When it comes to luxury items, fancy cars, exotic vacations and mega-mansions aren't the only casualties of a rocky economy. Some who once planned to tighten their tummies or boost their breast size with surgery are thinking twice about going under the knife, leading to a drop in patients opting for cosmetic procedures.
"Overall, I think it's safe to say that most plastic surgeons have seen a significant decrease in their practice," says Daniel Rousso, president of the American Academy of Facial Plastic and Reconstructive Surgery and a surgeon with a private practice in Birmingham, Ala.
According to 2009 statistics the American Society for Aesthetic Plastic Surgery (ASAPS) released earlier this month, cosmetic surgical procedures declined 17 percent in 2009. In 2008, they saw a decrease of 15 percent. Since most insurance companies don't cover the costs of elective aesthetic surgeries, many in today's soft economy simply can't afford procedures viewed more as luxuries than necessities. That's especially true because an increasing number of patients belong to the middle class.
"Twenty years ago people thought only movie stars and rich women had plastic surgery," Renato Saltz, president of the ASAPS, said in a statement. "Now people in every income bracket know someone who has had a plastic surgery procedure or would consider plastic surgery for themselves."
Fear of being fired for taking too much time off from work for recovery is also causing some to put off that desired face-lift or bit of liposuction. "An empty desk is a vulnerable desk," notes Emily Pollard, an American Society of Plastic Surgeons spokeswoman and a plastic surgeon in the Philadelphia area.
The decline in those undergoing cosmetic surgery has been "fairly even across the board, although there are some parts of the country that felt more of an effect from the economy," Dr. Rousso says.
How has Pittsburgh fared?
The decrease in Pittsburgh's aesthetic surgery industry is "not quite as dramatic as perhaps seen in some of these other markets," says Leo McCafferty, president-elect of the Allegheny County Medical Society and a plastic surgeon with a private practice in Shadyside.
But the recession hasn't left Pittsburgh's cosmetic surgery market unscathed. Several local surgeons report fewer patients choosing major surgical procedures. James Fernau, a plastic surgeon with a practice and medical spa in Findlay, says the drop in surgeries he performed over the past two years is so great it has contributed to a significant decline in his business.
Many local surgeons also mention more patients gravitating toward nonsurgical aesthetic procedures, such as fillers and Botox, because these treatments provide quick results at an affordable cost and with little or no recovery time. According to the ASAPS's latest statistics, nonsurgical procedures made up 85 percent of cosmetic procedures performed last year.
"What's helped us get through the downturn is that we don't just do surgery," says Suzan Obagi, director of the UPMC Cosmetic Surgery and Skin Health Center. "The patients were opting for doing some of these less aggressive procedures in order to kind of tide themselves over."
According to Dr. Saltz in a later interview, plastic surgeons across the country have tried to boost business through offering payment plans, introductory seminars, specials and discounted prices.
Locally, Dr. Fernau is offering 40 percent off on breast augmentation and liposuction through April 15.
Paul Leong, a plastic surgeon and owner of Ideal Facial Plastic & Laser Surgery in Pittsburgh, Sewickley and Ligonier, held a ladies-night-out event at SouthSide Works in January. The evening featured live demonstrations, information about skin care and cosmetic procedures, and a certificate for $100 off a Botox treatment or any dermal filler.
Questions to ask before surgery
Thinking about refreshing your look with a cosmetic procedure? Here are some questions to keep in mind:
Does the plastic surgeon have the proper credentials?
In Pennsylvania, all surgery facilities -- including outpatient offices and clinics -- must be state licensed. Doctors administering procedures in an outpatient facility should have privileges to perform the same treatment in a hospital. No-surgery procedures, such as Botox or dermal fillers, also should be performed in a medical office.
For no-surgery procedures, who will be giving the treatment?
Even if a doctor isn't administering the procedure, a physician should be on site in case complications occur.
Low- or no-interest finance plans also are common among local plastic surgeons. These plans are nothing new, but more patients are turning to them as an alternative to using credit cards. Most surgeons list current specials or payment plans on their websites or encourage patients to make an appointment to discuss financing options. But patients should beware of deals that seem too good to be true -- because sometimes they are.
There are "a lot of strict ethical codes against coercion, and there are a lot of things you could do that could be interpreted as coercion," says Lori L. Cherup, a plastic surgeon and owner of Radiance Plastic Surgery in Bridgeville and McKees Rocks. "We are not allowed to give our services away at raffles and things like that ... if anyone tries to do that stuff they are really taking a risk with their career."
Surgeons warn that some doctors offering procedures for prices significantly lower than their local competitors could be a red flag that the person administering the treatment may not be properly qualified. There are certain overhead expenses involved with procedures that ensure they are done properly and safely, Dr. McCafferty says. "We just can't cut corners there."
It is important for patients to do their homework and not just go for the cheapest procedure in town, Dr. Saltz notes (see story above right).
"There's much more consideration that people are going through before they make their final decision, but it's actually been for the better," Dr. McCafferty says. "It makes them think more."
In recent months, there are signs that things may be on the upswing as some plastic surgeons in the area report seeing a jump in appointments for the spring.
"We've already seen in the past month a huge increase," Dr. Fernau says.
Doctors in other parts of the country have noticed similar trends.
"I'm not celebrating yet," says Dr. Saltz, who has two private practice offices in Utah. "I'm just hopeful that what we saw in December, January and February will continue and get stronger."
In the meantime, plastic surgeons are staying optimistic.
"I think aesthetic surgery will recover, and I think the market will be even bigger in the future because men are more anxious and eager to avail themselves" of the benefits of plastic surgery, Dr. Cherup says.
In 2009, more than 900,000 cosmetic procedures were performed on men, up more than 8 percent from 2008, the ASAPS reported. Doctors also note an increase in patients turning to cosmetic procedures to make them more competitive in the job market.
"It's not all bleak. I really don't want to paint that picture at all," Dr. Obagi says. "It's like you do in any situation. You make lemonade out of lemons until the economy turns."