Every figure on this page links to the organization that produced it, and each was re-checked against that source before publishing. How plastic surgeons use video, and the numbers behind plastic and cosmetic surgery: our YouTube Data API read of the 474 most-viewed ‘plastic surgery’, ‘plastic surgeon’ and ‘BBL’ videos and of a year of uploads from 28 U.S. practice channels; our count of plastic surgeons in the federal NPI registry, by state and for Palm Beach, Broward and Martin counties; Medicare’s plastic surgeons and what it pays for breast reconstruction; procedure counts from The Aesthetic Society and ISAPS; BLS and Census counts for surgeons and physician offices; the FDA’s breast implant lymphoma and adverse event counts; our count of SEC annual reports that name plastic surgeons, and what implant makers disclose; peer-reviewed studies of plastic surgery video, social media and BBL safety; Florida’s office-surgery and BBL law and the federal and YouTube rules on before-and-after video; and where the popular plastic surgery numbers came from.
Plastic surgery practices’ and surgeons’ own channels posted 58.3% of the on-topic videos among YouTube’s 200 most-viewed results for each of ‘plastic surgery’, ‘plastic surgeon’ and ‘BBL’ and drew 75.1% of their views, from 47 channels (our read, Nov 10, 2026). (Mark Studios)See details
Views were concentrated: one surgeon’s channel drew 20.3% of those on-topic views, and the three most-viewed channels, all plastic surgeons’ own, drew 47.1% (our read). (Mark Studios)See details
Media, news, podcast and creator channels posted 33.1% of the on-topic videos and drew 20.5% of views; patients’ own surgery or recovery stories were 3.7% of videos and 1.3% of views (our read). (Mark Studios)See details
‘BBL’ on YouTube is mostly not about surgery: 70.8% of the videos in its most-viewed results were off-topic or counted-only, including 63 Big Bash League cricket videos and 42 songs (our read). (Mark Studios)See details
Videos of 60 seconds or less were 52.1% of the on-topic videos and drew 82.8% of the views. In the year to Nov 10, 2026, 28 U.S. practice channels from the sample posted 4,858 videos, a median of 142 each (our read). (Mark Studios)See details
The NPI registry lists 6,318 active individual NPIs with a plastic surgery primary taxonomy in the 50 states and D.C.; Florida has 550, with 62 in Palm Beach County, 50 in Broward and 8 in Martin (our count, Nov 10, 2026). (Mark Studios)See details
3,907 plastic and reconstructive surgeons billed Medicare Part B fee-for-service in 2024, down 11.2% from 4,399 in 2019 (CMS; our calculation). (CMS)See details
The Aesthetic Society estimated 1,671,147 aesthetic surgical procedures in the U.S. in 2023, led by liposuction (394,527); its own procedure table implies a 41.7% rise from 2019 (our calculation). (The Aesthetic Society)See details
The FDA counted 1,380 unique breast implant lymphoma (BIA-ALCL) cases and 64 deaths worldwide through June 30, 2024, and 10,318 reports of systemic symptoms (“breast implant illness”) from 2008 to mid-2024. Reports are not rates. (FDA)See details
The “1 in 3,000 BBL deaths” figure is not printed in the 2017 surgeon survey it is credited to, which gave 1:3448 for one year among other estimates; the earliest “approximately 1/3000” we found is a July 2018 task force advisory, and a 2019 re-survey found 1 in 14,952. (Several)See details
Florida law lets a doctor doing a BBL in an office inject fat only into the subcutaneous space, under ultrasound guidance (Fla. Stat. 458.328, as read Nov 10, 2026). (State of Florida)See details
15 SEC annual reports filed in 2025 said “plastic surgeon” or “plastic surgeons”, the fewest since 2004; 512 did from 2001 to 2025 (our count with EDGAR full-text search). (Mark Studios)See details
Who makes the most-viewed plastic surgery videos on YouTube?
Plastic surgery practices and surgeons' own channels drew 75.1% of the on-topic views when we read YouTube's 200 most-viewed results for each of 'plastic surgery', 'plastic surgeon' and 'BBL' on November 10, 2026 (our calculation). They posted 58.3% of the on-topic videos from 47 channels. Media, news, podcast and general-creator channels posted 33.1% and drew 20.5%; other clinicians drew 2.5%; and patients telling their own surgery or recovery story posted 3.7% of the videos and drew 1.3% of the views. We pulled the three searches with the YouTube Data API: 474 unique videos from 234 channels, of which 326 were on-topic, with 2,206,100,537 lifetime views (about 2.2 billion). 107 videos appeared in both the 'plastic surgery' and 'plastic surgeon' lists. We classed every channel by hand from its own text; credentials were not checked. The files are youtube-videos.csv, youtube-channels.csv and youtube-us-plastic-surgeon-channels.csv.
A handful of surgeons hold most of the views. The most-viewed channel, Doctor Youn, drew 20.3% of on-topic views, and the three most-viewed channels, all plastic surgeons' own, drew 47.1% (our calculation). One tummy tuck scar short from Clayton Moliver, MD, a Houston plastic surgeon, had 396,027,346 views (about 396 million) by itself, 18.0% of all on-topic views. Leaving out the Doctor Youn channel, practices and surgeons still drew 68.8% of the remaining on-topic views.
'BBL' is mostly not a plastic surgery search. 70.8% of the videos in the 'BBL' list were off-topic or counted-only, with 81.7% of the list's views (our calculation). 63 were about the Big Bash League, Australia's cricket competition, 42 were songs or lyric videos and 9 were esports, most featuring the Turkish team BBL Esports. 3 were sexualised, adult or prank material, which we counted without opening. By contrast, only 1.0% of the 'plastic surgery' list was off-topic. Across the whole sample 31.2% of the videos were off-topic or counted-only. In the on-topic part of the 'BBL' list, practices and surgeons drew only 28.5% of the views, media and general creators 54.7% and patients' own stories 13.3%; in the 'plastic surgery' list practices and surgeons drew 78.7%.
Surgeons on YouTube react, reveal and rate. 60 on-topic titles were reaction, analysis or rating videos such as 'Plastic Surgeon Reacts', and all 60 came from practice or surgeon channels (our calculation from titles, read by hand). 52 titles promised a before-and-after, a result, a reveal or a transformation; they drew 32.4% of on-topic views, and practices and surgeons drew 94.7% of those views. 86 titles were about celebrities or named public figures, and 58 of them came from practice or surgeon channels. Titles about botched surgery, deaths, failures or regret were a media subject: 36 such titles, with media, news, podcast and general creators drawing 68.1% of their views.
Short videos carried the views. 52.1% of on-topic videos ran 60 seconds or less, and they drew 82.8% of on-topic views; among practices and surgeons, 67.4% of on-topic videos ran 60 seconds or less (our calculation). 55.5% of on-topic videos were published in 2024 or later. YouTube's altered or synthetic content disclosure field was absent on all 474 sample videos.
30 of the 47 practice or surgeon channels were U.S.-placed, by their own text or their country setting, and they drew 65.4% of on-topic views (our calculation). 8 practice or surgeon channels were in India, the most of any other country, and 3 practice channels, two in Seoul and one in Istanbul, marketed to patients from abroad in their own text. In all, 25.2% of on-topic videos came from channels placed outside the United States. 5 named on-topic channels gave a Florida place: Dr. William Miami and Elite Plastic Surgery in Miami, Primera Plastic Surgery in Orlando, NBC 6 South Florida, and Al Jazeera English with a documentary on Miami's cosmetic surgery industry. None named Palm Beach, Broward or Martin county.
We also read a full year of uploads from 28 of the U.S.-placed practice or surgeon channels, leaving out the two whose every sample video we withheld. They posted 4,858 videos between November 10, 2025 and November 10, 2026, and the median channel posted 142 (our calculation). 15 channels posted 100 or more, while 3 posted one video or none. Dr. Michael Gartner's channel (Gartner Plastic Surgery, New Jersey) posted the most, 518. The median upload of the year had 6,473 views, far below the million-view videos that top search, and 62.0% of the uploads ran 60 seconds or less. The three Florida practice channels posted 151 videos in the year. Doctor Youn's main, Shorts and podcast channels count as three channels here.
Patients' own surgery stories, private people, minors and celebrities named in connection with surgery are published as class and counts only, and sexualised, adult and prank videos are counted without being opened. We withheld 109 of the sample videos from the public files: 63 titles naming a celebrity or other public figure, 23 titles naming or telling a private person's own surgery story, 6 about children or teenagers, plus the patients' own stories from 11 channels, the counted-only videos and two titles our screen withheld. Their views still count in every share above. This is one day's view-sorted search ranking, not a census, and we did not watch the videos.
Who makes the plastic surgery videos people find on YouTube and TikTok?
Surgeons make a large share, but not most, of what ranks. In a Rutgers study published in 2019, U.S. board-certified plastic surgeons appeared in 50.3% of the most-surfaced YouTube videos on five common cosmetic operations (our calculation from 72 videos (Aesthetic Surgery Journal)). Each study below sampled the top results for its own search terms on its own date and defined “surgeon” its own way, so the table gives each study’s year, platform and finding side by side. Quality scores use DISCERN (1 to 5, higher is better), the modified EQIP (out of 27) or PEMAT.
