Dr. Stephen Mulholland's Plastic Surgery Blog

International Cosmetic Surgery Statistics for 2013

July 28th, 2014

International cosmetic surgery statistics 2013

The International Society of Aesthetic Plastic Surgeons (ISAPS) collected data from 1,567 plastic surgeons for their 2013 international study. They collected data to see what and how many procedures were performed in various countries around the world. Participating countries included the United States, Brazil, Mexico, Germany, Spain, Colombia, Italy, Venezuela, Argentina and Iran. We went through the data and rounded up some interesting highlights so you don’t have to:

  • The total number of surgical and non-surgical cosmetic procedures performed worldwide in 2013 exceeds 23 million.
  • The most popular procedure was Botulinum Toxin (this includes Botox, Dysport and Xeomin) overall.
  • What are the top five countries where the most surgical and non-surgical procedures happen? It’s the United States, Brazil, Mexico, Germany and Spain.
  • The most frequently performed cosmetic surgical procedures were breast augmentationliposuctionblepharoplasty, lipostructure and rhinoplasty.
  • Penile enlargement was the least performed surgical procedure worldwide. Germany tops this list with 2,786 procedures performed.
  • The USA topped the list by far with their total of non-surgical procedures performed; there were 2,554,275 non-surgical procedures performed. The USA accounts for 21.4% of the worldwide total, while countries like Brazil make up 5.5% of the worldwide total.
  • The countries with the least plastic surgeons are Saudi Arabia, Portugal and Israel. Saudi Arabia has 226, Portugal has 176 and Israel has 170. These numbers are small compared to the US (6,133), Brazil (5,473) and China (2,800).

Older Men Undergo Cosmetic Surgery to Compete at Work & Dating Scene

July 23rd, 2014

Older men are undergoing cosmetic surgery to compete at work and dating scene

Throw out the stereotypes that women are the ones fretting over their wrinkles, because today more men are more aware of their signs of aging and are willing to correct them. Men’s interest in cosmetic surgery has persisted due to a few key reasons; men above their 40s and 50s want to ensure they look youthful enough to compete in the workplace. They also want to make sure they look good enough to attract younger women.

“Men are being subject, as women have been for so long, to ageism,” says Dr. Mulholland, a Toronto plastic surgeon. He says a lot of the men he sees are in upper management or senior positions. “These men are seeing signs of aging that make them look tired, which projects lack of confidence or lack of ability to negotiate the boardroom, and they have these young guys nipping at their heels,” he says. “The older CEO is no longer the model.”

The other reason for men’s interest in the restoration of their youth and looks concerns attracting younger women. Men in their 60s who get divorced are back on the market for single ladies—but they’re usually looking for the younger ones in their 30s or 40s. This reason alone drives these men to clinics to liven up their appearance to get a woman’s attention.

One of the most common non-surgical procedures men request for is Botox at Dr. Mulholland’s clinic, SpaMedica. Many men prefer not to undergo surgical procedures, so procedures involving laser energy to smoothen out wrinkles and the skin are highly popular.

The most common surgical procedures for men, however, have been documented by The American Society of Plastic Surgeons. Their study in 2013 revealed that rhinoplasty was the number one procedure for men that year. Other procedures that were high on the list include blepharoplasty (eyelid surgery), liposuction and gynecomastia (male breast reduction).

In the highly competitive and visual society we live in today, these findings shouldn’t be too surprising. The men today are more than willing to rejuvenate or fix their features to get a leg up in the boardroom or bedroom.

6 Celebrity Nose Jobs

July 22nd, 2014

Rhinoplasty is a cosmetic surgery procedure performed on the nose to change its shape, form and structure. While it can change the look of one’s nose, the procedure can improve the nose’s functions and airway flow to allow better breathing. People get rhinoplasty procedures (commonly known as nose jobs) for various reasons—they may have spent most of their lives loathing the overall appearance of their nose or they need to correct breathing issues that have persisted for years. Regardless of the reason for the procedure, picking an experienced board-certified plastic surgeon is one of the most important decisions.

