction (CoolSculpting, Emsculpt, etc.) | 745,967 | +9% |
| Sclerotherapy | 515,602 | +5% |
| Noninvasive skin tightening (Thermage, Ultherapy, Pelleve) | 438,211 | +7% |
Three takeaways:
Neuromodulators alone exceed all cosmetic surgery combined. At 9.5 million procedures, botulinum-toxin injections outnumber the top ten surgical procedures combined (~1.4 million). The category grew 9% year-over-year, consistent with expanding indications (hyperhidrosis, masseter reduction, platysma bands) and growing acceptance among male patients.
HA fillers remain the second-largest category. Over 5.3 million hyaluronic acid filler procedures were performed in 2023, up 8%. The Juvéderm Vycross family and Restylane NASHA/XpresHA lines dominate, though newer entrants like the RHA Collection and Belotero have gained share in specific anatomic areas.
Non-HA fillers are the growth story. Sculptra, Radiesse, and other biostimulators/composite fillers grew 8% to nearly 925,000 procedures — reflecting the shift toward longer-lasting collagen-stimulating treatments.
Surgical
| Procedure | 2023 volume | YoY change |
|---|---|---|
| Liposuction | 347,782 | +7% |
| Breast augmentation (implant, primary and revision) | 304,181 | +2% |
| Tummy tuck (abdominoplasty) | 170,110 | +5% |
| Breast lift (mastopexy) | 153,600 | +7% |
| Eyelid surgery (blepharoplasty) | 120,747 | +5% |
| Facelift (rhytidectomy) | 78,482 | +8% |
| Breast reduction (aesthetic patients) | 76,031 | +7% |
| Rhinoplasty | 47,307 | +6% |
| Breast implant removal | 41,115 | +9% |
| Buttock augmentation with fat grafting (BBL) | 29,383 | +3% |
Three patterns stand out:
Liposuction remains the top surgical procedure at nearly 348,000 cases, up 7%. GLP-1–driven weight loss has not reduced liposuction demand; instead, patients who lose significant weight with semaglutide or tirzepatide often seek liposuction for residual contouring.
Breast implant removals are rising fast at 41,115 procedures, up 9%. This reflects ongoing patient awareness of breast implant–associated anaplastic large-cell lymphoma (BIA-ALCL), capsular contracture concerns, and a cultural shift toward implant downsizing or explant.
Facelifts grew 8% — notable because facelifts are among the highest-cost, highest-downtime procedures. The growth likely reflects an aging patient cohort that previously relied on fillers and now seeks more definitive correction.
The longer arc: 2020 to 2023
Comparing 2020 (a COVID-depressed year) to 2023 shows dramatic growth, but the real magnitude is obscured by ASPS's methodology change in 2022. What is clear from the procedure-level data:
- Neuromodulators nearly doubled. From 4.4 million in 2020 to 9.5 million in 2023 (a 115% increase), though some of this reflects improved data capture rather than pure volume growth.
- HA fillers roughly doubled. From 2.6 million to 5.3 million (102% increase).
- Liposuction grew 65%. From 211,000 in 2020 to 348,000 in 2023.
- Breast augmentation is flat to slightly up. 193,000 in 2020 vs 304,000 in 2023 — but the 2020 figure was COVID-depressed.
What this means for patients
The rise of minimally invasive does not mean the rise of "minor." Neuromodulator and filler procedures carry real risks — vascular occlusion, ptosis, nodule formation, and rare but serious systemic effects. Volume does not equal safety; it equals accessibility.
Surgical procedures are not declining in absolute terms. Liposuction, tummy tucks, and facelifts all grew year-over-year. The surgical share is shrinking only because minimally invasive volume is growing much faster.
Provider choice matters more than procedure category. A well-performed filler injection by a board-certified dermatologist or plastic surgeon with vascular anatomy training is safer than a poorly executed one in any setting. Volume data tells you what the market is doing; it does not tell you who should be doing it.
What this means for providers
Injectable volume is the revenue engine. For practices that have not built robust injectable programs, the data shows where patient demand concentrates. Neuromodulators and fillers together exceed 14.8 million procedures — over four times the total surgical volume.
The body-contouring wave is real. Liposuction, tummy tucks, and body lifts are all growing, driven by post-GLP-1 patients. Practices that integrate weight-loss–adjacent contouring into their service line are positioned for continued growth.
The five highest-volume procedures account for 83.6% of minimally invasive volume, according to the 2024 cross-sectional analysis. Concentration is extreme: neuromodulators and HA fillers alone represent the majority of non-surgical activity.
Limitations of the data
- ASPS captures only board-certified plastic surgeons. Dermatologists, facial plastic surgeons, and med-spa injectors are excluded, so the actual US procedure volume is substantially higher.
- The 2022 methodology change means 2020-to-2023 growth figures overstate real increases.
- "Procedure" counts may not align with "patient" counts — a single patient receiving Botox and filler in one visit generates two procedure counts.
Sources
- American Society of Plastic Surgeons. 2023 Plastic Surgery Statistics Report. https://www.plasticsurgery.org/documents/news/statistics/2023/plastic-surgery-statistics-report-2023.pdf
- American Society of Plastic Surgeons. Plastic Surgery Statistics landing page. https://www.plasticsurgery.org/news/plastic-surgery-statistics
- Alhotan S. Minimally Invasive Procedures Dominate ASPS-Reported Procedural Volume in 2024: A Cross-Sectional Descriptive Analysis. Cureus. 2026. PMC: https://pmc.ncbi.nlm.nih.gov/articles/PMC13092329
- Portland Plastic Surgery Blog. 2023 ASPS Plastic Surgery Statistics Show Continued Growth. https://www.sanfranciscoplasticsurgeryblog.com/2023-asps-plastic-surgery-statistics-show-continued-growth
- Data source: American Society of Plastic Surgeons (ASPS) procedural statistics; analysis by AestheticMedGuide, run date 2026-06-10.