Peer-reviewed content studies of plastic surgery video and posts
77.1% of located patient videos named surgery abroad or in Miami
The pattern repeats across platforms and years: videos made or fronted by plastic surgeons score higher on quality tools, and videos by laypeople or other creators often draw more views. Each figure describes the top results on one search date, not everything posted.
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Do board-certified plastic surgeons lead plastic surgery posts on Instagram?
No, in the two hashtag studies that measured it. In a 2017 analysis of 21 plastic surgery hashtags, surgeons eligible for The Aesthetic Society (then ASAPS) made 17.8% of top posts (Aesthetic Surgery Journal); a 2020 update over 22 hashtags put their share at 4.17% (Aesthetic Surgery Journal Open Forum), a fall of 13.6 percentage points (our calculation; the hashtag sets differ). A 2021 network study of the Plastic Surgery Research Council’s Instagram community counted 64,737 users and found its most central accounts were residencies, academic surgeons, societies and journals (Aesthetic Surgery Journal).
How many plastic surgeons use social media for their practice?
Most who answer surveys do. Of 454 ASPS members who answered a survey published in 2018 (a 7.4% response rate), 61.9% had an active professional social media account, rising to 79.4% among those whose practice was mainly cosmetic (Aesthetic Surgery Journal). In a 2020 survey of ASPS trainees, candidates and members, 74.3 percent of private-practice surgeons used social media for patient acquisition far more than salaried surgeons (Plastic and Reconstructive Surgery). Both are self-selected samples.
Video consultations spread fast in the 2020 lockdown: 97.7% of 43 senior UK and European plastic surgeons surveyed used them, and 38.1% did not know or were unsure whether their platform’s encryption was adequate for health care (Aesthetic Plastic Surgery).
How do plastic surgery trainees handle patient photos?
On their own phones. In a U.S. survey of 71 plastic surgery trainees published in 2022, 99% used a personal phone for medical photographs, while 65% used HIPAA-compliant photo storage and 49% knew the standard guidelines (The American Surgeon). Patient photos and video used in marketing also fall under the HIPAA authorization rules covered in the rules section of this page.
What do people considering plastic surgery say they want from video and social media?
Information from the surgeon, though social media counts for little when they choose one. In a conjoint survey of 647 online panel members considering common aesthetic operations (published 2018), the preferred mix was comprehensive information delivered by the surgeon on live video (Aesthetic Surgery Journal). Among 369 U.S. adults considering plastic surgery (published 2024), a web search was the most common first step (32.2%) and the surgeon’s number of social media posts scored 5.62 out of 10, among the three least important of 36 factors (Plastic and Reconstructive Surgery). Both are stated preferences from crowdsourced samples.
Risk information changes stated intent. In an online survey of 489 women published in 2020, 78.1% found the BBL mortality rate higher than they expected, and 70.1% of those who had been willing or neutral became unwilling after reading about the risks (Aesthetic Plastic Surgery).
What do studies say about gluteal fat grafting (BBL) deaths?
The deaths cluster where fat goes into muscle and in high-volume budget clinics. The origin of the widely repeated BBL death rate is traced in the myths section; the studies here are the others. A University of Miami review counted 25 BBL-related fat embolism deaths in South Florida in 2010-2022, and 56% of them (our calculation) came after the 2018 ASERF guidelines and Florida’s 2019 subcutaneous-only rule; 92% followed surgery at high-volume budget clinics (Aesthetic Surgery Journal). These are counts without a denominator, not a death rate. Miami-Dade medical examiner pathologists reported that fat grafting after liposuction caused 8 of 10 deaths after elective gluteal procedures in their 2018 case series (Journal of Forensic Sciences).
Outside the U.S., 20,117 cases per death was the mortality estimate from 853 Brazilian board-certified plastic surgeons surveyed in July 2017, with death 16 times more likely when fat was injected into muscle (Plastic and Reconstructive Surgery). In Mexico, 413 plastic surgeons reported 13 deaths from gluteal fat injection over about 10 years, 20.3% of the liposuction-related deaths they reported (our calculation) (Plastic and Reconstructive Surgery). These are surgeon-reported surveys, not registries.
Surgeons have not all adopted ultrasound guidance. In a 2023 survey of 178 U.S. board-certified plastic surgeons (a 10% response rate), 48% of those who performed BBL did not use ultrasound, and about 60% of all respondents opposed requiring it (Aesthetic Surgery Journal). Where it was used, one center reported no fat embolism deaths and a 4% complication rate in 1,815 patients in 2019-2022 (Aesthetic Surgery Journal), and a 2025 meta-analysis of four studies covering 6,235 patients found no reported deaths (Aesthetic Surgery Journal). Four studies is a small base; no reported deaths is not proof of zero risk.
How often do complications from cosmetic surgery abroad reach home hospitals?
Often enough to be studied at single hospitals and nationally, though no study gives a rate. A 2023 systematic review found 589 patients in 44 published studies who came home with complications, most often infection (Annals of Plastic Surgery). At one U.S. tertiary hospital, 23.6% of 123 patients treated in 2014-2022 for complications of surgery done abroad or in another state needed admission (Aesthetic Surgery Journal). One U.S. health system spent $523,272 treating 41 plastic surgery tourism patients in 2015-2022 (Aesthetic Surgery Journal Open Forum), about $12,763 per patient (our calculation).
In the UK, one Glasgow (Scotland) unit saw 81 such patients in 2019-2023 (The Surgeon). Of 198 cases reported to the British Association of Aesthetic Plastic Surgeons in September 2022-September 2024, 76% had surgery in Turkey, and the authors estimated NHS treatment costs at £1.2 to £1.8 million over two years (Aesthetic Surgery Journal). Reporting to that database is voluntary.
How many cosmetic surgeries do U.S. plastic surgeons perform?
The Aesthetic Society, a membership body of board-certified aesthetic plastic surgeons, estimated 1,671,147 aesthetic surgical procedures in the U.S. in 2023, up 2.9% from 2022 and, in its words, 10.2% since 2019 (The Aesthetic Society). Its own table does not support the second number: the 2019 and 2023 totals it prints are the sums of the same 22 procedure rows, and they imply a rise of 41.7% (our calculation). The 2023 report is the newest edition the society makes public; later editions sit behind a login, which we did not use.
The figures are an extrapolation, not a census. They come from a CosmetAssure insurance database of more than 150,000 procedures by 762 surgeons over two years (The Aesthetic Society). Change rates from the 386 surgeons who reported in every quarter of 2022 and 2023 were applied to the 2022 national counts (The Aesthetic Society), with a stated standard error of +/- 5.0% (The Aesthetic Society). The 2022 edition used a different source: billing data from 200 member practices that reported every quarter from 2019 to 2022 (The Aesthetic Society). The figures cover cosmetic surgery only. Injectables and other non-surgical work are covered on our aesthetics video statistics page.
Five procedures made up 65.9% of the 2023 total (our calculation):
Face and neck procedures grew fastest. In The Aesthetic Society's 2023 data, facelifts rose 37.3% in a year to 96,061 (The Aesthetic Society), and neck lifts were up 97.3% on 2019 (The Aesthetic Society). Breast implant removal reached 74,326 procedures, up 40.2% on 2019 (The Aesthetic Society). The society's app for the ARISE breast implant registry had recorded 46,217 implant devices by the time of the 2023 report (The Aesthetic Society); registration is voluntary, so that is not a count of all U.S. implants.
Patients are mostly women in mid-life. Women had 93.4% of 2023 aesthetic surgeries (The Aesthetic Society), and patients aged 35 to 50 had 40.0% (The Aesthetic Society). For men, liposuction came first and gynecomastia treatment (male breast reduction) second, with 21,043 procedures (The Aesthetic Society). Surgery is slightly seasonal: March had 9.9% of the year's top-five procedures, July and September 7.2% and 7.1% (The Aesthetic Society). 64% of the surgeries were done in accredited surgical centers, 19% in hospitals and 17% in office-based surgery centers (The Aesthetic Society).
Volume per surgeon rose after the pandemic. In the 2022 data the average participating plastic surgeon performed 252 surgical procedures, against 289 in 2021 and 198 in 2019 (The Aesthetic Society). Surgical volume in 2022 stayed 37% above 2019 (The Aesthetic Society). The society put revenue from all aesthetic procedures by U.S. plastic surgeons at $11.8 billion in 2022, $8.5 billion of it surgical; the figure is estimated from procedure counts and fees (The Aesthetic Society).
We do not quote the American Society of Plastic Surgeons' annual statistics report on this page. The terms of use on plasticsurgery.org forbid downloading information from the site with bots, crawlers or other automated programs, and our research is collected by software.
How many buttock augmentations (BBLs) are performed?
The Aesthetic Society estimated 29,816 buttock augmentations by implants or fat transfer (the fat-grafting operation called a BBL) in the U.S. in 2023, down from 37,268 in 2022 and 33,308 in 2019 (The Aesthetic Society). The -20.0% change from 2022 was the steepest fall of any procedure it tracks (The Aesthetic Society). The row combines implants and fat grafting.
