????實際上，這是巴西在整形手術數量上首次超過美國。雖然美國擁有全球15.2%的整形外科醫生（巴西正在縮小和美國的差距，目前有13.6%的整形醫生），但巴西進行的美容整形手術數量占全球12.9%，高于美國的12.5%。不要把這些和非手術整形搞混了——非手術整形正以前所未有的速度增長，而且美國在這方面遙遙領先于其他國家。這種方法耗時短，價格低，具體做法有注射保適妥（Botox）或軟組織填充劑，使用激光美膚治療儀、緊膚治療儀、燃脂纖體儀和冷凍溶脂儀。

????ISAPS副總裁雷納托?薩爾茨在巴西長大。他說，2008-2009年的經濟危機造成整形手術增長放緩，從那以后，非手術整形一直處于高速發展狀態。

????薩爾茨指出：“整形者無力接受花費很高的手術，但他們仍有所動作。有些進行了激光治療，有些注射了保適妥，他們依然想變得好看，并沒有受到金融危機的影響?！?/p>

????2010年，美國的整形手術數量終于再次上升，非手術整形數量也繼續增長。美國美容整形外科學會（ASAPS）的數據顯示，2013年美國人在美容整形方面的支出超過了120億美元，比2012年增長了12%，其中約50億美元花在非手術整形上。

????薩爾茨說：“從我的實際經驗來看，越來越多的人并不想真的動手術，有人是不愿意花這筆錢，有人是不愿意等待。來的人在整形過程中都在玩筆記本電腦，離開時他們肚子上的脂肪就會減少25%。這些獲得認證的手術近5年，或者近10年才出現。我們看到的變化令人驚訝。”

????不過，如果問霍爾沃森，他會告訴你，人們對非手術整形普遍缺乏了解，這對整形醫生來說是令人沮喪的一件事。

????霍爾沃森說：“電視真人秀和媒體已經讓人們看到了許多整形手術，提高了人們的整形意識和接受度。以前人們總是要隱瞞這種事情，但現在人們對它的開放程度要高了很多，接受整形手術的程度也高了很多?！?/p>

????他同時指出：“[整形手術真人秀]不利的一面在于它們讓公眾越發認為整形手術就是美容整形?？匆幌挛覀冞@個領域的普通記錄就會發現，只有十分之一的整形是美容手術。我們治療燒傷，做胸部再造，修復頭部和面部損傷，做組織移植，無所不包。這也是讓我頭疼的問題之一，當別人在雞尾酒會上問我是干什么的，我總是得對整形醫生這個詞做許多解釋，不知道會不會這輩子一直這樣?！?/p>

????在薩爾茨看來，產生影響的不光是電視，還有網絡。

????薩爾茨指出：“有了互聯網以后，美就變得全球化了。這讓一些巴西人想變得像安吉麗娜?朱莉。在美國，增長最快的領域之一是隆臀；在巴西則是隆胸。我想這在很大程度上都和社交媒體以及Facebook有關。受互聯網影響，現在的整形者變得不一樣了；有時候他們覺得他們比你知道的還多。他們已經做了研究，如果你不能像里約的某位醫生一樣給他們做新式隆臀，那他們就會飛到里約去?！?/p>

????正如大家所想的那樣，當霍爾沃森在社交場合說他是一名整形醫生，人們的立即反應往往是“鼻子”和“胸部”整形?，F在，ISAPS中最引人注目的那些數據表明，人們也許還會問起男性生殖器整形。（財富中文網）

????譯者：Charlie

????This was in fact the first time ever that Brazil topped the U.S. for most surgical procedures performed. Although America has 15.2% of the world’s plastic surgeons (Brazil is catching up, with 13.6%), Brazil had 12.9% of the world’s aesthetic/cosmetic surgical procedures, compared to 12.5% by the U.S. That’s not to be confused with non-surgical procedures, which have risen more than ever before and which the U.S. leads by a wide margin. This category of shorter, cheaper procedures includes injections of Botox or soft-tissue fillers, skin lasers and skin-tightening devices, fat-melting and fat-freezing devices.

????Dr. Renato Saltz, who is vice president of ISAPS (and grew up in Brazil), says non-surgical procedures have been riding a wave ever since 2008 and 2009, when there was a slow-down in surgical procedures due to the economic crisis.

????“Patients couldn’t afford the big-ticket operation, but they still did something,” said Saltz. “They did some laser, some Botox, they still wanted to look better despite the financial crunch.”

????In 2010, the U.S. numbers for surgical procedures finally started growing again, and non-surgical procedures have continued to rise. In 2013, Americans spent more than $12 billion on cosmetic procedures, according to ASAPS, the American-focused version of ISAPS. That was up 12% from 2012. Some $5 billion of that was on non-surgical work.

????“In my practice we’re seeing more and more patients coming in who don’t want to have actual surgery, or don’t want to pay for it or wait for it,” Saltz said. “They come in, they’re on their laptops during the procedure, and then they leave and 25% of the fat in their tummy is gone. These are certified procedures that didn’t exist five or ten years ago, and that change we’re seeing is amazing.”

????Ask Dr. Halverson, though, and he’ll tell you that the general lack of knowledge about non-surgical procedures is one of the frustrating things about being in the plastic surgery field of medicine.

????“I think reality TV and the media has done a lot to show plastic surgeries and raise consciousness and make it seem okay; people always used to hide it, but now people are much more open about it, it’s much more acceptable to have had surgery,” said Halvorson.

????“The downside of [reality shows about plastic surgery] is that they reinforce the public perception that plastic surgery is nothing more than cosmetic surgery,” he added. “If you look at the classic text for our field, there are ten volumes, and only one of those is cosmetic. We do burn surgery, breast reconstruction, cranial and facial trauma, tissue transfers, a whole range. But that’s one of my pet peeves, is that for the rest of my life, when I go to cocktail parties and people ask what I do, I always have to follow it with various qualifying statements.”

????It isn’t just television that has had an impact, but also the Web, in the opinion of Dr. Saltz.

????“With the Internet, beauty has been sort of globalized,” he noted. “So you have Brazilian patients who want to look like Angelina Jolie. One of the fastest growing things in the U.S. is butt augmentation, and one of the fastest growing in Brazil is breast augmentation. I think a lot of this is totally related to social media and Facebook. And it’s a different patient now, thanks to the Internet; they come in and sometimes they think they know more than you do. They’ve done research and if you don’t do the same new type of butt augmentation as this guy in Rio, well, they’re going to fly to Rio.”

????Just as you’d expect, when Halvorson is at one of those social gatherings and says he’s a plastic surgeon, people tend to immediately mention “nose jobs” and “boob jobs.” Maybe now, based on some of the most striking data points in the ISAPS survey, they’ll also ask about penis jobs.