Amid Economic Pain, Americans Cut Back on Cosmetic Surgery

People are cutting back on cosmetic surgery and other elective surgeries in response to the dismal economy, reversing the booming popularity of tummy tucks, eye lifts, and breast implants, which have soared in popularity in recent years, particularly among younger people and the middle class.

When polled in October, 62 percent of members of the American Society of Plastic Surgeons said their business was down 20 percent or more from the year before. "I expect it's more than that in some areas, a 40 or 50 percent decrease," Michael McGuire, president-elect of the ASPS, said last week. That's particularly true in areas like New York, California, and Florida, which led the surge in popularity. A small survey by the society in October found that 60 percent of respondents said the economy had had an impact on their plans for cosmetic surgery. That's not surprising, given that cosmetic procedures aren't covered by insurance.

People may be shunning surgery not only because of the cost but because of the downtime for recovery. "Now, you just even don't want to take the time off [from work]," says Alan Gold, president of the American Society of Aesthetic and Plastic Surgeons, a group of doctors who specialize in cosmetic surgery. "You don't want them to think they can get along without you for too long." That holds true for noncosmetic elective surgery as well, Gold says, including carpal tunnel surgery, which is usually performed by plastic surgeons, and hernia repair. Although insurance usually covers these operations, deductibles and copays can be enough to make a patient think twice.

John Canady, director of the cleft lip and palate center at the University of Iowa, says one part of his work as a plastic surgeon has stayed stable: repairing birth defects. He adds, "People still get injured, people still get different kinds of malignancies and need reconstruction." Younger doctors and those who went into the field just to do cosmetic procedures are having a harder time, he says.

Alas, the fact that demand is way down doesn't mean that it's easy to find a two-for-one boob job. Surgeons say they are being more flexible with payment plans but that they don't see widespread discounting.

And as with all medical procedures, safety should always trump cost. Someone contemplating a cosmetic procedure should make sure the physician is board certified and has years of experience in the procedure in question. That's particularly true because doctors without experience in cosmetic procedures started offering such operations in recent years in an effort to boost their bottom line. "Consumers should do their homework," Canady says. "Cosmetic surgery can have complications."

The demand may be deferred, not denied. Alan Gold, who says he saw a similar downturn after 9/11, predicts that business will revive with the economy. Those who desire cosmetic procedures "are people who are concerned about their appearance or are concerned about age-related changes," he says. "They may defer that desire, but the desire isn't lost."