Ask most people to name the plastic surgery capital of the United States, and the answers cluster fast: definitely Beverly Hills; Miami, maybe; Manhattan, without question. But, according to newly released data from the American Society of Plastic Surgeons (ASPS), the real region isn’t anywhere on that list.
ASPS’s 2025 Procedural Statistics Report, which tracks cosmetic surgery volume across five U.S. regions, shows the South Atlantic—Florida, Georgia, North Carolina, South Carolina, Virginia, Maryland, Washington D.C., Delaware and West Virginia—performed 548,025 cosmetic surgery procedures in 2025, an 8 percent increase over 2024. That total is the highest of any region in the country, narrowly surpassing the entire Western region (California, Nevada, Arizona, Utah, Colorado, New Mexico, Montana, Idaho, Wyoming, Alaska, Hawaii, Oregon and Washington), which recorded 545,948 procedures, up 7 percent.
The margin is close in percentage terms, but the result upends the usual assumption that the West Coast, anchored by Southern California’s cosmetic surgery industry, leads the nation. By contrast, the Northeast—New York, New Jersey, Pennsylvania and New England combined—was the only region to decline in 2025, falling 1 percent to 84,124 procedures, the lowest total of the five regions tracked.
Taken as a share of the national total, the numbers are more striking still. The South Atlantic region alone accounted for roughly 36 percent of the 1.5 million cosmetic procedures performed nationally in 2025. Combined with Region 4 in the ASPS breakdown—Texas and the broader Southeast (Alabama, Kentucky, Mississippi, Tennessee, Arkansas, Louisiana and Oklahoma), which logged 231,383 procedures, up 7 percent—the broader South accounted for 779,408 procedures, more than half of all cosmetic surgery performed in the U.S. last year.
Nashville plastic surgeon Daniel A. Hatef, MD attributes the growth to a combination of demographic and cultural forces.
“As Texas and the South grow in population because of more favorable weather, taxes and quality of life, so does the number of patients seeking aesthetic surgery,” says Dr. Hatef. “However, this boom is not entirely population growth-driven. These states have always had a reputation for having the most attractive people, and so there is a little bit of competition to look your best. The combination of this quality of Southern culture and the incoming migration from other states has made our aesthetic market grow by leaps and bounds.”
The regional shift coincides with a broader change in what patients are seeking nationally. According to the same ASPS report, lift procedures (including facelifts, brow lifts, arm lifts and thigh lifts) were the fastest-growing category of 2025, with increases in the double digits across several procedure types. ASPS attributed much of that growth to the rise of GLP-1 medications: 82 percent of ASPS member surgeons reported receiving consultation requests tied to GLP-1-related weight loss, as patients seek to address loose or sagging skin following rapid weight loss.
The Midwest (Illinois, Indiana, Michigan, Ohio, Wisconsin, Iowa, Kansas, Minnesota, Missouri, North Dakota, Nebraska and South Dakota) recorded 113,843 procedures in 2025, up 8 percent, the second-highest growth rate of any region despite ranking fourth in total volume.
ASPS’s regional data is based on procedures reported by its more than 11,000 board-certified member surgeons and does not capture procedures performed by non-member or non-board-certified providers, meaning the true regional totals could be higher. Still, the pattern is consistent enough, and large enough, that it points to a durable shift rather than a one-year anomaly: the country’s cosmetic surgery volume is increasingly concentrated in the South, not the coasts most associated with the industry in popular culture.