There are two types of rhinoplasty procedures; open and closed. In an open rhinoplasty, surgeons cut the nostrils and open up the nose to see the full spectrum of the nose so surgeons can easily change and work on the nasal anatomy. Open rhinoplasty offers better visualization for surgeons and allows them to work on finer details. A closed rhinoplasty, on the other hand, involves internal incisions. There’s less chance of scarring in closed rhinoplasty. This type is best for those who want minimal work done such as refining the tip or removing a bump.

Some celebrities have been open about getting nose jobs because they had to modify them to fix their breathing (it’s also a very convenient excuse for celebrities to get work done). Some are reluctant to admit it while others have spoken freely about it like Jennifer Aniston. Here’s six celebrities who had nose jobs:

Eva Longoria's Nose JobEva Longoria


Alicia Keys


Blake Lively


Jennifer Aniston


Patrick Dempsey

Victoria Beckham's Nose Job

Victoria Beckham

The Difference Between Breast Implant Types and Shapes

July 17th, 2014

Breast augmentation

Deciding to have a breast augmentation procedure done can be a personal, exciting and confusing experience all at once. After deciding that this is the right decision, women have to think about what type of implant they want, what shape they want and what size they’d like. It can be an overwhelming process, especially when there are so many options available. Usually before the procedure itself, surgeons will use Vectra 3D breast imaging to show patients how they will look like with different breast implant shapes and sizes. Below, we have listed the most commonly used terms in breast augmentation if you’re interested in the procedure.

Saline breast implants

Saline implants are filled with sterile salt water. When they’re about to be implanted, the implants are empty but then filled with the fluid once they’re in place. If the implant shell were to leak, the saline implant collapses, and the saline will be absorbed and naturally expelled by the body. Saline breast implants are available to women 18 and older for breast augmentation and to women of any age for breast reconstruction.

Silicone breast implants

Silicone implants are pre-filled with silicone gel. The gel resembles closely to natural breast tissue and human fat. Most women feel that silicone breast implants look and feel more like natural breast tissue. Women who are 22 years old and above can have silicone breast implants. Women of any age can choose this option for breast reconstruction.

Breasts continue to develop until a woman reaches her late teens or 20s so that’s why there’s an age requirement for this procedure.

Round breast implants

Round shaped breast implants is the most common shape women use in breast augmentation. Women tend to choose this shape because it gives breasts ample lift, fullness and cleavage. Since the shape is round, there’s no risk of the breasts looking irregular if the implants were to shift and move around. While some women prefer the volume and shape these implants provide, others want a more natural looking breast implant shape such as the teardrop shape.

Gummy bear breast implants (or teardrop cohesive gel breast implants)

These implants are called gummy bear breast implants because they maintain their shape even if the implant shell breaks. The silicone gel inside the implant is thicker and more cohesive than regular silicone gel implants. Because of their firmness, these implants are believed to be less likely to break.

Gummy bear implants are shapely, like a teardrop shape. There’s more projection at the bottom and the implant tapers towards the top. Since the silicone is firmer than traditional silicone, the implants can be felt more easily compared to round-shaped implants in thin women.

Hand and Engagement Ring Selfies on the Rise

July 17th, 2014

Ellevate Cover

Dr. Ingrid Jarvis, one of our cosmetic dermatologists at SpaMedica, was featured in Elevate Magazine talking about the hand and engagement ring selfies trend. Announcements of an engagement is now very commonly done through posting photos of the sparkling ring and perfectly groomed nails and wrinkle-free hands. We’re living in a time where it’s not only rings that are being judged—the hands and fingers the ring rests on are judged too. With this explosion of the trend, more women are filing into cosmetic surgery clinics to get fillers and laser treatments on their hands and fingers. Dr. Jarvis talks about the different treatments that are available and what soon-to-be brides should expect when they come in for treatments.

Read this article here.

