The search for beauty is universal, but in recent years social networks and glow-up culture have intensified people’s desire to look better, younger and more successful. With filters and AI image-enhancing apps, an impeccable appearance is now easier to achieve than ever. What has made it accessible to millions, however, is the development of modern, minimally invasive and, above all, more affordable cosmetic procedures.
What was once a luxury reserved for Hollywood elites has now become a routine expense for millions of Americans seeking to smooth wrinkles, enhance their features and fight the signs of ageing. In 2023, Americans spent more than $4 billion on Botox alone, according to the latest figures from the American Society of Plastic Surgeons. By 2031, the global market for this product is projected to grow to $11.29 billion, which prompted the team at RationalFX to calculate the total amount spent on Botox and other popular beauty treatments in the United States.
Analysing the latest figures from the American Society of Plastic Surgeons, we calculated that Americans spent a total of $20.4 billion in 2023 on Botox, hyaluronic acid fillers, lip injections and other beauty enhancements. There were more than 25.4 million minimally invasive procedures in the country in 2023, suggesting that 7.5% of Americans underwent an aesthetic treatment that year.
When looking at the total amount of money Americans spend on different beauty procedures, skin resurfacing emerges as the leading category. Various treatments are grouped together under “resurfacing”, including chemical peels, microneedling, dermabrasion, ablative and non-ablative laser treatments, microdermabrasion and more. In 2023, a total of 3.5 million procedures of this kind were performed and, at an average price of $1,829, the total amount spent on them came to more than $6.4 billion.
However, botulinum toxin injections are far more prevalent among Americans, with 9.48 million procedures performed in 2023 across the US. The average price of the injections fell by 17.6% to $435 in 2023 (it was $528 in 2022); therefore, $4.124 billion was spent on Botox and similar products in 2023. Hyaluronic acid fillers have also become extremely popular thanks to their non-invasive nature and effectiveness in wrinkle correction. In 2023, more than 5.29 million hyaluronic acid-based dermal fillers were administered to Americans, costing them nearly $3.786 billion. The price of HA fillers also went down by almost 10% from the previous year to an average of $715.
Laser skin treatments such as laser hair removal, IPL therapy, laser tattoo removal and laser treatment of leg veins come next in terms of total spending. In 2023, Americans spent $2.162 billion on these treatments. The average price for this group of procedures rose sharply between 2022 and 2023, jumping from an average of $582 to $697 – an increase of 19.76%.
A little over a billion dollars was also spent in the US on non-invasive skin tightening – various procedures that stimulate the skin’s own collagen production and lift sagging areas – and on different lip augmentation treatments using injectable materials such as fat, collagen or silicone fillers. More than $800 million went on non-invasive fat-reduction procedures such as cryolipolysis (the destruction of fat by freezing) or injections to reduce double chins; another $800 million was spent on non-hyaluronic acid dermal fillers, while nearly $260 million was spent on the treatment of varicose veins (sclerotherapy).
What Is Botulinum Toxin And Why Is It So Popular?
Popular under the brand name Botox, the injections contain the muscle relaxant botulinum toxin, either on its own or in combination with other substances. This neurotoxic protein, produced by the bacterium Clostridium botulinum, can cause botulism in large quantities but simply relaxes muscles when used in small doses.
The effect is coveted by millions because it apparently reverses ageing, creating a youthful appearance. It does this by blocking the nerve signals that make muscles contract. When injected correctly into the face, the toxin relaxes the facial muscles and reduces unwanted wrinkles. If the dosage is miscalculated, however, the toxin can paralyse parts of the face, creating the so-called “frozen face”. Taking up to a week to develop fully, the effect lasts only a few months as the body metabolises the injected substance over time.
The cost of botulinum toxin injections can vary widely; each unit typically ranges from $10 to $18 and most procedures require between 30 and 40 units. Therefore, the total cost of the treatment can range from $300 to $600. Botox has to be reapplied every 5-6 months to maintain the effect, and because it is a minor, minimally invasive procedure, recovery is quick. The usual redness, swelling and bruising generally subside within a day or two.