The operation is concentrated in fewer hands and smaller settings than most. 39% of surgeons in the society's 2023 dataset did at least one buttock augmentation by fat transfer that year, against 98% who did liposuction (The Aesthetic Society). Fat-transfer buttock augmentation was the only procedure done more often in office-based surgery centers, 45%, than in accredited surgical centers, 44% (The Aesthetic Society). Office surgery is the setting Florida's rules address (see the rules section).
ISAPS's worldwide survey gives a much larger U.S. number for a later year: 134,404 buttock augmentations by U.S. plastic surgeons in 2025 (ISAPS). Plastic surgeons worldwide did 645,380 in 2025, flat on 2024 (ISAPS), so the U.S. share works out to 20.8% (our calculation). The two societies use different samples and extrapolations, so their counts should be read within each series, not against each other.
How does U.S. plastic surgery compare with the rest of the world?
The U.S. performs the most aesthetic procedures of any country, but Brazil performs the most surgery. ISAPS, the International Society of Aesthetic Plastic Surgery, estimated nearly 17.9 million surgical and 17.3 million non-surgical aesthetic procedures by plastic surgeons worldwide in 2025 (ISAPS). Comparing only procedures asked about in both years, surgery was up 25.3% on 2021 (ISAPS). The U.S. performed over 5.4 million procedures in all (ISAPS), of which 2,229,368 were surgical (ISAPS), 12.5% of the world's aesthetic surgery (ISAPS). Brazil performed 2,361,010 surgical procedures, the most of any country (ISAPS), and Turkiye 794,390 (ISAPS).
ISAPS's numbers are member-based estimates. ISAPS built its 2025 estimates on data from 2,900 of them (ISAPS); its U.S. figures also draw on The Aesthetic Society's dataset of more than 700 U.S. surgeons (ISAPS). Responses are projected to each country's estimated number of plastic surgeons. ISAPS puts that number at 60,400 worldwide (ISAPS), and says about 80% of them focus on aesthetic rather than reconstructive work (ISAPS).
The procedure mix differs by country. Worldwide, eyelid surgery was the most common aesthetic operation in 2025, with 2,457,677 procedures (ISAPS), and breast lifts rose 48.1% (ISAPS). In the U.S., liposuction led with 355,603 procedures, 16.0% of U.S. aesthetic surgery (ISAPS). Women had 85.6% of surgical procedures worldwide (ISAPS). Worldwide, 48.7% of aesthetic procedures were done in hospitals and 29.8% in office facilities (ISAPS).
Some countries treat many patients from abroad. In its 2025 survey, ISAPS asked surgeons what share of their patients came from other countries. In 2025, U.S. plastic surgeons said 8.0% on average (ISAPS). Surgeons in the Dominican Republic said in 2025 51.7%, the highest of any country surveyed, with the U.S. the most-cited origin (ISAPS). In the same 2025 survey, surgeons in Mexico said 33.3% (ISAPS), in Turkiye 32.4% (ISAPS) and in Colombia 31.5% (ISAPS); the U.S. was the most-cited origin for Mexico and Colombia. These shares are surgeons' own estimates, not patient records.
How many plastic surgeons are there in the U.S., Florida and South Florida?
The federal NPPES NPI Registry lists 6,318 active individual NPIs whose primary taxonomy is plastic surgery at practice locations in the 50 states and D.C., in our count from the registry’s public API on November 10, 2026 (our calculation). That covers three taxonomy codes: general Plastic Surgery (208200000X), Surgery of the Hand within plastic surgery, which 357 of them list (our calculation), and Plastic Surgery Within the Head and Neck, which 166 list (our calculation). With Puerto Rico and the other territories the count is 6,341 (our calculation).
The count leaves out surgeons who chose a different primary taxonomy. Another 513 active NPIs list the general surgery subspecialty “Surgery, Plastic and Reconstructive Surgery” as their primary taxonomy (our calculation), and facial plastic surgeons who trained in otolaryngology usually list an otolaryngology code. Taxonomy is self-reported: CMS does not check it, it is not board certification, and retired surgeons and trainees can keep an active NPI. NPPES changes daily, so a re-run gives slightly different numbers.
California has the most plastic surgery NPIs, 977 (our calculation). Florida has 550 and ranks No. 2 among the states and D.C. (our calculations). In South Florida, Palm Beach County has 62, Broward County 50 and Martin County 8, placing each NPI by the ZIP code of its practice address (our calculations).
How we counted: the API returns at most 200 results per call and can skip at most 1,000, so one query reaches no more than 1,200 NPIs. We ran one query per state, territory and military postal code for individual NPIs with the taxonomy description “Plastic Surgery”. Only California went past that reach, so we split it by the first two digits of the ZIP code until every slice ended on a short page, which means every slice was complete. The search also returns otolaryngologists, general surgeons and nurses whose taxonomy names contain the same words; we kept only NPIs whose primary taxonomy is one of the three plastic surgery codes. The registry matches a state or ZIP against any address on the record, so we removed duplicates and placed each NPI by its practice address. Our state and county counts are published as a CSV of counts only, with no names, NPIs or addresses.
How many plastic surgeons bill Medicare?
CMS’s Medicare Physician & Other Practitioners file lists 3,907 providers of type “Plastic and Reconstructive Surgery” who billed Medicare Part B fee-for-service in 2024 (CMS), down from 4,399 in 2019 (CMS), a fall of 11.2% (our calculation). In Florida the count fell from 352 in 2019 (CMS) to 289 in 2024 (CMS), a fall of 17.9% (our calculation). By the ZIP code CMS lists for each provider, 35 of the 2024 Florida providers were in Palm Beach County, 29 in Broward County and 7 in Martin County (our calculations).
The median plastic surgeon in the 2024 file billed Medicare for 57 beneficiaries in the year (our calculation). CMS assigns one provider type per provider from the claims, and providers with 10 or fewer Medicare patients are not listed at all, so the Medicare count is smaller than the NPI count above. Part of the 2019-2024 fall reflects the move of beneficiaries into Medicare Advantage, whose claims are not in the file. Original Medicare covers mostly people 65 and older and people under 65 with long-term disabilities, and Medicare does not pay for cosmetic surgery, so these files show only the reconstructive and repair side of the specialty.
What does Medicare pay surgeons for breast reconstruction and other reconstructive operations?
In 2024 Medicare’s average allowed professional fee for breast reconstruction with a tissue expander (CPT 19357) in a hospital or surgery center setting was $1,233.70 (CMS), and for free flap breast reconstruction, where tissue is moved from another part of the body with its blood vessels reattached (CPT 19364), $2,275.48 (CMS). The figures come from CMS’s by Geography and Service file, national facility-setting rows, all specialties, Part B fee-for-service claims only. They are the surgeon’s fee alone: the hospital or ambulatory surgery center is paid separately under other Medicare systems.
Operation (CPT)
Beneficiaries, 2024
Average allowed fee, 2024
Beneficiaries, 2019
Average allowed fee, 2019
Source
Breast reconstruction with tissue expander (19357)
Beneficiaries are distinct original Medicare patients on each facility-setting row, across all specialties. From 2019 to 2024 the number with tissue expander reconstruction fell 22.0%, free flap reconstruction fell 3.3% and breast reduction fell 10.6%, while delayed implant placement rose 33.9% (our calculations). Before inflation, the average allowed fee fell 23.3% for tissue expander reconstruction, 4.2% for free flap reconstruction and 13.1% for delayed implant placement (our calculations). CMS’s descriptions of these codes differ between the 2019 and 2024 files, so a 2019 service and a 2024 service under the same code may not be defined identically, and part of every fall in patient counts reflects the move to Medicare Advantage.
Florida had 285 beneficiaries with tissue expander breast reconstruction on facility rows in 2024 (CMS), 8.4% of the national count (our calculation), and 467 with a delayed breast implant placement (CMS).
Plastic surgeons are not the only specialists who bill these codes. Providers of type “Plastic and Reconstructive Surgery” billed at least 18.0% of 2024 Medicare services for a trunk muscle flap and at least 14.4% of services for the 30.1-60 square centimeter adjacent tissue transfer (our calculations). These are lower bounds: CMS publishes a provider’s line for a code only when 11 or more beneficiaries received it from that provider, so surgeons who did fewer are left out of the plastic surgery total.
How many surgeons does BLS count in the group that holds plastic surgeons?
BLS estimated 25,140 wage and salary jobs in "Surgeons, All Other" (SOC 29-1249) in the United States in May 2025 (BLS OEWS). BLS has no plastic-surgeon occupation. Plastic surgeons sit in this catch-all group with every surgical specialty that lacks its own code, such as general, vascular, thoracic and neurological surgeons, so the count is a ceiling for plastic surgeons, not a count of them. The survey covers employers only: surgeons who own their practice and take profits instead of a wage are left out. BLS put the relative standard error of the national estimate at 9.6% (BLS OEWS).
The group made up 50.9% of the 49,380 U.S. wage and salary surgeon jobs of all kinds (SOC 29-1240) in May 2025 (our calculation from (BLS OEWS)). Counting self-employed surgeons as well, the BLS Occupational Outlook Handbook put the group at about 27,500 jobs in 2025 (BLS OOH), and BLS Employment Projections found 5.3% of those jobs held by self-employed workers (BLS Employment Projections). BLS projects the group to grow 4.0% from 2025 to 2035, against 3.5% for all U.S. occupations (BLS Employment Projections).