How to Look Fresh and Youthful

July 16th, 2014

Dr. Mulholland, a Toronto cosmetic surgeon, sees several women at his clinic SpaMedica for different procedures from Botox to liposuction. Much of these women often want to maintain their youth or get it back. Sometimes, though, women don’t even have to have cosmetic surgery to look youthful; looking healthy and young starts with taking care of the skin and hair, according to Dr. Mulholland. After seeing thousands of clients, he has advice on how women should take care of their skin and hair if looking young and fresh is how they want to present themselves.


Healthy skin

Dr. Mulholland advises women to take care of their skin by avoiding the sun or including physician-directed skin care products in their skincare regime.

Dilated pores, spider veins and brown spots are other revealers of advanced age. Non-surgical treatments like FotoFacials and Crystal Peels can reduce these unwanted skin problems through radio frequency, intense pulsed light and infrared energy. This energy gently targets these skin problems over a course of treatments.

Other common problems are dark circles or lines underneath eyes. Sometimes, people have a combination of both. Dark circles are often hereditary and can be treated at a physician’s office. Lines can give someone a little character, but if they don’t want them at all, again, a visit to a physician’s office can eliminate them.

Proper makeup appliance with good cosmetics accentuates naturally attractive facial features. “People don’t have to be makeup experts, but when they see someone wearing bad makeup on the streets, they know it when they see it,” says Dr. Mulholland. Makeup trends are constantly changing, but seeing the skin instead of a mask full of makeup is key to looking youthful and fresh. Instead of hiding features, try to accentuate them.


Healthy hair

Dr. Mulholland says that very still, stiff-looking and over-coiffured hair can age a woman. Going overboard with hairspray or not maintaining hair at all can create an undesirable impression. Instead, having healthy hair that appropriately frames a woman’s face shape and features can shave off years of a woman’s appearance.

For some women, thinning hair and loss of hair becomes an issue as they age. This may happen due to hereditary factors, stress, pregnancy or PCOS. While people think that hair transplants are usually performed on men, more and more women are seeking hair transplants to regain hair volume. Not only does this help women regain some confidence, it automatically makes them look more youthful again.

Travelling Abroad For Cosmetic Surgery

July 15th, 2014

Foreigners head to Brazil for cosmetic surgery

Countries in Asia, South America and Europe are taking advantage of the emergence of medical tourism by welcoming tourists and happily performing cosmetic procedures at competitive prices. Instead of paying full prices for procedures in North America or the U.K, people are flying to developing countries to save thousands of dollars on their surgeries. So, how much do surgeries actually cost in other countries? Let’s just say if someone would have to pay anywhere from $6000 to $12,000 for a facelift in Canada, the same procedure would start from $1,900 in Brazil. Here are some countries that commonly see foreigners for cosmetic procedures:

South Korea

South Korea is the cosmetic surgery hub in Asia. Cosmetic surgery is so common (there’s a district called Gangnam with 500 closely located clinics) and sought out here that according to statistics, South Koreans are the most cosmetically enhanced people in the world.  More and more visitors are coming into the country annually as they become aware of South Korea’s qualified medical practitioners and facilities—it’s projected that 400,000 visitors will visit the country by 2015 strictly for medical procedures.


Brazil is home to the most cosmetic surgeons in the world. Having cosmetic surgery done here is quite common and is viewed as a norm. An ABC News article reports that the Brazilian government has made cosmetic surgeries deductible from income tax and that discounts are backdated for surgeries as early as 2004. For foreigners who travel here to get a nip and tuck, they’re usually treated very well and are met with no judgment—after all, cosmetic surgery is a cultural norm here and is even seen as a symbol of status.


When Colombia saw large improvements in their safety and tourism, they began building facilities strictly for medical tourists. There are about 500,000 cosmetic surgeries performed in Colombia each year, which ranks as the second highest number of cosmetic surgeries in Latin America. The number of tourists coming to Colombia is predicted to continually increase, but right now there’s 20,000 tourists coming each year for surgeries. There are even package deals available to foreigners with an apartment, housekeeper, chef and a combination of three different surgeries for $10,000.


