Liposuction has overtaken breast augmentation as the world’s most popular form of cosmetic surgery amid growing concern about the implants’ links to cancer, according to newly published data from the International Society of Aesthetic Plastic Surgery (ISAPS). The contouring procedure, which uses suction to remove excess fat, accounted for 14.8% of cosmetic surgeries performed worldwide, while the equivalent figure for breast augmentation fell to just over 13%. Changing trends are part of a global surge in aesthetic medicine, which saw over 30 million surgical and non-surgical procedures carried out in 2021, a jump of 19.3% from the previous year. The data, published Tuesday as part of ISAPS latest annual survey, suggests that the cosmetic surgery industry has not only recovered from two consecutive years of Covid-related decline — it has grown far beyond pre-pandemic levels. The total number of surgical procedures rose by over 33% between 2017 and 2021, while non-surgical procedures (the most popular of which is botulinum toxin, or Botox) grew by more than 54% in the same period. The number of breast augmentations also increased marginally, by 0.5%, over those same four years. But the report’s editor, Dr. Gianluca Campiglio, pointed to a relative decline when compared to other procedures. He linked this trend to concern over BIA-ALCL, a form of non-Hodgkin’s lymphoma — a cancer of the immune system — attributed to the implants. Campiglio, who works as a plastic surgeon in Italy, also highlighted a sharp jump in the number of patients seeking to remove their breast implants, a procedure that grew by almost 50% globally in the past four years. “The lower increase in breast augmentation, and related increase in implant removals … reflects our experience following publication of reports on BIA-ALCL in the preceding year,” he said in a press release. Campiglio meanwhile heralded the growth of liposuction as part of a wider growth in interest in body contouring. More than 1.9 million liposuction procedures were recorded worldwide in 2021, a jump of almost 25% from the preceding year. Also among the most popular procedures are rhinoplasty and abdominoplasty (or nose jobs and tummy tucks). Eyelid surgery was the third-most common procedure in the world in 2021, and the most popular among men. Elsewhere in the report, thigh lifts were found to be the world’s quickest growing form of cosmetic surgery, up over 53% from 2020. The report also highlighted a “notable increase” — of over 30% — in the use of hyaluronic acid, which is commonly injected as a facial filler. As in previous years, the USA was found to have the most cosmetic surgeons in the world. The country’s approximately 7,000 surgeons in the field accounted for almost a quarter of the procedures carried out worldwide, with Brazil and Japan finishing a distant second and third at 8.9% and 5.7%, respectively. Turkey, Colombia, Mexico and Thailand were meanwhile identified as the most popular destinations for patients traveling overseas for cosmetic treatments. ISAPS, which represents over 5,600 doctors in 117 countries, based its latest survey findings on data collected from over 1,000 cosmetic surgeons. The report only included procedures carried out by certified physicians, though in 2017, Dr. Debra Johnson, the then-president of the American Society of Plastic Surgeons, told CNN that “there are a lot of non-plastic surgeons providing cosmetic services.” “We always encourage patients to do their homework, make sure that their plastic surgeon is board-certified, that they’re well-trained in the procedures that the patient wants,” she said at the time.