What do surgeons in the "all other" group earn?
The median annual wage of U.S. wage and salary surgeons in "Surgeons, All Other" (SOC 29-1249, shared with other surgical specialties) was $414,010 in May 2025, and the mean was $373,930 (BLS OEWS). One in ten earned less than $80,320 a year and one in ten earned more than $655,320 (BLS OEWS). The median for all U.S. surgeons (SOC 29-1240) was $369,540 (BLS OEWS).
The group's median was 8.1 times the $50,980 median for all U.S. wage and salary occupations in May 2025 (our calculation from (BLS OEWS)). These are wages paid by employers; BLS does not measure what practice owners take home.
Where do surgeons in this group work?
Offices of physicians (NAICS 6211, all specialties) employed an estimated 13,130 wage and salary surgeons in "Surgeons, All Other" (SOC 29-1249) in May 2025, 52.2% of the group's U.S. jobs (our calculation from (BLS OEWS)); BLS put the relative standard error of that estimate at 18.6% (BLS OEWS). Their median annual wage in physician offices was $414,010 (BLS OEWS).
In May 2025, general medical and surgical hospitals (NAICS 6221) employed 8,760, or 34.8% of the group (our calculation from (BLS OEWS)), at a median annual wage of $344,520 (BLS OEWS). BLS publishes no industry split for plastic surgeons alone.
How many surgeons in this group work in Florida and South Florida?
BLS estimated 2,260 wage and salary jobs in "Surgeons, All Other" (SOC 29-1249, shared with other surgical specialties) in Florida in May 2025 (BLS OEWS). That is 9.0% of the U.S. total, while Florida held 6.9% of U.S. residents (23,462,518 of 341,784,857 on July 1, 2025, (Census Bureau)) (our calculation). The state estimate is loose: BLS put its relative standard error at 37.9% (BLS OEWS). Florida's location quotient for the group was 1.41, meaning the occupation's share of Florida jobs was 1.41 times its share of U.S. jobs (BLS OEWS).
The median annual wage of these surgeons in Florida was $429,990 and the mean was $391,060 in May 2025 (BLS OEWS). BLS publishes no 29-1249 series for the Miami-Fort Lauderdale-West Palm Beach metro area, which holds Palm Beach and Broward counties. In the Port St. Lucie metro area, which holds Martin County, BLS did not release an employment count but published a mean annual wage of $374,820 and a median of $419,070 (BLS OEWS).
How many physician offices are there, nationally and in Palm Beach, Broward and Martin counties?
There is no industry code for plastic surgery practices; they are counted with every other physician office in NAICS 621111. BLS's Quarterly Census of Employment and Wages averaged 226,698 private offices of physicians (NAICS 621111, all specialties) in the United States in 2025, with about 2.9 million jobs (2,904,306) and average annual pay of $116,597 per job across all staff (BLS QCEW). That was up 10.6% from 204,988 offices in 2019 (our calculation from (BLS QCEW)). The U.S. had 66.3 offices per 100,000 residents in 2025 (our calculation).
Florida averaged 21,918 private physician offices and 252,530 jobs in them in 2025 (BLS QCEW), up 12.9% from 19,407 offices in 2019 (our calculation from (BLS QCEW)), or 93.4 offices per 100,000 residents (our calculation). All three South Florida counties below have more offices per resident than the U.S. as a whole.
Private offices of physicians (NAICS 621111, all specialties)
QCEW counts employers covered by unemployment insurance, so a surgeon working alone with no staff is not in it. The Census Bureau counted 190,427 U.S. physician-office businesses with no paid employees in 2024 (Census Nonemployer Statistics), 19,222 of them in Florida (Census Nonemployer Statistics). Many are side or consulting income rather than full practices.
What do physician offices take in and spend on advertising?
U.S. offices of physicians (NAICS 621111, all specialties) had about $630 billion in receipts in 2022 ($630,209,309 thousand), per the 2022 Economic Census (Census Bureau). None of the Economic Census product lines for physician offices names plastic, cosmetic or reconstructive surgery: patient care is split by diagnosis chapter, so cosmetic surgery revenue cannot be read from it.
U.S. offices of physicians (NAICS 6211, all specialties) spent about $1.8 billion ($1,815,721 thousand) on advertising and promotion in 2024, per the Census Bureau's Annual Integrated Economic Survey (Census Bureau AIES). That was 0.28% of their total operating expenses (our calculation). The survey does not break out plastic surgery practices.
How many breast implant lymphoma (BIA-ALCL) cases has the FDA counted?
The FDA had received reports of 1,380 unique cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) from the U.S. and other countries by June 30, 2024, the newest tally on its page (FDA). The same reports and published case reports sent in as reports list 64 deaths over the same period (FDA). The FDA first identified a possible link between breast implants and this lymphoma in 2011 (FDA). BIA-ALCL is a lymphoma of the immune system, not breast cancer, and is usually found in the scar tissue and fluid around the implant.
These are medical device reports (MDRs), sent to the FDA by manufacturers, hospitals, clinicians and patients. The FDA says the system is passive: under-reporting, duplicates, unverified causes and the unknown number of people with implants mean the counts cannot give a rate or prove cause. A patient with the disease in both breasts is counted once per breast. Read every number in this section as a count of reports, not as a risk for any one person.
The FDA's own tables show the count rising at each update. It stood at 573 cases and 33 deaths on July 24, 2019 (FDA), 733 cases on January 5, 2020 (FDA), 1,130 cases and 59 deaths on April 1, 2022 (FDA), and 1,264 cases on June 30, 2023 (FDA). By June 2024 the case count was 2.4 times the July 2019 figure (our calculation), with 116 cases added in the last year (our calculation). Reporting campaigns and wider awareness push such counts up too, so growth in reports is not growth in disease.
What do the FDA's BIA-ALCL reports say about the implants and patients?
Textured-surface implants were named in 73% of the cases the FDA counted to June 30, 2024 (FDA). Allergan implants were named in 1,182 of the cases (FDA) and in 38 of the deaths (FDA). U.S. reporters filed 588 of the cases; the rest came from abroad or gave no country (FDA).
The median age at diagnosis was 53 (FDA), and the median time from the last implant to diagnosis was 8 years (FDA). Fluid around the implant (seroma) was the reported presentation in 666 cases (FDA). Many reports are incomplete: 937 cases did not say whether the implant was placed for reconstruction or augmentation (FDA).
When did the FDA act on Allergan's textured implants?
On July 24, 2019 the FDA asked Allergan to recall specific textured breast implant models from the U.S. market, and Allergan began a worldwide recall of its BIOCELL textured implants and tissue expanders (FDA). That day the FDA said 481 of the 573 cases it knew of were attributed to Allergan implants (FDA), and its analysis put the BIA-ALCL risk with Allergan BIOCELL textured implants at about six times the risk with other makers' textured implants sold in the U.S. (FDA). The FDA also said macro-textured implants were less than 5% of breast implants sold in the U.S. (FDA), against as much as 80% textured market share in France, Canada and Australia (FDA).
What labeling and consent rules did the FDA add for breast implants?
On October 27, 2021 the FDA restricted the sale and distribution of breast implants and approved new labeling for every legally marketed breast implant, with a boxed warning and a patient decision checklist (FDA). Under the order, implants may be sold only to providers and facilities that go through the "Patient Decision Checklist" with the patient; the implanting physician must sign it, and the patient gets the chance to initial and sign it (FDA). The rules grew out of a 2019 advisory panel meeting and the FDA's labeling guidance, issued in September 2020 (FDA).
The FDA's postmarket page lists warning letters to breast implant makers, including one to Allergan Aesthetics dated 05/14/2020 (FDA). On December 14, 2023 the FDA updated its risks page, adding ultrasound as an acceptable screening alternative for silent rupture and a new section on squamous cell carcinoma, other lymphomas and sarcoma (FDA).
How many reports describe "breast implant illness"?
The FDA found 10,318 medical device reports, received from January 1, 2008 to June 30, 2024, that describe systemic symptoms in people with saline or silicone breast implants, sometimes called breast implant illness (FDA). The FDA built this count by searching report narratives for a list of symptom terms and removing duplicates where it could. It says these symptoms and their causes are poorly understood.
Where an age was given, the average was 42.6 years (FDA). The average time from implantation to the first symptoms was 5.6 years where reports gave enough detail (FDA). Fatigue was the most frequent term, in 41.1% of the reports (FDA). 4,210 reports said the implants were later removed (FDA). Only 785 reports said how symptoms changed after removal (FDA). Those reports were not a study, so they cannot show how often removal changes symptoms.
What has the FDA said about other cancers in the implant capsule?
In September 2022 the FDA said it was aware of published reports of squamous cell carcinoma (SCC) and fewer than 30 cases of various other lymphomas in the scar capsule around breast implants (FDA). These lymphomas are separate from BIA-ALCL. By September 1, 2022 it had received 12 reports about these other lymphomas (FDA).
Its March 2023 update counted 19 published cases of SCC in the capsule (FDA) and 24 medical device reports about SCC as of January 15, 2023 (FDA), which may overlap with the published cases. The literature recorded 3 deaths (FDA). Diagnosis came roughly 7 to 42 years after the first implant (FDA). The FDA says how often this happens, and why, is unknown.
