Introduction This report aims to introduce the cosmetic surgery and plastic surgery in United States

Introduction
This report aims to introduce the cosmetic surgery and plastic surgery in United States. In this report, I will study the background of the plastic surgery industry and how the cultural shift affect the industry. Plastic surgery is defined as a specialized surgical specialty used to reconstruct facial and physical defects caused by birth disorders, trauma, burns or cancer. Plastic surgery aims to correct the site of physical dysfunction and is essentially a reconstruction in nature, while cosmetic surgery is defined as “completely elective” works, considered as purely for enhanced appearance purpose (American Board of Cosmetic Surgery, 2009). The desire to be satisfied in their own skin, desire to become an attractive person, and desire to be satisfied with their own image is one of the most significant forms of surgery in medical fields. The superior appearance enhances self-confidence and provides superior self-awareness. Although making the face and body more beautiful is not the main advantage of corrective strategies. Plastic medical procedures are a scientific and fragile craft that can make a person feel more confident. Plastic surgery will certainly improve a person’s mental state. Some researches indicate that plastic surgery procedures may increase self-esteem and make individuals more attractive. According to these aspects, even small changes can affect dramatically (Reza Rafie, S. and Salehahmadi, Z., 2012).

1. Provide background study on this industry, its contribution to the national GDP. You are encouraged to provide any relevant data.

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Year GDP (million) GDP Growth (%)
2015 $ 18,120,700 2.9
2016 $ 18,624,500 1.5
2017 $ 19,390,600 2.3
Table 1: Annual GDP in United States (Countryeconomy.com. ,2018)

Diagram 1: Cosmetic Surgery Procedures and GDP in 2001-2011 (Nassab and Harris, 2013)
Buinewicz Plastic Surgery is a clinic which located in Doylestown, United States. Buinewicz Plastic Surgery has more than 25 years of experience in cosmetic and plastic surgery’s industry. The goal of the clinic is to provide a natural-looking appearance for all the patients. The clinic provides cosmetic and plastic surgery such as breast implant, liposuction, tummy tuck, and facelift, it also provides spa services and hair restoration to patients (Buinewiczplasticsurgery.com., n.d.).
The U.S. economy grew by 2.2% quarterly in the first quarter of 2018, which was lower than the estimation of 2.3% and market expectations of 2.3%. The average growth rate of the United States’ GDP from the year 1947 to 2018 was 3.21%. A high record of 16.9% is reached in the first quarter of 1950 and reached a low record of -10% in the first quarter of 1958 during these years (Tradingeconomics.com, 2018). Due to the increasing of the population are paying for cosmetic and plastic surgery, there are 159 match positions for plastic surgery were provided in United States in 2017, and the number of plastic surgeons population increased by 2.4%. The GDP growth rate of 2017 is predicted to be 2.6% (Batista, 2017). From the table above, USA GDP in 2015 is $18,120,700, which is 2.9%, while in 2016 and 2017, the GDP are $ 18,624,500 (1.5%) and $ 19,390,600 (2.3%) respectively. Based on diagram 1, from the data provided by American Society for Aesthetic Plastic Surgery (ASAPS), the cosmetic surgery procedures in 2010 is 160000 and GDP for the same year is $11.5 million. In 2011, the procedures are slightly increased compared with last year and GDP is more than $15 million. According to American Society of Plastic Surgeons (2018), there was 2% increase in 2017, which was 17.5 million cosmetic surgery and minimally invasive cosmetic procedures performed in United States.
2. Using examples, explain how the cultural shift affects the cosmetic and plastic surgery industry.

Today, cosmetic and plastic surgery is growing because of the economic development, changes in social and cultural norms, globalization and access to cultural media, and increasing visits to Western countries. The cultural changes in different societies have increased people’s concerns about their appearance and thus increased demand of plastic surgery. However, the psychological factors are the main reason for cosmetic and plastic surgery. People are interested in modifying and improving their appearance. Compared to men, women are more emphasizes on their appearance as this society is appearance orientation.
In United State, cosmetic surgery did not accepted widely by ethnic groups in the past. Many ethnics thought that cosmetic and plastic surgery will affect their identuty. However, cosmetic surgery is no longer seen as a sign of rejection of ethnic’s identity by minorities. In fact, some of the women are looking forward to enhance their beauty. Non-Caucasian patients have the same motivations and desired in cosmetic and plastic surgery as Caucasians ethnics, such as reduce the appearance of aging, improve body contours, enhance symmetry, and change tissue volume. Non-caucasian performed some procedures that are not significant different from races such as lip reduction, breast reduction, botox, injectable fillers and tummy tack (Wimalawansa et al. n.d.). However, the developments in technology made people are more willing to consider and accept cosmetic surgery for altering their physical appearance.

