Nip & Tuck

The sluggish economy has changed the way cosmetic surgeons operate

The sagging economy made for a financial nip and tuck for area cosmetic surgeons in 2009. 

As potential clients kept a wary eye on savings accounts and job security, many women of a certain age shelved plans for elective cosmetic procedures, such as breast augmentations and tummy tucks. Meanwhile, job-seeking baby boomers, dubbed "unretired" because the soured economy thrust them back into the job market, opted for facelifts and noninvasive procedures as a cosmetic means to stay competitive in an ever-tightening job market.

"People who never would have thought of [having plastic surgery] in the past are doing this," said Dr. Rick Green, a plastic surgeon at Salmon Creek Plastic Surgery.

Green reports bookings up about 40 percent in 2009 with a revenue uptick of 25 percent. 

The American Society for Aesthetic Plastic Surgery keeps tabs on nationwide stats for cosmetic surgeons. In 2008, the most recent data available, there was a 12 percent nationwide decline in cosmetic procedures, which still totaled more than 10 million. 

Even with the 2008 decline, the nation's cosmetic surgery appetite hasn't been satiated.  In 1997, some 2.1 million Americans opted for cosmetic surgery, making 2008's numbers an overall increase of 162 percent.

Reflective of the tough economic times, breast augmentations, typically a younger woman's procedure, locally were down 60 percent in 2009 compared to 2008. And abdominoplasty procedures, better known as "tummy tucks," were down 20 percent in 2009, Green said.

"For somebody who's a mom and has kids in school, $6,000 (for a breast augmentation procedure) is a lot of money, especially if you're not convinced that you'll have a job or that their husband's job will still be there," Green said.

The tightened credit market also played a role in the reduction of procedures for the 20 to 40-year-old set.

"Many younger patients had been using credit-based sources of financing," said Dr. Mark Jewell, a Eugene, Ore. cosmetic surgeon and assistant clinical professor at the Oregon Health Science University in Portland.

Jewell said his 2009 Visa charges were off 20 percent compared with 2008 figures.

"That was an economic indicator," Jewell said.

Meanwhile, baby boomer men and women, many of whom were contemplating retirement but instead faced evaporated retirement accounts or pink slips, have suddenly found themselves thrust into the job market alongside candidates some 20 to 30 years their juniors.

"In this economy, we're seeing more people going for procedures to enhance everything to get a job," said Jeff Russell, executive director of the International Association for Physicians in Aesthetic Medicine.

Russell offers a slightly tongue-in-cheek example of the changing times: a few years ago, cosmetic procedures were a go-to item for the newly divorced set, many of whom were reentering the dating market. Now it's a desire to re-enter the job market that is sending new customers his way.

But cosmetic surgeons, who typically earn a living with their scalpel, have been forced to retool in an economy where cash doesn't flow easily and clients need to put their best face forward. Non-invasive procedures, like Botox injections and fillers, while not as long lasting as a $7,000 facelift, are more likely to fit into a client's lean budget.

"For patients that want to do something, we've been able to bundle Botox with fillers," Jewell said.

Surgeons say that reconstructive surgeries, like what might be needed after an auto accident or severe burn injuries, have been unaffected by the downturn. Medical insurance typically picks up those costs.

Meanwhile, offices that deal with wellness and non-invasive procedures say they're seeing an increase in demand for their services – again from the looking-for-work crowd.

Dr. Susan Hughes of Transformations Spa MD opened her business in Oct. 2008 in the midst of the recession. Her business focuses on holistic means to health, such as weight loss and nutrition. But she also offers chemical peels, Botox and liposuction procedures. According to Hughes, business has been so brisk that she outgrew her office and last month relocated to a larger one.

"People want to look younger and refreshed and they want to feel good about how they are looking and feeling," Hughes said.

But lower-end services, which run in the hundreds of dollars compared to thousands for a facelift, has changed the way some businesses operate. Like Jewell's bundling of injections and fillers, some offices have changed their operating models to rely on low-cost, yet high-demand procedures, which can shore up a balance sheet and keep a business afloat during the economic storm.

Meanwhile, area plastic surgeons say they're seeing a faint glimmer of light at the end of the tunnel in the form of a steady uptick in the Conference Board Consumer Confidence Index, which rose for the third consecutive quarter and now stands at 55.9 on a 100-point scale.

Green said he had booked several breast augmentation consultations last month in what he called a hopeful sign of a coming economic rebound.

Jewell had a similar outlook. "I think that the money that people have to spend on cosmetic surgery is a
leading indicator of the economy," he said.