How many adverse event reports do breast implants generate each year?
Our read of the FDA's adverse event database (MAUDE, through the openFDA API, data updated November 4, 2026) finds 31,393 reports received in 2025 for silicone gel-filled breast implants (product code FTR) (openFDA) and 8,852 for saline-filled implants (product code FWM) (openFDA): 40,245 in all (our calculation). Reporters filed 30,891 of the silicone reports (openFDA) and 8,767 of the saline reports (openFDA) as injuries, 98.5% of the total (our calculation). 2 saline reports were filed as deaths (openFDA); a report filed as a death does not mean the implant caused it.
The yearly series jumps between 2016 and 2019. In 2017 the FDA required makers in its Alternative Summary Reporting program to also file public "companion" reports, and it ended that program in June 2019 (FDA). Counts from before and after that change are not comparable. Saline reports have fallen since 2019, down 42.8% by 2025 (our calculation). One patient can produce several reports and manufacturers file most of them, so these are report counts, not complication rates.
Nothing in this section is medical advice. The FDA's own pages explain the risks of breast implants and what it asks patients and clinicians to report.
How often do annual reports to investors mention plastic surgeons, and video?
Rarely: 15 Form 10-K annual reports filed in 2025 contained the phrase "plastic surgeon" or "plastic surgeons", by our count with SEC EDGAR full-text search (our calculation). That was the lowest count since 2004, when 13 such filings were made; 23 were filed in 2024 (our calculation). The count was 11 in 2001 and peaked at 28 in both 2017 and 2018 (our calculation). Across 2001 to 2025, 512 filings from 121 companies used either phrase, and 12 more were filed in 2026 through November 10, when we ran the search (our calculation). Filing year 2025 mostly means fiscal 2024 reports. The count covers only Form 10-K filers: InMode files a Form 20-F, and private practices and private device makers file nothing.
Most of these filers sell to surgeons rather than employ them: 9 of the 15 filings from 2025 came from medical device makers (our calculation). Only 13.3% of the 2025 filings, 2 of 15, also contained "video" or "videos" (our calculation), against 17.4% of all filings with either phrase from 2001 to 2025 (our calculation). We read the passages around both words in the 2 filings from 2025: in Allurion's, video means telehealth video calls in its weight-loss app; in Elutia's, sales and educational materials in video formats (our calculation). Neither describes video made by or for plastic surgery practices.
"Social media" appeared with "plastic surgeon(s)" in 6 filings from 2025, after a peak of 15 in 2018; the first year with any was 2009 (our calculation). In 4 of the 6 from 2025 it meant the company's own marketing (Establishment Labs, The Beauty Health Company, Venus Concept and NanoVibronix); Apyx Medical named social media as a driver of cosmetic surgery demand, and Utah Medical Products used the term for lawyers recruiting plaintiffs (our calculation).
2 filings from 2025 pair "plastic surgeon(s)" with "YouTube": Venus Concept's and The Beauty Health Company's, both listing YouTube among their own social media channels (our calculation).
Yearly counts with sector splits, filer names and query links are in our EDGAR counts file, and the passages we read in our contexts file. EDGAR's search does not stem words, so "plastic surgery", "cosmetic surgeon" and "aesthetic surgeon" are not counted.
What do breast implant makers tell investors?
Establishment Labs, maker of Motiva implants, reported $45,557 thousand of North America revenue in fiscal 2025, against $4,410 thousand in fiscal 2024, out of total revenue of $211,076 thousand (Establishment Labs 10-K): 10.3 times as much in a year (our calculation). It received FDA premarket approval for Motiva implants in September 2024 and began U.S. sales in October 2024 (Establishment Labs 10-K). Each figure below is the company's own statement in an annual report on SEC EDGAR; these companies sell the implants they describe.
By December 31, 2025, Establishment Labs had over 1,500 U.S. accounts and $45.6 million of U.S. Motiva sales (Establishment Labs 10-K). Motiva implants are registered in over 100 countries (Establishment Labs 10-K), and it says it sold over 4.8 million breast implants from October 2010 through December 2025 (Establishment Labs 10-K).
It ran 607 medical training sessions for plastic surgeons in fiscal 2025, against 239 in fiscal 2024 (Establishment Labs 10-K), 2.5 times as many (our calculation). Its sales organization had 278 employees and contractors at the end of fiscal 2025 (Establishment Labs 10-K).
Its fiscal 2025 marketing strategy includes social media engagement, influencers, conferences, online advertising and patient and physician education (Establishment Labs 10-K). The same report warns that using social media and high-profile influencers raises the risk that promotional content is alleged to break FDA advertising and promotion rules (Establishment Labs 10-K).
Establishment Labs says seasonal patterns can cut U.S. breast augmentation volume by approximately 20% to 30% in certain periods, with dips in January and February and from late June to early August (fiscal 2025 report) (Establishment Labs 10-K).
AbbVie (Allergan Aesthetics) does not report breast implant sales on their own: its fiscal 2025 report lists Natrelle breast implants inside Other Aesthetics, with Alloderm, CoolSculpting, SkinMedica, Latisse and DiamondGlow (AbbVie 10-K). Other Aesthetics brought $1,265 million of worldwide net revenues in fiscal 2025, against $1,279 million in fiscal 2024 (AbbVie 10-K). Its advertising expenses, for all AbbVie products, were $2.1 billion in fiscal 2025 (AbbVie 10-K); the report does not split out aesthetics advertising.
AbbVie's fiscal 2025 report counts about 150 lawsuits alleging breast implant-associated anaplastic large cell lymphoma (ALCL) and 1,320 other lawsuits over Allergan's Biocell textured implants, withdrawn worldwide in 2019, in the federal multidistrict litigation in New Jersey (AbbVie 10-K). Its fiscal 2024 report counted about 135 ALCL and 1,100 other lawsuits there (AbbVie 10-K, fiscal 2024), so the federal case grew by about 220 non-ALCL lawsuits in a year (our calculation; AbbVie rounds every count). The fiscal 2025 report adds about 75 ALCL and 470 other lawsuits in U.S. state courts and about 70 ALCL and 1,080 other lawsuits in other countries (AbbVie 10-K). These are lawsuit counts, not counts of illness; FDA's own case counts are in the breast implant safety section.
Sientra, a U.S. implant maker until its 2024 bankruptcy, sold its breast implants and fat transfer systems for U.S. augmentation exclusively to board-certified and board-admissible plastic surgeons (fiscal 2022 report) (Sientra 10-K). That report, citing the American Board of Plastic Surgery, says approximately 7,500 board-certified plastic surgeons were actively practicing in the United States (Sientra 10-K); the board's count is undated in the filing.
Sientra educated people interested in breast augmentation, reconstruction and scar treatment through social media profiles on Facebook, Instagram, LinkedIn and Twitter (fiscal 2022 report) (Sientra 10-K), and warned that its direct-to-consumer marketing and social media efforts may bring extra regulatory scrutiny (Sientra 10-K).
Its net sales were $90.6 million in fiscal 2022, its last Form 10-K (Sientra 10-K). Sientra filed for chapter 11 bankruptcy on February 12, 2024 (Sientra 8-K), and at an auction on March 28, 2024 it named Tiger Aesthetics Medical the buyer of substantially all its assets except the Biocorneum scar business (Sientra 8-K).
What do device makers that sell to plastic surgeons say about video and social media?
They name plastic surgeons as customers and describe their own social channels, but say little about surgeons' video. Apyx Medical says its Renuvion helium plasma device is aimed mainly at the cosmetic surgery market, for plastic surgeons, facial plastic surgeons and cosmetic physicians (fiscal 2025 report) (Apyx 10-K). Its Surgical Aesthetics segment sales were $45,332 thousand in fiscal 2025, up 17.4% (Apyx 10-K), on advertising costs of about $1.6 million (Apyx 10-K). Apyx names the influence of social media among the drivers of cosmetic surgery demand (fiscal 2025 report) (Apyx 10-K).
Company
Fiscal year
What the annual report says
Source
SkinHealth Systems (Hydrafacial; The Beauty Health Company until its renaming)
2025
Most customers are dermatologists, plastic surgeons and medical spas; about 69% of delivery systems and consumables sold into that professional medical channel in the U.S. and Canada. Keeps Snapchat, Facebook, TikTok, Instagram and YouTube accounts. Advertising costs $6.0 million, 31.0% less than in fiscal 2024 (our calculation)
Markets its ARTAS hair restoration robot to hair restoration surgeons, dermatologists, plastic surgeons and aesthetic physicians; present on Facebook, Twitter, YouTube, Pinterest, LinkedIn and Instagram; its business development managers help practices with social media and digital marketing. Revenue $64.8 million, down 15.1%
About 30,900 platforms installed worldwide, sold primarily to plastic and facial surgeons, aesthetic surgeons, medical spas, dermatologists and OB/GYNs; advertising expenses $11 million
Besides core practitioners such as dermatologists and plastic surgeons, many non-core practitioners (gynecologists, family and primary care physicians) have expanded into aesthetic procedures. Filed for chapter 11 on March 5, 2025
Plastic surgeons used acellular dermal matrices in approximately 76,000 women in 2022, reconstructing about 125,000 breasts (company estimate). Makes sales materials in printed, video and multimedia formats
For non-surgical context only (injectables, covered in depth on our aesthetics video statistics page): AbbVie's Botox Cosmetic net revenues were $2,602 million worldwide in fiscal 2025 (AbbVie 10-K), with U.S. sales down 11% (AbbVie 10-K), and Juvederm Collection brought $993 million (AbbVie 10-K), down 15% on lower consumer demand (AbbVie 10-K). With Other Aesthetics, AbbVie's three aesthetics lines came to $4,860 million in fiscal 2025, 6.1% less than in fiscal 2024 (our calculation).
