Demand for Noninvasive Fat Reduction Is Plummeting

This article is based on a piece that originally ran on Jolene Edgar’s Substack, Aesthetics Unfiltered.

The American Society of Plastic Surgeons’ (ASPS) annual trend-spotting report has arrived, plotting the popularity of plastic surgery and noninvasive procedures. Every year, it analyzes key shifts in aesthetic medicine—and never fails to provide a juicy surprise or two.

The 2024 installment that just came out had a few highlights: Demand for cosmetic interventions mostly held steady across the surgical and minimally invasive categories, without any major spikes. While facelifts and related glow-ups like brow lifts and lip lifts dominated on social media, the most popular plastic surgery procedures in ORs were actually butt and thigh lifts and, interestingly enough, cheek implants, each recording a three percent uptick from the previous year. In the nonsurgical realm, neuromodulators (like Botox, Xeomin, and Dysport) and hyaluronic acid fillers (such as Restylane and Juvéderm) claimed the top two spots, respectively. Next up, people were getting more skin resurfacing treatments (peels, lasers, microdermabrasion), which came in third, up six percent from 2023.

What caught my eye, though, was a far bigger number in the % CHANGE 2024 vs 2023 column: negative 40%. It’s the data equivalent of a free fall, and it was attached to the number of noninvasive fat reduction procedures—CoolSculpting, Vanquish, Kybella, and the like—performed by plastic surgeons year-over-year. They fell from 745,967 in 2023 to 447,581 in 2024.

What’s most surprising about the drop-off, according to some doctors, is the sheer fact that it took so long to transpire. When I posted on Instagram about the rapid decline, plastic surgeons replied with comments like, “Finally!” and “Thank god!” Consider the track record of these treatments—some are as famous for complications as results—and factor in the Ozempic phenomenon, and you can perhaps see why these methods for freezing or heating or otherwise killing fat cells have begun to fall from favor.

Bob Basu, MD, a board-certified plastic surgeon in Houston and the president-elect of the ASPS, attributes what he calls the “steep decline” to both the GLP-1 boom and what he sees as the modern patient’s bang-for-buck mentality.

“The rise of GLP-1 medications for weight loss has fundamentally changed the landscape,” Dr. Basu says. By targeting visceral fat—“the deep intra-abdominal fat [cushioning our organs] that no plastic surgery or device can reach,” he explains—these drugs deliver wholly transformative results. And since people who lose considerable weight are typically left with loose, hanging skin, they’re shifting focus to refining their shape and tightening their skin with both surgical nips and tucks as well as minimally invasive skin-tightening modalities, he says. (These can include radiofrequency treatments, like Renuvion and BodyTite.)