Iran is known for an extensive network of highly-equipped hospitals, medical specialists and nurses. Iran sees at least 30,000 medical tourists per year, and that’s not counting the 200,000 tourists who visit the country for health, wellness and spa purposes. Iran also carries another title; their country has the highest rate of nose jobs in the world.

Let’s not forget to raise the issue of safety and risks. Safety can be a risk factor when travelling abroad for cosmetic surgery. “Sometimes unqualified surgeons, or people that aren’t even doctors, try to do procedures without the expertise or the credentials which increases the risk for patients,” says Dr. Lina Triana, president of the Colombian Plastic Surgery Society, who was quoted in Colombia Reports. The internet and technology age allows anyone to create websites to advertise skills and services they might not even be capable of; it’s always best to do extensive research before agreeing to go under the knife, even if it’s at a cheaper price.

Buy Cosmetic Surgery Procedures With Inheritance Money

July 14th, 2014

Buy cosmetic surgery procedures with inheritance money

How do you feel about using inheritance money for cosmetic surgery procedures? Some people have decided to use this money to enhance their appearance.

According to Beauty4Media, a cosmetic surgery review website called Good Surgeon Guide has seen an increase in people paying for their cosmetic procedures from money that was left for them by a relative who has passed away.

Inheritance money is traditionally spent on houses and vacations or it could be put away in savings and stocks. However, there are people who struggle with managing their inheritance money or they immediately spend it all. These new findings show that some people feel more inclined to spend the cash on revamping their looks rather than their homes.

One woman did just this when her parents passed away. She was an only child who nursed her elderly parents by herself. After they passed away, their estate was passed over to their daughter. She decided she wanted to rejuvenate herself and her looks through cosmetic surgery. She had the last few years of her life on hold to care for parents, so she decided to jump back into her life in a bold way.

Beauty4Media reports these procedures are some of the most common requests people ask for when they are paying with inheritance money: faceliftsbreast liftsbreast implantsliposuction and tummy tucks.

Some people may think this isn’t a good way to spend the money, but if the money is in that person’s hands and getting cosmetic surgery makes them happy, then that’s what counts.

SpaMedica’s Laser Hair Removal Technology featured on The Morning Show

July 11th, 2014

SpaMedica on The Morning Show

Dr. Krajden and the SpaMedica team were featured on The Morning Show today. The Morning Show can be seen on weekdays from 6am to 9am in Toronto. Topics such as news, weather and entertainment are covered on the show as well as interviews with celebrities and news makers. On today’s show, the SpaMedica team showcased our laser hair removal technology which includes the Vectus, InMode and Light Sheer Duet system.

Dr. Krajden noted the speed and lack of pain in laser hair removal. To treat one leg, it takes only four minutes. There’s no topical required which means the procedure is painless. People of all skin types and hair types can have laser hair removal done. After six treatments, patients can see an 80% reduction of hair. Our technology makes hair removal painless and quick, so there’s no excuse to skip out on it if you’re looking to permanently remove some hair.


5 Facts on Botox

July 11th, 2014

Botox Injections

In 2012, facial rejuvenation procedures experienced a large growth. In this year, there were 6.1 million Botox injections, which is the highest number to date. It shouldn’t be shocking to note that Botox is the number one minimally invasive cosmetic procedure performed every year. Here are some facts to get you in the know on this non-surgical procedure.

  1. In 2004, the U.S. granted approval to Botox to treat symptoms of severe underarm sweating in people aged 18 and over.
  2. During shipment process, Botox must be very cold and contained in dry ice containers. It arrives in dry power form which is then mixed with liquid before it’s injected.
  3. The U.S. approves five different uses for Botox while other countries have approved 16 uses. In other countries, some uses that Botox treats include: eyelid spasms, teeth griding and vocal cord disorders.
  4. Botox is also used to treat excessive sweating (hyperhidrosis) and overactive bladders
  5. It can take about 4-7 days for Botox to take effect on the treated area