What does a public cosmetic surgery chain disclose about video and advertising?
AirSculpt, which runs body contouring centers in the U.S. and Canada, is the clearest case of a surgical business built on video and photos. Its fiscal 2025 report says it has collected over 300,000 before-and-after photos and runs AirSculpt TV, a program on its Instagram page and website (AirSculpt 10-K), and that it keeps Facebook, Instagram and YouTube accounts as marketing tools (AirSculpt 10-K). Its 10-K does not use the phrase "plastic surgeon"; AirSculpt recruits and trains its own surgeons.
AirSculpt's advertising costs were $27.3 million in fiscal 2025, about 90% of it digital (AirSculpt 10-K).
It performed 11,852 cases in fiscal 2025, against 14,036 in fiscal 2024 (AirSculpt 10-K): 15.6% fewer (our calculation). That puts fiscal 2025 advertising at roughly $2,300 per case (our calculation).
Its customer acquisition cost was approximately $3,114 per customer in fiscal 2025, against $2,950 in fiscal 2024 (AirSculpt 10-K). AirSculpt sells the procedures it describes; these are its own figures, not independent counts.
What does Florida law require for a BBL done in a doctor's office?
Since 2023, Florida law has written the gluteal fat grafting (BBL) standards into the statute itself. Under Fla. Stat. 458.328 as read in the 2026 Florida Statutes, fat may be injected only into the subcutaneous space, never across the fascia over the gluteal muscle, and never into or under the muscle (Florida Statutes). The physician must use ultrasound guidance, or board-approved technology that equals or exceeds it, while placing and moving the cannula (Florida Statutes).
The office must keep a ratio of one physician to one patient from anesthesia to extubation, and the surgeon may not start another procedure on another patient at the same time (Florida Statutes). The statute sets no numeric cap on BBLs per surgeon per day; this one-at-a-time ratio is the limit it uses.
The surgeon must examine the patient in person, in the same room, no later than the day before the procedure (Florida Statutes).
Fat extraction and the gluteal fat injections must be done by the physician and may not be delegated (Florida Statutes).
Offices that do gluteal fat grafting must show extra financial responsibility, for example liability cover of at least $250,000 per claim with an annual aggregate of at least $750,000, according to the Florida House staff analysis of the 2024 law (Florida House).
The statute's history note lists three session laws: 2019-130, 2023-307 and 2024-181 (Florida Statutes). Chapter 2023-307 (HB 1471) added the BBL standards and took effect July 1, 2023 (Laws of Florida). Chapter 2024-181 (HB 1561, Office Surgeries) took effect when the Governor signed it on May 10, 2024 (Laws of Florida); the Florida Senate passed it 39 votes to 0 on March 4, 2024 (Florida Senate).
Which Florida offices must register for office surgery, and how many are registered?
A Florida office must register with the Department of Health if a physician there removes more than 1,000 cubic centimeters of supernatant fat by liposuction, or does any Level II or Level III office surgery (Florida Statutes). The Board of Medicine must fine a physician $5,000 per incident for doing such a procedure outside a registered office or licensed facility; the 2024 law changed this from $5,000 per day (Florida Statutes).
No current count is published on an open page. The two newest public figures come from Florida House staff analyses, and they disagree although both cite the same Department of Health license lookup dated March 21, 2023: the 2024 analysis says 724 offices were registered (Florida House), and the 2023 analysis says 719 (Florida House). Neither count says how many of those offices do BBLs; the 2024 analysis notes that offices were not required to tell the Department whether they do them.
The Board of Medicine's office-surgery page says a registering surgeon without hospital privileges needs a transfer agreement with a hospital no more than thirty minutes transport time away (Florida Board of Medicine).
What does the Board of Medicine's office-surgery rule add?
Rule 64B8-9.009, the Board of Medicine's standard of care for office surgery, was last amended in a version effective 9/16/2024 (flrules.org). Its gluteal fat grafting paragraph says fat may only go into the subcutaneous space and must never cross the gluteal fascia (Rule 64B8-9.009).
Rule 64B8-9.009 (version effective 9/16/2024)
Limit
Source
Liposuction in a physician's office, supernatant fat removed
Under Fla. Stat. 458.351, a physician involved in an adverse incident in an office must report it to the Department of Health by certified mail postmarked within 15 days (Florida Statutes). Since 2023, a procedure in an office surgery setting that ends in hospitalization must be reported this way (Florida Statutes).
How did Florida's BBL rules start?
The Board of Medicine first acted by emergency rule. Emergency rule 64B8ER19-1 was published on 6/28/2019 (flrules.org), and the permanent amendment to rule 64B8-9.009 took effect on 09/03/2019 (flrules.org). In its emergency notice the Board cited the 2017 ASERF task force survey: 692 surgeons who had done 198,857 gluteal fat grafting procedures in their careers and reported 32 deaths from pulmonary fat emboli (Florida Administrative Register). It also cited the January 2018 inter-society advisory's death rate of about 1/3,000 patients, which the advisory called the highest for any aesthetic procedure (Florida Administrative Register). The section on popular numbers below traces where that rate came from and how it changed.
When the Legislature tightened the rules in 2024, House staff wrote that South Florida had 25 deaths after BBLs between 2010 and 2022, citing Pazmiño and Garcia's 2023 study in Aesthetic Surgery Journal (Florida House). Of those 25 deaths, 23 followed surgery at high-volume, low-budget clinics (Florida House).
What do Florida's advertising rules mean for a plastic surgeon's videos?
Any ad for health care services that names a practitioner must state the type of license the practitioner holds (Fla. Stat. 456.072(1)(t)) (Florida Statutes).
A Florida physician may call himself or herself a board-certified specialist only with formal recognition from a board of the American Board of Medical Specialties or another board the Board of Medicine recognises (Fla. Stat. 458.3312) (Florida Statutes).
Board rule 64B8-11.001 treats an ad as false, deceptive or misleading if it creates false or unjustified expectations of beneficial assistance (Rule 64B8-11.001).
“False, deceptive, or misleading advertising” is a ground for disciplining a medical doctor under Fla. Stat. 458.331(1)(d) (Florida Statutes).
Can a Florida plastic surgeon consult by video?
Yes, for consultations. Florida's telehealth law, s. 456.47, defines telehealth as synchronous or asynchronous telecommunications used to provide care, which covers live video visits (Florida Statutes). A telehealth provider whose remote evaluation is enough to diagnose and treat need not do a physical examination first (Florida Statutes), but for a BBL the office-surgery statute separately requires an in-person examination before the procedure. Telehealth records, including video, audio, electronic records, are confidential (Florida Statutes). The telehealth statute was created by chapter 2019-137 and last amended in 2023 (Florida Statutes).
What do federal rules say about before-and-after videos and patient testimonials?
The FTC's Endorsement Guides (16 CFR Part 255) were last republished on July 26, 2023 (eCFR). A testimonial about a key result is read as typical: if the advertiser cannot show the result is what patients will generally get, the ad should clearly disclose the generally expected performance (eCFR). Ads that present “actual consumers” should use real ones in both the audio and video, or say clearly that they are not (eCFR). The Guides' own before-and-after example, about weight loss rather than surgery, says “before” and “after” pictures of a woman who says she lost 50 pounds in 6 months are likely to be read as typical (eCFR). The FTC's 2024 rule on consumer reviews, at 16 CFR 465.2, makes it a violation for a business to write, create or sell fake reviews or testimonials (eCFR).
Patient photos and video are also health information. Under HIPAA, 45 CFR 164.508(a)(3), a practice must obtain an authorization from the patient before using protected health information for marketing, with narrow exceptions for face-to-face talks and small promotional gifts (eCFR). If a third party pays the practice for the marketing, the authorization must say that remuneration is involved (eCFR). HIPAA's de-identification list includes Full face photographic images and any comparable images, so a recognisable face in a video is not de-identified (eCFR).
What do YouTube and TikTok allow for surgery videos?
YouTube's violent or graphic content policy does not allow content that shows medical procedure footage with the intent to shock or disgust viewers (YouTube Help). Videos YouTube age-restricts instead of removing cannot be seen by anyone under 18 or signed out (YouTube Help). Its advertiser-friendly guidelines, as read on November 10, 2026, split surgery content by focus:
Educational medical or cosmetic procedure videos focusing on the procedure itself rather than on body parts, fluids or waste can earn full ad revenue (YouTube Help).
Videos of medical professionals explaining how to perform a specific operation receive no ad earnings (YouTube Help).