Injected in much smaller amounts, micro-Botox, or Baby Botox, is now trending among younger generations for its reportedly natural-looking results. It is often chosen by individuals in their 20s who want to tackle early signs of ageing yet maintain features with no visible sign of treatment. Similar to Baby Botox, the so-called “preventative Botox” has also gone viral, claiming to stop wrinkles appearing in the first place.
Middle-Aged Americans Are the Most Common Botox Users
As expected, more than half (5.4 million or 57%) of all botulinum toxin injections in 2023 were performed on men and women in their 40s and 50s. The second most common age group for the anti-wrinkle treatment is people aged 55 to 69, at 23%. Overall, the botulinum toxin is most prevalent among middle-aged Americans: 80% of all Botox procedures were carried out on patients between 40 and 69.
More than 1.7 million Botox injections were administered to Americans aged 30 to 39, accounting for roughly 18.5% of the total. A little over 137,000 procedures were performed on patients aged 20 to 29 (around 1.5%). Interestingly, 27.5 thousand teenagers (19 and younger) also received Botox in 2023. While this may seem unusual, it indicates the growing popularity of beauty trends such as Baby Botox and preventative Botox on social media.
Of course, we should not forget that beyond its anti-ageing effects, botulinum toxin has many other cosmetic and therapeutic uses; it is used to treat chronic migraine, spastic disorders and neurological conditions affecting the neck and various other muscles.
Botox vs. Hyaluronic Acid Fillers
The only minimally invasive cosmetic treatment that comes close in popularity to botulinum toxin is hyaluronic acid-based dermal fillers. In 2023, 5.3 million of these procedures were performed on Americans, with just over half (50.3%) administered to patients aged 40 to 54. Around 35.5% of all HA fillers were given to men and women aged 55 to 69, making this treatment the second most popular beauty procedure among middle-aged Americans. In total, 85.8% of all hyaluronic acid fillers were injected into people between 40 and 69.
So, why is Botox more popular than hyaluronic-acid dermal fillers? Both treatments have proven anti-wrinkle effects – HA fillers add volume to wrinkles and areas of the face that have lost fullness, while botulinum toxin smooths wrinkles caused by facial expressions. However, the safety profiles of the two treatments differ. Botox is a toxin that may cause various side effects, especially when not administered by a licensed professional. Fillers, on the other hand, can lead to lumps or overfilling.
While botulinum toxin injections need to be performed every three or four months, the effects of hyaluronic acid-based fillers last longer – 6 to 18 months. Both treatments are generally safe, with few side effects, and neither is permanent. Downtime for fillers may be slightly longer, as the injector sometimes needs to shape and “sculpt” the material. Another advantage of Botox is its price: it costs $435 on average, compared with $715 for HA fillers.
Other Popular Beauty Treatments
Botox, hyaluronic acid fillers, skin resurfacing, laser skin treatments and non-hyaluronic acid fillers are the most popular cosmetic procedures in the United States. In 2023, more than 9.4 million botulinum toxin injections were performed nationwide, followed by over 5 million hyaluronic acid fillers. However, this is just a small part of the vast aesthetics industry that sees millions of Americans undergo dozens of different procedures, from facials to lip enlargement and laser treatments.
Skin resurfacing – a variety of procedures such as dermabrasion, chemical peels, ablative and non-ablative lasers and microdermabrasion – is particularly popular among those aged 55 to 69. A total of 3.5 million procedures were performed in 2023, and more than 2 million of them were carried out on patients in this age bracket. For those aged 70 and above, skin resurfacing is also the most popular procedure, with around 560,000 carried out in 2023.
Laser skin treatments rank fourth, with 3.1 million performed across the United States in 2023. This group of treatments includes laser hair removal, IPL therapy, laser tattoo removal and even laser treatment of leg veins. They are most frequently sought by individuals aged 40 to 54, with a little over a million procedures administered to this age group in 2023.
