By Ashley Wong

Los Angeles is known for boob jobs. Miami is where people go for Brazilian butt lifts. New York is all about the face-lift. And everything might not be bigger in Texas after all.

Aesthetic trends in cosmetic surgery can vary widely by region, according to plastic surgeons across the country and data from the American Society of Plastic Surgeons.

The group's 2024 report on cosmetic surgery trends offered a region-by-region breakdown of the most requested procedures nationwide. For ASPS member surgeons, 43% of cosmetic butt-implant procedures performed were done in central Southern states like Texas and Kentucky, while 33% of chin augmentations performed were done in the Midwest region, which includes states including Ohio, Minnesota and Kansas.

Nationwide, liposuction was the top request last year, according to the report. And with the increased ease of access and popularity of GLP-1 drugs such as Ozempic and Mounjaro for weight loss, surgeons said patients everywhere were asking to get smaller. They also ascribed a spike in excess-skin removal and lifts in areas such as breasts and thighs to the rise of weight-loss drugs.

We spoke to 14 surgeons in 10 states about the most popular trends and what they were seeing in their own practices. Here's a look at the data and trends across different regions.

Outdoorsy features in Mountain states and the West Coast

People living in the mountain states including Colorado and Utah tend to request procedures that give them a sleek, trim frame, several surgeons said. Residents want to look like they're getting their fresh air and staying active, without calling attention to work they've had done.

In Park City, Utah, "you see very fit, small implants, very tight abdomen, built bodies," said Dr. Renato Saltz, a plastic surgeon who works there and in Salt Lake City. "Everybody is riding their bikes, running, hiking. In the winter, everybody's skiing." He said that facial procedures, breast augmentations and tummy tucks were in-demand with his patients in Utah.

Utah has one of the highest numbers of plastic surgeons per capita in the country. Patients in the state often ask for a more natural look, surgeons there said.

"Every single face I do here, patients from here, they always remind me, 'Renato, I'm here. I'm not in California. I'm not in Florida. Don't pull too much!'" Saltz said.

The report found that 37% of the country's breast augmentations -- already a popular procedure nationwide -- were recorded by ASPS member surgeons in the Pacific and mountain states, such as California and Utah.

On the West Coast, particularly in Southern California, surgeons said that they've noticed breast implants are often vastly bigger than the country's average.

"This is a well-known thing," Dr. Kelly Killeen, a plastic surgeon in Beverly Hills, said. "Even here in Southern California, the Orange County surgeons put in implants that are 400 or 500 CCs [cubic centimeters], and the Los Angeles plastic surgeons are putting implants in that are 200 to 300 CCs."

Despite the larger-than-average implant sizes, some California surgeons also said they were seeing more patients asking for their previous breast augmentations to be shrunken down or removed entirely -- part of a broader nationwide shift toward smaller implants.

Subtlety and youth in the Northeast and Midwest

Body-contouring procedures such as tummy tucks, liposuction and breast lifts are in high demand in the Northeast and parts of the Midwest, surgeons said. The data from the American Society of Plastic Surgeons also showed that lifts to the lower part of the body, such as the thighs, were among the most popular body procedures in those two regions. Top facial procedures included chin augmentations, particularly in the Midwest area, face-lifts and rhinoplasties, also known as nose jobs.

Plastic surgeons in the Northeast said their patients preferred a trim, less curvy body shape. That's why the Brazilian butt lift is not a top request for Northeast surgeons overall, some surgeons there said. Patients coming to Dr. Naveen Ahuja, a plastic surgeon in New Jersey, often ask him to make them look younger, in more natural ways. His top requests from patients are tummy tucks, breast augmentations and liposuction. Rhinoplasties are also a common request, he said.

"When you get to Southern California and you get to Miami, I think you get a preference for a more aggressive form of correction, more products, tighter lift, that kind of thing, more than I typically see here," Ahuja said. "My colleagues, when I look at their before-and-afters from those locations, I'd say there's more of a prevalence of that."

Some patients have asked him for aggressive transformations, but for the most part, they want softer changes.

"There has been a trend towards 'less is more,'" said Dr. Sameer Patel, plastic surgery chief at Philadelphia's Temple University Hospital and president of the Robert H. Ivy Pennsylvania Plastic Surgery Society. "For instance, there's smaller breast implants, less filler. So again, enhancement, but not huge implants or unnatural results."

Dramatic transformations in the South And Southeast

Texas is populous and geographically large, painting a more complicated picture. Dr. Kristy Hamilton, a Houston plastic surgeon, said that at a plastic surgery training meeting in July where she met surgeons from all over the country, she learned that the breast-implant sizes for patients in Los Angeles were far bigger than the ones she's been inserting recently in Houston.

"If you see the implants that had been placed 20 years ago with patients that are now coming in for revisions, they are big," Hamilton said, referring to patients who come to her to shrink their previous breast augmentations through revision or removal of implants.

Across the board, she said, augmentations at her practice have gotten smaller. "There's the saying, 'Everything is bigger in Texas,' but that's not what my patients coming in now are looking for," she said.

"Texas is diverse," said Dr. Henry Mentz, a plastic surgeon in Houston. By his observations, Austin and Houston residents typically prefer a more natural look, while those in Dallas go for more dramatic changes.

In Florida, a curvier silhouette is still prized, said surgeons practicing in the state. Miami, a body-conscious and tanning-friendly party destination, is known among plastic surgeons as a major hub for augmentations and lifts as well as large-volume implants or fat transfers. 50% of butt augmentations performed by ASPS surgeons using fat grafts -- fat transfers from one part of the body to another -- were done in the Southeast region in 2024, according to data from the American Society of Plastic Surgeons.

"In Florida they want high-end results, and they don't care if someone goes, 'Oh, my God, you got a face-lift!'" said Dr. Norman Rowe, a plastic surgeon who operates clinics in Palm Beach, New York and New Jersey . "If that ever happened in New York, if one of my patients' friends said that to him, I'd be out of business."

In Palm Beach, Rowe said the majority of his requests were face-lifts, breast augmentations and blepharoplasties -- an increasingly popular type of eyelid surgery with a fast recovery period. Most patients in Florida favor surgery over less invasive techniques like Botox or lasers, he added.

Requests for plastic surgery at his clinic in Palm Beach exploded, he noted, just after Donald Trump won the 2024 presidential election, and the number of patients rolling in since then has stayed high. (Trump often spends time at his estate in Mar-a-Lago.)

"As soon as he won in November, there were people coming in wanting procedures done," Rowe said. "And they want more of an aggressive [lift]. They're more into looking chiseled, they want their jawline super defined."

Not every surgeon believed in hard-and-fast visual cues. Dr. Sara Dickie, a plastic surgeon in the Chicago area, said, "I don't go to a region and say, 'Oh that person looks like they're from the Midwest.'"

Write to Ashley Wong at ashley.wong@wsj.com

(END) Dow Jones Newswires

September 24, 2025 20:00 ET (00:00 GMT)

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