Plastic surgery has since expanded from treatments aimed mainly at repairing damage to include elective changes like liposuction or tummy tucks. While it’s now a multibillion-dollar industry, just 4% of Americans say they have ever had elective cosmetic surgery, according to a Pew Research Center survey conducted in spring 2016. Less invasive procedures like skin or lip injections are also rare; just 2% of U.S. adults report having had this done.

Cosmetic surgery is uncommon among all major demographic groups, but there are some gender differences. Women are roughly three times as likely as men to say they have undergone this type of procedure, and this gender gap is seen across age groups.