Liposuction led US cosmetic surgery in 2025... Can a PA run the first consult?

Who this is for

This is for the physician or medical professional who owns a plastic surgery or aesthetic medicine practice with self-pay body contouring patients. That includes a dermatology practice or med spa, whether the clinician is a physician, nurse, physician assistant, or other. An operations lead will find it useful too: the person who sets the marketing budget and decides which clinician sees each new patient first.

What we found

In the US, liposuction was the most common cosmetic surgery in 2025, at 317,196 procedures. The Los Angeles Times reported that count from the statistics of the American Society of Plastic Surgeons (ASPS). The society classed the 1% decline from 2024 as statistically flat. A separate worldwide survey of plastic surgeons found liposuction patients clustered at ages 35 to 50.^1,2

In two academic clinics, advanced practice providers saw body contouring patients before a surgeon did. Advanced practice providers (APPs) is the US's umbrella term for physician assistants and nurse practitioners. APPs checked patients against medical criteria and sent more than half of those they evaluated on to a plastic surgeon.^3,4 We'd argue a typical private practice's initial consult for self-pay liposuction is intended to run that same check. It also has to win the booking for qualified patients who may be considering multiple offices and clinicians.

How did liposuction volume change in 2025, and which ages chose it?

The US society reports that the volume of cosmetic surgical procedures in 2025 increased 7% compared to the previous year. Liposuction, breast augmentation, and tummy tucks (abdominoplasty) were the most in-demand procedures.⁵

The International Society of Aesthetic Plastic Surgery (ISAPS) drew its 2025 survey from data on 2,900 plastic surgeons. It counted 1,849,828 (1.8M) liposuction procedures worldwide in 2025, down 11.4% from 2,087,189 (2.1M) in 2024. Liposuction ranked second. Only eyelid surgery ranked higher among surgical procedures worldwide.⁶

In the same survey, 44% of liposuction procedures took place on patients aged 35 to 50. Botulinum toxin injections were also most popular in that age band. Most breast augmentations and rhinoplasties (nose surgery) took place on patients aged 18 to 34 while nonsurgical fat reduction was spread quite evenly across both age groups.² On our reading, a practice offering both may see surgical liposuction patients cluster in a narrower age band than nonsurgical fat reduction patients. We cover trends in older patients in a different article.

Which channels bring plastic surgery consults, and what do they cost?

Geek Powered Studios, a Texas-based digital marketing agency, reports lead-to-consultation rates by channel for plastic surgery practices. Here, a lead-to-consultation rate is the share of inquiries that go on to a consultation. The agency puts it at 18.9% for leads from unpaid search results, 10.7% for Google Ads, and 6.2% for Facebook ads. By the agency's own account, the unpaid search rate is the highest of any digital channel in 2026. Patient acquisition cost is marketing spend per new patient won. The agency puts it at $610 for plastic surgery in 2026.⁷

Aesthetix Media, a New Mexico-based marketing agency, gives 2026 benchmarks for Google Ads aimed at plastic surgery. It puts the Google Ads cost per consultation at $200 to $600 in 2026. It sets a target return on ad spend of 5:1 to 15:1. The agency defines return on ad spend as revenue from marketing-sourced procedures divided by total marketing spend.⁸ To see which Google ads a cosmetic surgery practice may run by law, read Google ad limits.

So, can a physician assistant or nurse practitioner run a body contouring consult?

Yes. In both academic clinics studied, APPs ran the first visit and sent ready patients on to a surgeon.

A 2026 study in Plastic and Reconstructive Surgery reviewed an APP-run body contouring clinic at an academic center. Patients came for brachioplasty (arm lift), abdominoplasty (tummy tuck), lower body lift, or thighplasty (thigh lift). Of 949 appointments scheduled, 836 (88.1%) were completed. Patients had to meet set criteria before a follow-up consult with the surgeon. Criteria included controlled medical conditions, nicotine abstinence, a stable weight, and a set time since any previous weight-loss surgery.³

Of the patients the APP clinic evaluated, 455 (54.4%) met those criteria and were referred to a plastic surgeon. The other 381 (45.6%) were not eligible for surgery. Of the 455 referred, 256 (57.4%) were approved for surgery. The authors call APPs "a force multiplier" in an academic body contouring clinic. They credit APPs with "more efficient use of surgeon consultation time."³

