What Downturn? Americans spent 12 billion to look good.

Americans spent nearly $12 billion on cosmetic procedures last year — much of it on breast implants, surgical face-lifts and Botox injections — feeding a medical practice that has gained popularity with everyone from young professionals to aging baby-boomers.
Saving face doesn’t necessarily mean patients have to go under the knife, a panel of doctors said Thursday at the annual meeting of the American Society for Aesthetic Plastic Surgery at the Mandalay Bay Convention Center. From hyaluronic acid injections to fractional resurfacing, nonsurgical options are an essential part of “facial rejuvenation,” said Dr. Trevor Born, a plastic surgeon from Toronto and New York City. Results from volumizing agents, or fillers, can be fabulous, he said.
“Certainly deciding what filler to use can be confusing,” Born said. It started with Botox and now includes Restylane, Puragen, Sculptra and Evolence.
Dr. Paul Lorenc of New York said cosmetic surgery has become more popular today because it’s much easier to perform, there’s less downtime for recovery and it’s exposed in the media.

“Ultimately, we’re doing a better job for our patients with less recovery time,” he said. “What we were doing 10 years ago was archaic. We have progressed tremendously in the name of patient benefits and patient safety.”
Other factors that might influence someone’s decision to pursue nonsurgical procedures include decreased risk of serious complications and the patient’s medical history.

The cost of nonsurgical cosmetic treatment is quite a bit less than surgical alternatives, said Dr. Barry DiBernardo of Montclair, N.J. Expenditures for nonsurgical procedures totaled $4.56 million in 2008, compared with $7.22 million for surgical procedures, the society reported.

The No. 1 surgical procedure nationwide was breast augmentation (355,671). The average cost is $3,885 for silicone gel implants and $3,603 for saline implants.

“It’s for form,” DiBernardo said. “If someone is flat and they want to go buy a bathing suit or an evening gown, they’re not made for them. It’s about three-dimensional proportion.”

The top nonsurgical procedure was Botox injections (2.46 million) at an average cost of $443 each.
Face-lifts are still the main component of cosmetic treatments, with 132,000 procedures performed in 2008 at an average cost of $6,728.

Lorenc said he routinely uses nonsurgical procedures to complement surgical practices and maintain a great post-surgery result. Patients are often well-educated, well-informed people who want to enhance their image, not be radically different, he said.

“It’s about the norm,” Lorenc said. “People are getting a little older. In today’s economy, it’s competitive and people have to stay in the job market and this is a certain way that can help them keep their jobs. Wall Street guys are competing with 32-year-olds at half the price. They’ve got to look good.”

Since 1997, the number of cosmetic procedures has increased 457 percent to 11.7 million surgical and nonsurgical procedures in the United States in 2007. Women had 10.6 million, or 91 percent, of the procedures.