This is the annual review of what we actually performed at Centre for Surgery — drawn from our own caseload mix rather than from social media speculation or industry forecast pieces. It is a different question from “what is the most-talked-about procedure” or “what is going viral on TikTok”; it is the simpler question of what consultant plastic surgeons in a CQC-regulated London clinic spent their time doing across the year. The answer holds reasonably steady from year to year, with marginal shifts driven by underlying changes in patient demographics, available techniques, and the wider regulatory landscape.
For the wider commentary on UK cosmetic surgery trends, see our companion piece on top trends in cosmetic surgery. This page focuses specifically on what our patient caseload looked like.
The procedures that dominate by volume
Breast augmentation
Breast augmentation is consistently our highest-volume single procedure, typically accounting for around 25% of our annual caseload. The procedure has remained the most popular cosmetic surgery in the UK across BAAPS audit data for several years.
What has shifted within the breast augmentation caseload is the type of result patients now ask for. Implant size requests have moved noticeably smaller. Anatomical implants, smaller-volume implants in the 250-350cc range, and submuscular placement for thin tissue patients have become more common; very large round implants and overly augmented appearances are now distinctly less requested. The conversation at consultation is now more often about how to achieve a result that does not look obviously augmented than about how to maximise visible size.
The technical question that comes up most often in our consultations is implant pocket location (subglandular, dual plane, submuscular) — driven by the patient’s existing tissue thickness, breast shape, and lifestyle considerations rather than by surgeon preference.
Breast lift with augmentation
A consistently growing portion of our breast caseload is breast lift combined with augmentation — typically accounting for 15-20% of breast cases. The combined procedure addresses two related but distinct problems at once: the volume loss that accompanies pregnancy, breastfeeding, and weight changes, and the position changes (ptosis) that accompany those same factors plus ageing.
Where appropriate, we use a vertical (lollipop) lift technique rather than the older anchor (inverted T) approach. The vertical incision produces less visible scarring and works well for moderate ptosis, though the anchor approach is still appropriate for more significant tissue redundancy. The right technique for an individual patient depends on the degree of ptosis, breast volume, and skin quality — not on a one-size-fits-all preference.
Liposuction
Liposuction typically accounts for around 18% of our annual caseload, performed in two main contexts. The first is liposuction as a standalone procedure for genuine localised stubborn fat in patients with good baseline body composition. The second is liposuction as a component of larger procedures — combined with abdominoplasty in lipoabdominoplasty, with breast surgery in mummy makeover, or with breast augmentation to refine the chest wall and axillary region.
Within the liposuction caseload, we have seen growing interest in:
- VASER liposuction for athletic-definition results in patients already at a good baseline.
- 360 liposuction for comprehensive torso contouring.
- Submental (chin and neck) liposuction as a standalone procedure for a defined “double chin” appearance.
What we continue to emphasise at consultation: liposuction is a contouring procedure, not a weight loss procedure. The best results come from patients who are at or near their goal weight and have specific areas of stubborn fat that have not responded to lifestyle change. The clinical evidence is clear that operating outside this profile produces poorer results and higher complication rates.
Abdominoplasty
Abdominoplasty (tummy tuck) accounts for around 15% of our annual procedures, with the highest demand from two patient groups: post-pregnancy women whose abdominal wall and skin envelope have not returned to baseline, and post-weight-loss patients (both natural weight loss and now increasingly GLP-1-driven weight loss) with significant abdominal skin redundancy.
The procedure is technically demanding and the most consequential body contouring operation we perform. Variations include:
- Mini abdominoplasty — limited skin and fat excision below the umbilicus, for patients with isolated lower abdominal laxity and no muscle separation. See mini tummy tuck.
- Standard abdominoplasty — full skin and fat excision from pubis to umbilicus, rectus muscle plication where there is diastasis, umbilical repositioning. The most common variant.
- Extended (fleur-de-lis) abdominoplasty — adds a vertical incision component for circumferential redundancy, typically used post-major-weight-loss.
- Lipoabdominoplasty — combined with liposuction for refinement of flanks and adjacent areas.
Combined with breast surgery in a mummy makeover, abdominoplasty becomes part of one of our higher-volume combined procedures.
Breast implant revision
Breast implant revision has grown steadily across recent years and now consistently accounts for 12-15% of our breast caseload. The drivers:
- Time. Breast implants placed 10-20 years ago are now reaching the point where revision is appropriate — for capsular contracture, malposition, rupture, or simply for patients who want a different result than they originally chose.
- Changed preferences. Patients who chose larger implants in their 20s and 30s frequently ask for smaller replacements or removal entirely in their 40s and 50s.