YouTube's health source panels and health shelves are open to individual licensed professionals. A channel needs more than 1,500 valid public watch hours in the last 12 months, or 1.5 million valid public Shorts views in 90 days (YouTube Help). The eligible professions start with “Licensed Doctor”, which covers plastic surgeons (YouTube Help), while channels run by pharmaceutical companies, health insurers or medical device companies, such as implant makers, are not eligible (YouTube Help). U.S. health professionals could first apply on October 27th, 2022 (YouTube Official Blog).
TikTok's U.S. healthcare ad policy, as captured in July 2026, allows cosmetic surgery ads only if they follow local law and are restricted to audiences aged 18 years or older (TikTok, archived).
What do the popular plastic surgery numbers really say?
Three claims travel through practice websites, news stories and marketing guides: that one in 3,000 people die from a Brazilian butt lift, that selfies drive demand for plastic surgery, and that video lifts conversions by 80%. We read each at its source and say below what that source measured. Pages that repeat a number are linked only as dated evidence of how it spread, never as a source for the number. Nothing here is medical advice.
“1 in 3,000 people die from a BBL”
The figure is a rounded 2018 summary of rough 2017 estimates, and later surgeon surveys found lower rates. It goes back to a task force of the Aesthetic Surgery Education and Research Foundation (ASERF), the research arm of The Aesthetic Society, a surgeons’ membership society. Mofid and colleagues (Aesthetic Surgery Journal, 2017) sent an anonymous web survey to 4843 plastic surgeons worldwide (Aesthetic Surgery Journal abstract), and 692 answered, reporting 198,857 gluteal fat grafting (BBL) cases over their careers (Aesthetic Surgery Journal abstract). From that recall the paper computed a career death rate of 1:6214 (Aesthetic Surgery Journal, PMC). For the prior 12 months, 574 surgeons reported 17,519 cases and five deaths, an annual rate of 1:3448 (Aesthetic Surgery Journal, PMC).
The task force added two estimates built on estimated case counts. Four deaths in facilities accredited by AAAASF in 2014-2015 gave 1:2351 (Aesthetic Surgery Journal, PMC), and deaths it confirmed against The Aesthetic Society’s procedure statistics gave 1:4000 for 2011 to 2016 (Aesthetic Surgery Journal, PMC). It confirmed 25 U.S. deaths over about five years from autopsy reports and interviews, and said that count was incomplete (Aesthetic Surgery Journal abstract). For comparison it cited AAAASF’s rate for all procedures in its facilities of 1:55,000 for 2001-2011 (Aesthetic Surgery Journal, PMC). The paper itself said its estimates run from 1:2351 to 1:6241 (its own misprint of 1:6214) and that none should be read as the actual rate (Aesthetic Surgery Journal, PMC). It never prints 1 in 3,000.
The round number appears a year later. The earliest dated form we found is the Inter-Society Gluteal Fat Grafting Task Force advisory of July 11, 2018, as reprinted by AmSpa, a med spa trade association: “The death rate of approximately 1/3000 is the highest for any aesthetic procedure” (AmSpa reprint). It added that there were three deaths in Florida alone in 2017 (AmSpa reprint). In August 2018 Practical Dermatology quoted the American Society of Plastic Surgeons as saying the rate is estimated to be as high as 1:3,000 (Practical Dermatology), and in October 2018 LaingBuisson’s IMTJ reported that the British Association of Aesthetic Plastic Surgeons asked UK members to stop the procedure, citing 1 in 3,000 operations (LaingBuisson IMTJ). The round figure sits between the paper’s estimates; the advisory does not say which one it used.
Later surveys found lower rates after surgeons changed technique. Rios and Gupta (Aesthetic Surgery Journal, 2020) re-surveyed members of The Aesthetic Society and ISAPS in 2019 and reported a trend from 1 in 3448 in 2017 to 1 in 14,952 in 2019 (Aesthetic Surgery Journal abstract); only 0.8% of surgeons said they injected into deep muscle, against 13.1% in 2017 (Aesthetic Surgery Journal abstract). A 2017 survey of Brazilian Society of Plastic Surgery members (Cansancao et al., Plastic and Reconstructive Surgery, 2019; 853 responses) estimated one in 20,117 (Plastic and Reconstructive Surgery abstract). A 2021 review by surgeons who perform the procedure (Del Vecchio et al., Plastic and Reconstructive Surgery) said the safety concern stems from a publication stating one in 3000 (Plastic and Reconstructive Surgery abstract) and that more recent surveys show about one in 15,000 (Plastic and Reconstructive Surgery abstract). All of these are surgeons’ answers to anonymous surveys, with the limits the 2017 paper names.
Florida is the exception the surveys miss. Working with Miami-Dade Medical Examiner autopsies and public records, Pazmiño and Garcia (Aesthetic Surgery Journal, 2023) counted 25 BBL fat embolism deaths in South Florida from January 2010 to April 2022, 14 of them after the 2018 guidelines and Florida’s 2019 subcutaneous-only rule (Aesthetic Surgery Journal abstract). 92% of those patients had surgery at high-volume, budget clinics in South Florida (Aesthetic Surgery Journal abstract). The study counts deaths, not a rate, because it has no count of South Florida cases. It cites the 2019 survey as 1/14,921 (Aesthetic Surgery Journal, PMC), not the 1 in 14,952 in that survey’s own abstract. Repeaters still print the 2018 number: a March 2026 Pulse Nigeria article says Aesthetic Surgery Journal research put the risk at about 1 in 3,000 procedures (Pulse Nigeria).
Use instead: “In 2017 an ASERF task force estimated BBL deaths at between 1:2351 and 1:6214 cases; a 2019 re-survey of surgeons reported 1 in 14,952, and South Florida medical examiner records still showed 25 deaths from 2010 to 2022.” Say these are surgeon-survey estimates, give the year, and do not compare one survey’s rate with another’s as if they measured the same thing.
“Selfies drive plastic surgery demand”
The selfie figures are shares of surgeons reporting what they see, not counts of patients. They come from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), a membership society of facial plastic surgeons, which surveys a select group of its roughly 2,200 members online each December through ACUPOLL Precision Research and does not publish how many answered (AAFPRS). In its 2019 survey 72% of members reported patients seeking procedures to look better in selfies (AAFPRS); in 2020, 75 percent (AAFPRS); in 2021, 77 percent said it was a driving factor for patients (AAFPRS); and in 2022, 79 percent agreed the selfie trend continues upward (AAFPRS). The “up 33 percent” and “up 35 percent” in those releases are changes in the share of surgeons since 2016, not rises in patients.
The idea is older than AAFPRS’s own start date. The academy says it first identified the trend in 2016, but its March 2014 release already used “selfie” in its title (that release survives only on a press-wire site we do not read), and the earliest figure we found is its poll of members on 2012, which found a 31 percent increase in requests for surgery as a result of social media photo sharing, as relayed by Practical Dermatology in March 2013 (Practical Dermatology). The “Zoom” version began in the December 2020 survey, where looking better on video calls was a new trend reported by 16 percent of members (AAFPRS), and reached 79 percent a year later, in the December 2021 survey (AAFPRS). AAFPRS’s December 2025 survey release does not mention selfies.
Use instead: “In AAFPRS’s December 2022 survey of its members, 79 percent of facial plastic surgeons agreed that wanting to look better in selfies was still trending up.” Say it is surgeons’ impressions from a member survey with no published sample size.
“Video lifts conversions 80%”
The figure is a best case from one video vendor, EyeView, about a client website, not health care. In February 2009 EyeView’s blog said viewers of its videos for one client, UMOO, were 80% more likely to become depositing users, comparing viewers with non-viewers (EyeView, archived), which does not test what adding a video does. By August 2010 Unbounce, a landing-page software seller, wrote that a study by eyeviewdigital.com showed video on landing pages can increase conversion by 80% (Unbounce, archived). Healthcare marketing carried it on with other names attached: a March 2018 Practice Builders guide for healthcare practices credits Hyperfine Media, a video agency, for landing-page video lifting conversion rates by 80 percent (Practice Builders), and a July 2026 Web Tonic page for health and wellness brands says video on healthcare landing pages lifts conversions by up to 80%, crediting WifiTalents, a statistics aggregator (Web Tonic). Both firms sell marketing.
The larger later evidence points the other way. Unbounce’s own 2021 analysis of about 35,000 customer landing pages in each of three periods (Unbounce) concluded that video appears to have a minimal or negative impact on landing-page performance (Unbounce). Its April 2025 article of landing-page examples still says landing pages with video can increase conversions by 80% (Unbounce). We found no conversion test by a plastic surgery practice. Use instead: “Unbounce’s 2021 study of about 35,000 landing pages per period found video had a minimal or negative effect; we found no conversion test by a plastic surgery practice.”
We started from the questions people search for about plastic surgeon video statistics and looked for the organization that actually produced each answer. Every figure on this page sits in an evidence ledger with its source, the exact table or paragraph it came from, the measurement period, the population measured, and the date we checked it. This edition holds 528 figures from 39 publishers.
