Number One Went Down and Nobody Mentioned It

Black and white torn-paper collage of two cut-out portraits with engraved magnolia beside a large numeral five.

Every August my specialty publishes its numbers, and every August the same list goes out. Liposuction is number one. Fifth year in a row.

The part that got left out is that liposuction fell 1 percent. So did most of the list, more or less. Four of the top five barely moved.

Number one is a component, not a request

“Liposuction is certainly the most common procedure in my practice, and the main reason is that it’s part of any body contouring procedure. When I perform a tummy tuck, liposuction is included in the abdomen and the lower back. When I perform an arm lift, I do liposuction first. When I do a thigh lift, I do liposuction first. When we perform many breast procedures, we’re often doing liposuction of the lateral chest, the axilla, or the upper back.”

“On top of that, procedures like the Brazilian butt lift and fat transfer involve taking fat from other areas using liposuction to transfer to the buttock, and even to the breast.”

Count every one of those as a liposuction and of course it wins. That is a counting decision, not a popularity contest.

The one number that moved

Eyelid surgery, up 19 percent, the most popular facial surgery of the year.

“It seems to be the first part of the face that patients notice as they age, especially the upper eyelid skin, which can hang and even rest on the eyelashes, giving the patient the impression of being tired and even making makeup hard to put on.”

“The lower eyelids are also quite popular, as more and more patients with fat loss can see the lower eye bags more easily, along with the tear trough deformity.”

Rank it differently and the list changes completely

“In my practice, I’ve really seen a huge increase in face procedures, specifically the deep plane face lift and deep plane neck lift, as well as the total endoscopic deep plane face lift, otherwise known as the ponytail lift.”

“The reason we’re seeing this increase exponentially is that patients are noticing signs of facial aging earlier, or they’ve been on GLP-1s and have had accelerated aging from fat loss in the face and skin sagging.”

Facelift 13 percent. Neck lift 21. Forehead lift 29. Facial fat grafting 39, the biggest jump of anything in the report. None of it in the top five.

The bit worth stealing

“The most interesting thing about a face lift procedure is that it can make you look ten to fifteen years younger. Of course, that depends on the age at which you get the procedure. If you get it at forty, you’re probably going to look like you’re in your early thirties, or even late twenties. But time keeps moving forward, so if we repeat the procedure ten years later, we take you back to that earlier stage of yourself. Now you’re in your fifties, looking like you’re in your thirties.”

“So the earlier we do the procedure, the sooner we can keep bringing you back to a younger age. That has really changed the game, because these procedures are not as invasive, we don’t have to make as big changes, and we can maintain that youthfulness.”

Wait for one big operation, or start earlier and stay ahead of it. Those are different plans, and the second one is newer than most people realise.

One caveat

These are estimates extrapolated from more than 3,000 board-certified plastic surgeons, not a census, and they count only board-certified plastic surgeons. Everything done outside that group is missing from the table. For a top five list, fine. For anything about safety, that absence is the whole story.

Consultations at Southwest Plastic Surgery in El Paso.

Call (915) 590-7900 or text 1-866-814-0038.

#StayBeautiful


Source: ASPS 2025 Procedural Statistics Report, national table. Commentary from Dr. Agullo’s 2026-09-07 dictation.

The Page Nobody Reads in the Plastic Surgery Statistics

Black and white editorial collage, cut-out portraits with torn paper edges and engraved botanicals.

There is a ritual to this. My specialty publishes its annual numbers, two hundred outlets publish the top five list, and everyone moves on by Thursday.

Liposuction won. It has won five years running. It actually declined 1 percent and still won by a mile.

Now turn to page 26, where the country gets split into regions. On five procedures, my eight-state region went the opposite way from the national number. The one I want to talk about is the nose.

Rhinoplasty fell 5 percent nationally. Here it rose 16.

“This does match what I see. I’ve seen an increase in surgical rhinoplasty procedures in both men and women. In many places, people are turning to injectable fillers for a liquid rhinoplasty, or non-surgical nose job. But many patients have noticed that when this is done, the nose actually becomes bigger, because filler is volume.”

“We’re adding volume to hide the dorsal hump and maybe push the tip up. But with time, the filler flattens out and migrates to the sides, making the nose look wider and the tip more bulbous.”

You are solving a shape complaint with volume, and volume does not stay where you put it.

“For a real reduction, surgical rhinoplasty reshapes the structure of the nose and reduces its size, removing the dorsal hump, refining the tip, and even narrowing the nose, and it can also remove old filler. A surgical rhinoplasty is a permanent procedure.”

Why the top five is a boring list

Four of the five barely moved. The only real mover is eyelid surgery, up 19 percent.

“These are the usual procedures that made the top five, and they really didn’t move much during 2025. I could see that during 2025 there was a bit of a slowdown in plastic surgery procedures, and I think that was due to changes in the economy. But we’re seeing an increase in 2026.”

“Eyelid surgery did blow up a lot, and it’s also a procedure we’ve performed increasingly over the last two years. It seems to be the first part of the face that patients notice as they age, especially the upper eyelid skin, which can hang and even rest on the eyelashes, giving the patient the impression of being tired and even making makeup hard to put on.”

An economic read, not an aesthetic one. That is not in the report either.

What I am actually seeing

“In my practice, I’ve really seen a huge increase in face procedures, specifically the deep plane face lift and deep plane neck lift, as well as the total endoscopic deep plane face lift, otherwise known as the ponytail lift. These face lifts are often combined with facial fat grafting, upper and lower eyelid surgery, microneedling with radiofrequency or laser resurfacing, sometimes an upper lip lift, fat transfer to the lips, and earlobe reduction.”

“The reason we’re seeing this increase exponentially is that patients are noticing signs of facial aging earlier, or they’ve been on GLP-1s and have had accelerated aging from fat loss in the face and skin sagging.”

“The most interesting thing about a face lift procedure is that it can make you look ten to fifteen years younger. Of course, that depends on the age at which you get the procedure. If you get it at forty, you’re probably going to look like you’re in your early thirties, or even late twenties. But time keeps moving forward, so if we repeat the procedure ten years later, we take you back to that earlier stage of yourself. Now you’re in your fifties, looking like you’re in your thirties.”

The honest caveats

Region 4 is eight states, so I cannot tell you what El Paso did. Nobody publishes that.

These count only board-certified plastic surgeons. For the procedures growing fastest, the uncounted volume is the part worth worrying about.

I have written the full regional breakdown, including the one figure in the report I refuse to quote until ASPS explains it.

Ready to talk?

Call (915) 590-7900, text 1-866-814-0038, or book at drworldwide.com.

Follow along @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.

#StayBeautiful


Source: ASPS 2025 Procedural Statistics Report. Commentary from Dr. Agullo’s 2026-09-07 dictation.