Lip augmentation procedures, specifically those using injectable products, also remain popular. In 2023, more than 1.4 million procedures were performed, but no data are available on the specific age groups or sexes that sought this treatment.
Non-hyaluronic acid fillers, which are typically used to maintain youthful skin for several years, last longer than most minimally invasive procedures and are therefore quite popular. These dermal fillers do not contain hyaluronic acid and may use calcium hydroxylapatite (CaHA), poly-L-lactic acid or other active ingredients. They are most commonly used by patients aged 40 to 54, with 430,751 fillers administered to this group; another 369,614 were given to Americans aged 55 to 69.
Plastic Surgeries Also on the Rise
Botox and hyaluronic acid-based dermal fillers, along with other non- or minimally invasive cosmetic procedures, have become the go-to options for achieving a more youthful appearance. However, plastic surgeries continue to thrive, with Americans undergoing a total of 1,575,244 cosmetic surgeries in 2023 at a cost of $9.32 billion. Between 2022 and 2023, these surgeries increased by 5.13%. Although they are much more expensive and invasive in nature – suggesting overall higher health risks and longer downtime – many individuals choose them for more dramatic transformations that go beyond simple wrinkle removal.
In 2023, liposuction dominated the cosmetic surgery market with 347,782 procedures performed at a total cost of $1.64 billion. This suggests that roughly one in a thousand Americans underwent liposuction in 2023. Other procedures that also exceeded $1 billion in expenditure include breast implants (304,181 surgeries), tummy tucks (170,110) and breast lifts (153,600). Breast implants are particularly popular among people aged 30-39, with more than 100,000 procedures carried out in this age group. In addition, 120,747 eyelid surgeries were performed in 2023, and more than half of them were on patients aged 55 to 69.
Men Are Also Interested in Beauty Procedures
The market for cosmetic enhancements has long been dominated by women, with men seldom taking part. Nevertheless, our report shows that, despite the relatively low numbers, men are increasingly interested in improving or changing their looks through cosmetic surgery and various non-invasive procedures.
Botulinum toxin injections emerge as the most popular cosmetic procedure among men. More than 569,000 men underwent the treatment in 2023, followed by laser skin treatments (487,349), skin resurfacing (242,600) and hyaluronic acid fillers (145,933). Compared with the 569,000 Botox injections given to men, 8.1 million women received the anti-wrinkle substance. This means that only 6.01% of all botulinum toxin injections in the US were administered to men in 2023.
The 490,000 laser treatments performed on men in 2023 represent 15.71% of all procedures of this type. Interestingly, more than 11% of all non-HA fillers – 105,706 out of 818,843 – were administered to men.
When it comes to plastic surgery, more than 95,000 operations were performed on men in the US in 2023, accounting for roughly 6% of all cosmetic surgeries that year. With 23,831 procedures, breast reduction for gynaecomastia (an enlargement of the breast tissue caused by hormonal imbalances) was the most popular surgery among men. The second most common procedure was liposuction – 20,879 men underwent it (6% of all liposuctions in 2023). Another 15,397 men had eyelid surgery (12.75% of all procedures of this type). Interestingly, 430 male patients had a buttock augmentation procedure, known as a Brazilian butt lift, and a further 78 buttock implant surgeries were carried out on men, representing 6.32% of all such procedures.
Percentage-wise, the picture is quite different. Just over a third of all ear surgeries (33.61%) were carried out on men, as were more than a quarter (25.86%) of all cheek implant procedures. Figures also show a male interest in achieving the chiselled jawline look, with 22.06% of all chin augmentation surgeries in 2023 performed on men. In addition, more than 12% of all eyelid surgeries and neck lifts were performed on men, while around 14.5% of all nose jobs (rhinoplasty) involved male patients.
Methodology
We analysed the information provided by the American Society of Plastic Surgeons for 2022 and 2023 regarding plastic surgeries and minimally invasive cosmetic procedures. We calculated the amount of money spent on different procedures by multiplying their average cost by the number of procedures performed. We then compared the figures for men and women and for patients in different age groups.