BACKGROUND: The number of cosmetic procedures performed annually is on the rise and is being performed by more specialties. PURPOSE: We sought to determine the relative outpatient cosmetic procedure experience of dermatology and other specialties. We also examined demographic data of patients who underwent cosmetic procedures. METHODS: Demographics and data from the National Ambulatory Medical Care Survey (NAMCS) were analyzed to estimate the number of visits for office-based cosmetic procedures from 1995 to 2003 by specialty and type of procedure. RESULTS: In order of decreasing frequency, the percentage of all cosmetic procedures performed in the outpatient setting by specialty was as follows: dermatology (48%), plastic surgery (38%), general surgery (>4%), otolaryngology (>3%), ophthalmology (>3%), facial plastic surgery (1%), family practice (<1%), pediatrics (<1%), and internal medicine (<1%). Most cosmetic procedures were performed on white, female patients in the 40- to 59-year-old age group. There was a mean of 55 visits per 1,000 whites and 27 visits per 1,000 nonwhites. Chemical peels and soft tissue fillers were the two most common procedures. CONCLUSIONS: Dermatology as a specialty performs more office-based cosmetic procedures than other specialties. On a per-physician basis, dermatologists and plastic surgeons have far more experience with cosmetic procedures than other physicians.