According to Eunjung (2016), Americans are increasingly obsessed with their beauty, which has contributed to the surge in cosmetic and plastic surgery. In 2015, there were 15.9 million surgical and minimally invasive cosmetic procedures in the United States. From 2000 to 2015, the number of cosmetic and plastic surgeries performed in the United States increased by 115%, from 7401495 procedures increased to 15908330 procedures. The reasons going for plastic surgery are because they want to improve their appearance and attract attention from others. According to Bracco (2016), one woman is being fired because she looks older. Furthermore, some of the people cannot get a job due to their appearance. Plastic surgery not only can increase self-confident, it also can boost your career. In fact, people are prefer to look at an attractive and pretty people, attractive appearance enable you to increase relationship with colleagues and increase job security, as you don’t have to worry about being fired just because you are looking older, especially in marketing or insurance career.
Cosmetic surgery procedures help people to lose weight. Many people are looking for cosmetic surgery because it related to health issues. According to National Health and Nutrition Examination Survey (NHANES), 70.2% of the adults are overweight and 37.7% are considered have obesity in United States (National Institute of Diabetes and Digestive and Kidney Diseases n.d.). Being overweight or obese makes one look ugly and become a laughing stock of others. In addition, overweight can cause many problems, and in several cases obesity can kill a person. In the past, people need to keep exercise to reduce weight, and exercise are time consume and difficult to continue for some of the people. As a result, cosmetic surgery is a faster way to lose their weight and becoming popular. Through plastic surgery, people can get rid of the problem of overweight and lead a healthy lifestyles.
Most people undergo cosmetic surgery because they are involved in serious accidents such as car crashes or motor vehicles accident. These accidents can cause serious damage to their appearance, and only plastic surgery can help solve these injuries. During the past, accident victims cannot find a way to recover the facial disfigurement, after the introduction of plastic surgery, reconstructive surgery help accident victims to get back to their previous look. Furthermore, people will increase their self-esteem after undergo plastic surgery. By solving physical problems, patients have greater confidence in themselves and more satisfied with their physical appearance. Plastic surgery may have positive effect because it helps accident victims to regain their confident.

In this new era, cosmetic or plastic surgery is not an abnormal thing in society. Even celebrities and social media began to speak more openly and discuss about their surgical procedures journey via social media such as Instagram. Everyone has the right to express his/her opinions, but many people think that there is nothing wrong to undergo a cosmetic surgery because it is exist to satisfy the desire of beauty . In fact, we all do this in different ways, whether it is surgery or makeup.
SWOT Analysis
Strength
Buinewicz Plastic Surgery clinic has many facilities, such as spa. The spa is one of the strength of the company. When talking about the spa treatment, normally people will think about the beauty salon, so the spa treatment become one of the strength of the clinic as there are few of the clinics combine the spa treatment with plastic surgery services. The quiet atmosphere lets the customers feel relax and unwind and spa treatment enhance the health and appearance of skin. Buinewicz Plastic Surgery provides several treatments such as scars, fine lines and wrinkles, sun exposure damage skin, acne and other blemishes to customers. Buinewicz Plastic Surgery has provides loyalty cards to the customers. Loyalty customers can buy any 3 treatments and get the 4th treatment at 25% discount, which includes fillers, botox, silkpeel, skin resurfacing, chemical peels and dermafacials. Excellent staff with strong knowledge in the field is the strength of the clinic. The doctors in the clinic are expect and professional. Dr. Brian R. Buinewicz has over 23 years of experience in plastic surgery industry and received triple certification while Dr Annie Buinewicz has more than 25 years of experience in medical field. The location of the clinic is convenient and the patients can easily reach there. The clinic is locate on a busy street and can easily attract the eyesight of patients.

Weaknesses
The higher cost of treatment becomes an abandon to patients. Some of the patients may not able to afford plastic surgery. Undifferentiated of services is one of the weaknesses of the clinic. Plastic surgery industry are growing rapidly and all of the clinics are offering the same cosmetic or plastic surgery procedures to the patients, it cause that the patients cannot differentiate the options that provide by the clinics. To attract more patients, Buinewicz Plastic Surgery clinic can create a blog and update relevant and content on the blog to let more people recognize the clinic. Moreover, Buinewicz Plastic Surgery can create something unique in the business such as connect the health care service with the technology. For example, patients can download their lab results from the portal instead of calling, it may become more convenient to the patients (Medical Healthcare Marketing, 2017).

Opportunity
In the past 10 years, the popularity of cosmetic plastic surgery has growing rapidly. In United States, there are increasing trends in plastic surgery, according to American Society of Plastic Surgeons report, Americans spent more than $16 billion on cosmetic plastic surgeries and minimally invasive procedures in 2016. The growing demand may become an opportunity to expand the business (Rossman, 2017).

The advanced technologies in future allow the business to grow further such as the 3D printing, personalized tissue engineering, transplanting complex structure and etc. 3D printing is printing out the facial structure or features such as nose and eyes and manipulate it on the computer, and then print out to make comparison with the original. Personalized tissue engineering is the physical structures such as ears and skin can be grown in the lab and implanted to the patient to restore the shape and function. Furthermore, the complexity of the full face transplant can be performed due to the introduced of the transplanting complex structure technology (Zwivel, 2017). All of these technologies in future able to reduce the risk of surgery and operation time.