- Implant explant requests — sometimes combined with breast lift to address the residual tissue redundancy — have become more common. See implant removal with breast lift.
- Revision of overseas surgery — patients who had primary augmentation in Turkey or Eastern Europe and now require correction. This subgroup accounts for a meaningful portion of our revision work.
Revision breast surgery is technically more demanding than primary surgery. The pocket may need to be modified, capsules excised partially or fully, implant size or shape changed, and skin envelope reduced or supported with a lift. The consultation for revision work is more involved than primary, with more imaging review and more careful pre-operative planning.
Procedures growing within the caseload
Gender-affirming surgery
Demand for FTM top surgery has grown consistently year on year. The procedure — bilateral mastectomy with chest masculinisation — is well-established with reliable techniques. The patient demographic for this work is significantly younger than for general cosmetic surgery, and the consultation pathway differs from cosmetic work, with more attention to psychosocial readiness and coordination with other care providers where relevant.
Intimate surgery
Labiaplasty has grown consistently in our caseload, driven both by greater openness in discussing intimate concerns and by the increasing recognition that post-pregnancy and post-puberty changes can be effectively addressed surgically. Common variations include labia minora reduction (the most frequent), clitoral hood reduction, labia majora reduction, and mons pubis liposuction or excision. These procedures are increasingly combined where multiple concerns coexist.
Post-weight-loss body contouring
The most consequential growth area in our caseload is body contouring after weight loss — both the established post-bariatric pathway and the newer post-GLP-1 pathway. Procedures here include abdominoplasty, arm lift, thigh lift, lower body lift, and breast lift, often staged over multiple operations across 6-18 months. See body contouring after weight loss for the full discussion.
The GLP-1 effect is real. Patients who had no realistic prospect of major weight loss before 2022-2023 are now arriving at the post-weight-loss contouring stage in significant numbers, and we expect this category to continue growing across 2025-2026.
Procedures that have stabilised or moderated
Brazilian butt lift (BBL) demand has not grown the way some commentators predicted in 2019-2020. The procedure continues to attract patients, and we continue to perform it for appropriate candidates — but the volumes have not matched the social-media-driven hype, and patients are more cautious now about a procedure with a real (and well-publicised) safety history.
Buccal fat removal saw a brief spike in 2022-2023 but demand has moderated. Patients are increasingly aware that the procedure is essentially irreversible and that the slim, hollowed mid-face appearance it produces may not age well into the patient’s 50s and beyond.
Very large breast implants — the requests have moved smaller, in line with the broader natural-result preference.
Non-surgical work continues to grow
Alongside the surgical caseload, our non-surgical work has grown steadily. The treatments where the clinical evidence supports their use:
- Morpheus8 and Morpheus8 Body for mild-to-moderate skin laxity.
- FaceTite and BodyTite for combined mild fat reduction and skin tightening.
- Fotona 4D as a gentler facial skin-tightening option.
- Anti-wrinkle injections and dermal fillers for facial concerns within the range supported by clinical evidence.
What we do not offer: any of the unregulated injectables marketed as “fat dissolving” or “magic” treatments outside the medical regulatory framework, devices marketed with claims that exceed published evidence, and treatments aimed at under-18s (which would in any case fall foul of the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021).
The patient profile underlying these numbers
Our patient demographic skews female (consistent with national figures showing women account for around 93% of UK BAAPS procedures), with the largest age band sitting in the 35-55 range. The most common starting point for consultation is a specific concern that the patient has carried for a defined period — usually months or years — rather than an impulse decision. The patients we operate on most often have done significant research before arriving, are clear on what they want, and are willing to engage with the realistic limits of what surgery can achieve.
We turn away a meaningful proportion of consultation patients — for some procedures, 25-40%. Reasons include unsuitable medical status, unrealistic expectations, signs of body dysmorphic concern that would not be helped by surgery, recent or active mental health issues that would benefit from stabilisation first, weight outside the appropriate range for the procedure, or signs that the patient is being pushed toward surgery by someone else rather than choosing it themselves.
Booking a consultation
If you are considering any of the procedures discussed here, the next step is an in-person consultation at our Baker Street clinic. Call 0207 993 4849 or use the contact form.
Related reading
- Top trends in cosmetic surgery
- How to lose weight before cosmetic surgery
- Cosmetic surgery before-and-after photos on social media
Centre for Surgery · CQC-regulated · GMC specialist-registered surgeons · 95–97 Baker Street, Marylebone, London W1U 6RN · 0207 993 4849 · Book a consultation · Finance from 0% APR
