Knife over Needle

The ‘Botox boom’ has been widely documented over the past few years, with the introduction of safer non-surgical injectable treatments largely credited as being behind the rapid growth of today’s aesthetic industry.

However, according to the results of a survey by The International Society of Aesthetic Plastic Surgery (ISAPS), the number of non-surgical procedures taking place worldwide in 2017 decreased by five per cent. This included a drop of 20 per cent in facial rejuvenation procedures, as well as a one per cent drop in injectable treatments.

Interestingly, in comparison, there was an overall increase of five per cent in surgical cosmetic procedures in the same time frame. Are patients now choosing knife over needle?

Where surgery soars

Although the non-surgical aesthetics industry has boomed over recent years –partly in thanks to the evolution of treatments and impressive results – there is still very much a place for surgery. In lots of cases, in order to get the desired results, surgery is the only answer.

Here, we take a look at the key findings:

Lower body lift

Aside from breast augmentation, which continues to see a rise in procedures year-on-year, the lower body lift saw a whopping 22 per cent increase.

A lower body lift is a procedure that addresses excess fat on the abdomen and back, creating a more pleasing profile. It does this by lifting the thighs and buttocks, smoothing the appearance of cellulite dimples, tightening lower abdominal muscle structure, and resolving the other cosmetic issues in this area of the body.

This would be a suitable procedure for someone with substantial excess skin of the lower body, and there is no non-surgical alternative. Although clinical devices that use ultrasound and radiofrequency, for example, have been shown to have tightening affects on lax skin, in extreme cases surgery is the only answer.

As a nation that continues to battle with the bulge, it is fairly obvious why these procedures have seen such a rise.


Rhinoplasty also saw a considerable increase in procedures, with 11 per cent growth. Again a very common surgical procedure, rhinoplasty is still seen as the gold standard for reshaping the nose, despite non-surgical nose procedures constantly evolving. Having such a prominent place on the face, and in turn, being one of the first things people will see when they look at you, it is easy to see why the nose may be the one area in which patients are willing to invest surgically.


Injectables such as dermal fillers and botulinum toxin have been dominating the non-surgical facial cosmetic market of late. They have the capability to lift, sculpt and add volume to the face, providing patients with an overall more youthful appearance. But again, can they really beat the traditional facelift?

Facelifts saw a worldwide increase of nine per cent (465,296 procedures) in 2017, indicating their popularity, whereas injectables as a whole, saw a one per cent decrease. Normally popular fillers hyaluronic acid and poly-l-lactic acid were down by three per cent and nine per cent respectively, whereas botulinum toxin saw a small increase of one per cent.

Further to that, non-surgical skin tightening treatments saw a 15 per cent decrease, indicating that some patients are demanding more radical results.

The future

Non-surgical procedures and treatments will no doubt continue to advance, but for those looking for permanent and more obvious results, surgery appears to remain the benchmark for a significant proportion of patients.

Get a quote

Leave your details, we'll give you a callback to provide a quote