Threats
Political unstable in United States can affect the economic in the country, and create uncertainty in market. This uncertainty will increase the uncompensated risk together with the investment and is therefore will affect the growth. People are unwilling to invest to the clinic, it will impact the financial performance of the business. Over millions of Americans in each year are traveling abroad for cosmetic surgery such as UK and Korea. The industry in South Korea is growing rapidly. Surgery is cheap, efficient, and excellent and advanced equipment have emerged from old American hospitals and cater to the global medical tourism market (Frame, 2018). The reasons of people prefer to go abroad for plastic surgery are they have variety of choices and procedure to choose compare with the own country and they can get a better results. Moreover, some of the surgeons can only be found abroad and the cost of operation is cheaper and patients can operate in the first-class establishment. Increase competitors in the market may bring a huge impact to the business. Increase in competitors will reduce the growing rate of clinic and increase the level of rivalry between competitors in the market. The clinic has to reduce the price in order to compete with them and this may affect the profit of the clinic.
4. What are the challenges faced by marketers? Discuss.

According to the American Society of Plastic Surgeons, cosmetic surgery are booming, $10.1 billion business each year in the U.S. Cosmetic and plastic surgery face additional pressure and challenges in future because of the increased demand for a more youthful appearance. The advance medical technology and techniques have made plastic surgery have more choices than before. However, there are few challenges faced by cosmetic and plastic surgery industry such as economic crisis, health issue and social media.
Economic crisis will give a huge impact to the professional and industry. Tourists who come to United State for plastic surgery will look for another country. People will tend to look into lower budget treatment especially cosmetic surgery because it is a wants not a need. Furthermore, many cosmetic and plastic surgery procedures are expensive. The face lift and body lift cost $12125 and $15125 respectively in America (Bonomi, 2018). The cost of surgery will decrease the demand of American. These costs are simply the basic cost of the program. The cost of surgery are including the surgeon cost, hospitalization and anesthesia fees as well as the drug costs and consultation cost (Holley, 2017).
Cosmetic enhancement is on the rise. Many people are dissatisfied with their appearance and they went for cosmetic surgery. However, the doctor cannot 100% guarantees that the surgery will be successful. Plastic surgery carries the risk of medical complications like other surgery, such as death. The most common risks caused by plastic surgery are infections, severe bleeding, which can lead to numbness, tissue death (necrosis), peripheral fluid accumulation (serum), and nerve damage in the area of congestion (hematoma). Plastic surgery can also cause thrombosis and deep vein thrombosis (Holley, 2017). People nowadays are more health conscious and the increase awareness about the risk of cosmetic and plastic surgery among individual will be a bigger challenge in this field.

Social media is one of the challenge that faced by the plastic surgery industry. Social media provide a platform to patients to make consultation online. Social media allows the patients to have a better understanding about cosmetic surgery. However, the social media also can affect the cosmetic surgery through the review that provide by the patients. Patients often use social media to discuss their overall experience. Some of the patients give the bad review without having any surgery experiences, the reviews are based on the outcome of communication with the staff. The bad reviews can affect the overall performance of hospital or clinics and the sales will drop significantly. In addition, some of the websites are promoting the risk and negative side of cosmetic surgery, which has impact the perception of customers in this industry. Thus, social media is a powerful tool and needs to be used effectively to avoid pitfalls.

The challenges that faced by the marketers are not only limited to cost, social media, the side effect of the plastic surgery may be the biggest challenge in this area. Many side effects will arise after operation such as scarring, numbness and swelling. Regardless of what type of surgery, it contains many uncertain risks that we didn’t know. Individuals who are willing to go for a cosmetic surgery to improve specific aspects of body or face should consider the risk. Patients have to conduct research and gather as much information as possible before visiting a plastic surgeon and the decision to undergo the surgery should think seriously.
Conclusion
Currently, cosmetic surgery is spread all over the world. This rapidly developing field involves several factors such as socio-economic development, cultural norms changes, globalization and impact of the Western culture, advertising and social media. Nowadays, cosmetic surgery is becoming a profitable business. It focuses only on the appearance of people rather than the sex, age and ethnicity.

The advanced technology and cheaper treatments are the trend in cosmetic surgery. This condition meets consumer needs and also fit well into the 21st century issues, which will lead to further demand for cosmetic surgery such as the effects of sun exposure, diet and malnutrition, an aging population, and a sedentary lifestyle. Laser therapy is recently become main stream and is growing rapidly in the market. Further development of new technologies, as well as the development of cheaper versions of the existing technologies, is equally important to the future market.
However, consumer concerns have become increasingly important. Due to the fear of dissatisfied of surgeons, consumers are increasingly sceptical about the reliability of the industry. Although the number of reported problems is estimated to be less than 20%, it has been amplified by raising awareness of the risk of errors in treatments such as infections, scars and nerve damage (Owen, 2015). In a nutshell, despite of the advanced technology, every procedures have its own risk, patients have to think properly before going for plastic surgery.

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