On November 10, 2026, each sourced figure on this page was re-fetched with the fetch cache cleared and matched against the recorded wording: BLS occupation estimates and Quarterly Census of Employment and Wages files (through the BLS data API and open data files, and Internet Archive copies of bls.gov pages, because bls.gov refuses automated requests); Census Nonemployer Statistics, the 2022 Economic Census and the Annual Integrated Economic Survey (through the Census data API) and Census population files; Medicare files through data.cms.gov, within its stated crawl delay; The Aesthetic Society’s and ISAPS’s own statistics reports; FDA pages on fda.gov (some through Internet Archive copies after they were taken down) and the openFDA device event API; the Florida Statutes, Laws of Florida, Florida Administrative Code and Register, Florida House and Senate bill pages, eCFR and YouTube Help; SEC filings on EDGAR; the AAFPRS’s own releases; and journal articles (PubMed and PMC records re-read through NCBI’s E-utilities, because the pages answer scripts with a bot check). Our YouTube figures come from the YouTube Data API, our plastic surgeon counts from the NPPES NPI Registry API and our filing counts from EDGAR full-text search. We left out the American Society of Plastic Surgeons’ own site, because its terms bar collecting information with bots or other automated programs, so its annual procedure report is not quoted here; and sources whose robots rules bar AI agents, among them Meta’s ad-policy pages, MDLinx and News-Medical. Medical subject matter is reported as each source states it. Nothing here is medical advice.
We only cite the producer: government agencies, regulators, company filings and official posts, and the survey owner's own report. We do not cite statistics roundups, Statista-style aggregators, or salary sites without a public method. We did not bypass paywalls or sign-up forms; where a full report was gated, we used only the figures its publisher states publicly.
Figures marked "our calculation" are arithmetic on the cited numbers, and anyone can reproduce them:
sum of Tot_Srvcs on published 2024 provider-and-service lines of type Plastic and Reconstructive Surgery for HCPCS 15734 / sum of Tot_Srvcs on the national office and facility rows for 15734 x 100
sum of Tot_Srvcs on published 2024 provider-and-service lines of type Plastic and Reconstructive Surgery for HCPCS 14301 / sum of Tot_Srvcs on the national office and facility rows for 14301 x 100
count of distinct NPIs over all complete state and ZIP-prefix slices with a primary 2082 taxonomy and a practice-location state among the 50 states or DC
count of distinct Florida NPIs whose practice-location ZIP maps to the county (Census Bureau 2020 ZCTA-to-county relationship file; a ZIP split across counties goes to the county holding its largest land-area part)
count of distinct Florida NPIs whose practice-location ZIP maps to the county (Census Bureau 2020 ZCTA-to-county relationship file; a ZIP split across counties goes to the county holding its largest land-area part)
count of distinct Florida NPIs whose practice-location ZIP maps to the county (Census Bureau 2020 ZCTA-to-county relationship file; a ZIP split across counties goes to the county holding its largest land-area part)
on-topic videos whose channel place (own text or country setting) is a country other than the U.S. / on-topic videos x 100; channels with no place count as not outside
27.3 million / 11,852, rounded to the nearest $10 (advertising is rounded by AirSculpt to $0.1 million; not the same measure as its customer acquisition cost, FIL-050)
This edition contains no Mark Studios customer data.
Limitations
No single count of plastic surgeons exists. Our NPI count covers individual NPIs whose primary taxonomy is plastic surgery (a clinician picks the code, NPIs stay active after some retire, and 513 more list a general-surgery “plastic and reconstructive” code); Medicare counts only surgeons who billed Part B; BLS groups plastic surgeons with other surgical specialties in “Surgeons, all other” and does not count self-employed owners in that estimate; and Census and BLS count offices of all physicians together in NAICS 621111. We print the counts side by side rather than choose one.
Medicare is one slice. Original Medicare covers mostly people 65 and older and people with disabilities and does not pay for cosmetic surgery. The amounts are the surgeon’s fee only, and CMS hides small counts, so shares by specialty are lower bounds.
Procedure counts are society estimates. The Aesthetic Society builds national estimates from participating practices’ billing data and ISAPS from a survey of its members worldwide; their buttock augmentation counts differ several-fold, so read each within its own series. The American Society of Plastic Surgeons’ figures are not quoted because its site terms bar automated collection.
FDA reports are not rates. Medical device reports count reports, not patients or incidence; reporting rules changed in 2017 to 2019, so counts before and after cannot be compared.
Studies differ in design. Social media and BBL safety studies rest on surgeon surveys with low response rates, medical examiner records from one region, or samples of videos on one search day. We report what each measured and promise nothing about any surgeon, procedure or video.
Our YouTube read follows YouTube’s ranking. The 474 videos are what YouTube’s search returned for three terms (the top 200 results of each, sorted by views, with no country filter) on November 10, 2026. It is not a census of plastic surgery video. View counts are lifetime snapshots, and we sorted 234 channels by hand from their public text; board certification was not checked. Patients’ own surgery stories, titles naming celebrities or private people, and minors are published only as a class and counts, so some views cannot be recomputed from the public CSV. Sexualised titles were counted without being opened. No video was watched.
Filings count words. EDGAR full-text search finds a phrase, not a topic: in most filings that say “plastic surgeon”, plastic surgeons are customers of a device maker. We read by hand only the 2025 filings that also mention video.
Rules are dated. Statutes and rules are reported as we read them on November 10, 2026. This is not legal advice. Every “earliest we found” in the origins section rests on web pages, PubMed, EDGAR and the Internet Archive; newspaper databases were not searched.
How to cite this page
For a single figure, cite the original publisher named next to it, and link here if the verification trail is useful to your readers. Each figure has its own anchor, so you can link straight to it, for example https://www.markstudios.com/research/plastic-surgeon-video-statistics#DRV-017. To cite the page as a whole:
Mark Studios. "Plastic Surgeon Video Statistics." Last verified Nov 10, 2026. https://www.markstudios.com/research/plastic-surgeon-video-statistics
APA
Mark Studios. (2026, November 10). Plastic surgeon video statistics. https://www.markstudios.com/research/plastic-surgeon-video-statistics
MLA
“Plastic Surgeon Video Statistics.” Mark Studios, 10 Nov. 2026, www.markstudios.com/research/plastic-surgeon-video-statistics.
Chicago
Mark Studios. “Plastic Surgeon Video Statistics.” Last modified November 10, 2026. https://www.markstudios.com/research/plastic-surgeon-video-statistics.
BibTeX
@misc{markstudios_plastic_surgeon_video_statistics_2026,
author = {{Mark Studios}},
title = {{Plastic Surgeon Video Statistics}},
year = {2026},
month = nov,
url = {https://www.markstudios.com/research/plastic-surgeon-video-statistics},
note = {Last verified 2026-11-10}
}
Our calculations and the evidence table are free to reuse with attribution and a link to this page. Each underlying figure remains the claim of its original publisher, and some publishers ask for a link when their figures are reused.
American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS; surgeons' membership society), AAFPRS 2021 Survey Results (2022-02). Accessed 2026-11-10.
We re-verify every figure quarterly and when a major source publishes a new edition. The next scheduled review is February 2027. Corrections go to contact@markstudios.com.
Nov 10, 2026: First published with 528 figures from 39 publishers, each checked against its original source.
Frequently asked questions
How many plastic surgeons are there in the United States?
It depends on who counts. Our count of the NPI registry finds 6,318 active individual NPIs whose primary taxonomy is plastic surgery in the 50 states and D.C. (November 10, 2026). 3,907 plastic and reconstructive surgeons billed Medicare Part B in 2024. BLS counts 25,140 jobs in “Surgeons, all other”, a group plastic surgeons share with other surgical specialties (May 2025).
How many plastic surgeons are in Florida and in Palm Beach, Broward and Martin counties?
Florida has 550 active plastic surgery NPIs in our count of the NPI registry: 62 in Palm Beach County, 50 in Broward and 8 in Martin. NPIs are identifiers, not practices.
Who makes the most-viewed plastic surgery videos on YouTube?
Mostly surgeons. In our November 10, 2026 read of YouTube’s most-viewed results for ‘plastic surgery’, ‘plastic surgeon’ and ‘BBL’, practices’ and surgeons’ own channels drew 75.1% of on-topic views; patients’ own stories drew 1.3%.
Is a BBL really fatal in 1 in 3,000 cases?
That figure is a 2018 rounding of 2017 surgeon-survey estimates. The 2017 study gave several rates, including 1:3448 for one year, and said none was the actual rate; a 2019 re-survey of surgeons found 1 in 14,952. Researchers counted 25 BBL-related deaths in South Florida from 2010 to 2022. This is not medical advice.
What are Florida’s rules for a BBL in a doctor’s office?
As read on November 10, 2026, Fla. Stat. 458.328 lets the physician inject fat only into the subcutaneous space, requires ultrasound guidance, keeps a ratio of one physician to one patient, and requires an office doing such procedures to register with the Department of Health. This is not legal advice.
How many cosmetic surgeries are done each year?
The Aesthetic Society estimated 1,671,147 aesthetic surgical procedures in the U.S. in 2023, led by liposuction. Worldwide, ISAPS estimated nearly 17.9 million aesthetic surgical procedures by plastic surgeons in 2025.
How many breast implant lymphoma cases has the FDA counted?
The FDA counted 1,380 unique BIA-ALCL cases and 64 deaths worldwide in medical device reports and the literature through June 30, 2024; 73% of the cases involved a textured implant.