A 2023 study in that journal's open-access companion reviewed a second APP-run clinic for body contouring, from February 2020 through January 2021. The study's abstract reports 196 patients evaluated for breast reduction, panniculectomy, arm lift, or thigh lift. Panniculectomy removes the apron of skin and fat that hangs below the belly. Of the 196, 110 were appropriate candidates and went on to see a surgeon. Among those 110, 63 (57%) had insurance approval, 25 (23%) were denied, and 20 (18%) were pending. Fifty-five patients were not yet ready for surgery at their first APP visit.⁴

Both clinics screened patients against medical criteria, and patients in the 2023 clinic also went through insurance review. Their results describe the patients these academic clinics screened and accepted.

What does Florida law say about a PA seeing first visits, and what do PAs earn across specialties?

Florida law lets a referred patient choose a supervised practitioner, such as a physician assistant (PA), for the first visit. A section of the Florida Statutes governs formal supervisory relationships between physicians and other licensed practitioners. When another practitioner refers a patient, the patient may decide to see the physician or a licensed practitioner the physician supervises. Before the initial examination or consultation, the patient signs a form recording that choice. The supervising physician must review the record of that first visit and ensure a written report reaches the referring practitioner within 10 business days.⁹

The same section limits how spread out a supervising physician's offices may be. An office that is not the physician's primary place of practice must be within 25 miles of it or in a neighboring county. No two offices may be more than 75 miles apart, and the physician may supervise only one office besides the primary one.⁹ A practice that wants a PA seeing first visits at a second office will find those limits shape where that office can be. Rules differ by state, so whether a given setup qualifies is a question for the practice's counsel.

The U.S. Bureau of Labor Statistics counted 168,900 physician assistant jobs in 2025, across all specialties. The median pay for physician assistants was $135,880 a year in 2025.¹⁰

What consult-to-booking rates do marketing vendors report for body contouring surgery?

AestheticSuite AI, a vendor to aesthetic practices, puts the average conversion rate for surgical body contouring consults at 40% to 48%. A conversion rate here is the share of consults that end in a booking. The vendor writes that nonsurgical, lower-cost treatments "consistently convert at higher rates because they carry less financial and recovery-related friction."¹¹

Aesthetix Media, a marketing agency that publishes advertising benchmarks for plastic surgery practices, puts average plastic surgery consultation-to-booking at 30% to 45% in 2026. A top performer's rate runs 50% to 70%. The agency writes, "If consultation-to-booking rate is below 40%, it is a sales problem, not a marketing problem." It points such practices to patient coordinator training, consultation scripts, and the financing presentation.⁸

Projected Growth Consulting, a firm advising plastic surgery practices, treats consultation conversion below 50% as a sign of a problem. It does the same for what it calls marketing conversion below 30%, which on our reading means the portion of leads that become consults. The firm says these thresholds are not universal industry benchmarks. It calls them "signals" that a practice should inspect its own definitions, response process, and handoffs.¹² For more about how long patients take to book after a consult, see follow‑up windows.

If we were thinking about actioning these findings, we would ensure we had logged each new body contouring patient's source (web form, phone call, etc.) along with their age. We would also check how often the practice's body contouring consults book and use it as an indicator of whether we might need more marketing spend or if there is room for improvement with in-clinic workflows. AestheticSuite AI advises a practice to agree on its own definitions of success, which may differ by treatment, before making changes. Staffing is a separate question with a similar first step. Before hiring a physician assistant or nurse practitioner for first visits, we would first determine what the state requires via the practice's lawyer or another state law expert. A fast follow is to define what an APP-conducted visit would need to achieve to be beneficial. At a high level, the visit needs to both screen the prospective patients for physical and mental readiness for the procedure as well as sell them on the results.

About this review

We read 12 sources in November 2026. They were one federal labor statistics page, one Florida statute, two peer-reviewed studies, three surgeon society publications, one newspaper report, and four vendor pages. For both clinic studies, we read only the abstracts.

The ASPS data cover US cosmetic surgery during 2025, and the ISAPS survey covers procedures plastic surgeons reported worldwide for 2025. The two clinic studies cover academic body contouring clinics and were published in 2023 and 2026. The Florida statute is the 2026 text. The labor data cover physician assistants nationally in 2025, and the vendor pages date from 2026.

Fractional Aesthetics is a growth strategy practice for aesthetic medical businesses.