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Nip/Tuck Trends Across the Nation

Zocdoc has a lot of interesting data on patient booking behavior. Zoctrends is a new series where we’ll explore data points that are timely or relevant to larger healthcare conversations. In each story, we’ll highlight a few facts and figures. The data we share is anonymized from the start, so nothing can ever be traced back to you, and the conclusions we draw only apply to Zocdoc patients, who may not be representative of the general population. For more information on Zocdoc’s privacy policy, check out our Terms of Service.


Cosmetic procedures are on the rise across the country: Between 2012 and 2017, according to the American Society for Aesthetic Plastic Surgery, the number of surgical cosmetic procedures increased by 27.6 percent, while nonsurgical procedures saw a 36.7-percent bump. Within each category, the most popular surgical procedure is breast augmentation, followed by liposuction, and the leading non-surgical treatment is Botox.

We wondered how different geographic regions compare to the country as a whole, and to one another, when it comes to cosmetic procedures. Are boob jobs and Botox all the rage from sea to shining sea? Are any procedures unusually big in only one part of this vast, sometimes vain nation? Do Southerners and Northerners save up for the same kinds of nips and tucks?

With help from Amaya Wittmaack, a data consultant and epidemiologist, we analyzed cosmetic appointments booked by 363,296 Zocdoc patients across the country between 2013 to 2018. We included both surgical and nonsurgical procedures, as well as consultations and follow-up visits related to them.

To analyze geographic trends, we compared the national average booking rates for 61 different types of cosmetic appointments to the booking rates in the Northeast, the South, the Midwest and the West. Our goal was to see which cosmetic appointments were disproportionately popular and unpopular in each area, rather than to find visit reasons with the highest raw volume. Our data has limitations, including the fact that Zocdoc patients aren’t representative of the general population. So we don’t know if our findings reflect national patient behavior trends. 

Here’s what we found

Each region had a different most popular cosmetic visit reason. By “most popular,” we mean “disproportionately popular for one region compared to the country overall.”

Cosmetic breast surgery (breast augmentation), however, was unusually unpopular in both the Midwest and the West.

Getting a little more granular

  • The West had the highest booking rates for anti-aging procedures (including filler treatments, facelifts and radio-frequency skin tightening), Botox, skin-resurfacing procedures (including dermabrasion, chemical peels and nonspecific skin resurfacing) and eyelid/eyebrow procedures (including eyelid surgery consultations and follow-up visits, and eyelid reshaping surgery or blepharoplasty, aka “getting your eyes done”). The West had the lowest rate of acne appointments.
  • The Northeast had highest booking rates for hair loss, breast augmentation and “other plastic surgery” (including plastic surgery consultations and follow-up visits, ear surgery and chin corrections), and the lowest rate of Botox.
  • The Midwest had the highest booking rates for acne and tattoo removal. In fact, Midwestern tattoo removal was the No. 1 appointment in terms of disproportionate regional popularity. 
  • The South had the lowest booking rate for tattoo removal.

The chart below shows the odds of 11 popular cosmetic visit reasons being booked in each region, with 1.00 representing average national odds.

Adding in age and gender 

We also looked at the intersection of age, gender and geographic location to see who’s booking the bulk of cosmetic procedures in different regions and what their aesthetic hang-ups are. Here are a few of our findings:

  • Of all Zocdoc patients, Midwestern men under 20 were most likely to book appointments for acne.
  • While the average age of cosmetic patients was comparable across the board, we found regional differences in age distribution. Both the Midwest and South had above-average rates of patients under 20 and over 40, while the West had a high rate of patients over 40 only and the Northeast was disproportionately heavy on patients in their 30s.
  • The gender split for cosmetic appointments was relatively even across all regions, with men booking at higher-than-average rates in the West and women booking at higher-than-average rates in the South.

It’s worth noting that acne boasted the highest booking volume by far of any cosmetic visit reason. But because acne appointments were booked at comparable rates nationally and regionally, skincare didn’t emerge as a trending visit reason anywhere. Additionally, acne toes the line of what constitutes a “cosmetic” visit reason. Typically, cosmetic procedures and treatments are elective, and thus aren’t covered by health insurance. But if a patient goes to the dermatologist with a chief complaint of acne, their care will be (or at least should be) covered.

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The Paper Gown, powered by Zocdoc, covers health and healthcare with a focus on patient experiences — inside and outside the exam room, before check-ups and after surgery, across all states of health. We strive to tell stories that help patients feel informed, empowered and understood.