Cosmetic surgery experiences some nips and tucks

Thanks to the economy, Americans aren't scheduling nearly as much cosmetic surgery as they used to.

Sixty-two percent of the members of the American Society of Plastic Surgeons saw cosmetic procedures drop in the first half of 2008, compared with the first six months of 2007, according to a recent survey by the society.

The two procedures most doctors are doing fewer of? Liposuction and breast augmentation.

Doctors on the coasts have reported cosmetic business declining by as much as 50 percent. That's a big drop in a big business.

In 2007, Americans spent more than $12 billion on cosmetic procedures, typically not covered by insurance, according to the society. And that's in doctors' fees alone.

"It's not just the money; it's the time away from work," said Dr. Michael McGuire, a plastic surgeon who practices in Santa Monica, Calif. "More and more people are concerned about taking time off from a job that might not be as stable as it was."

The losses are big enough that a seminar on the subject was added to the society's recent annual meeting in Chicago.

Dr. Bahman Guyuron, chairman of the Department of Plastic Surgery at University Hospitals Case Medical Center in Cleveland, reported some reduction in procedures.

"We are seeing a little bit more cancellation and postponement of the surgeries," he said.

But a lot of his patients are either wealthy and not worried about the economy, or they've been planning -- and saving -- for their surgeries for a long time and they're not about to give it up.

Others aren't forgetting about beauty altogether. Some are postponing cosmetic procedures until the economy recovers, said Dr. Michael Wojtanowski, chief of plastic surgery at Cleveland's Fairview Hospital.

And many are opting for less-expensive and less-invasive procedures: wrinkle reducers such as Botox and fillers such as Juvederm or Restylane.

But even with less expensive -- and less permanent procedures -- patients are being more selective.

"They'll say 'I only want to get $300 worth of Botox today,'" said Dr. Lydia Parker, a dermatologist in Ohio.

Others are using low- or no-interest payment plans offered by doctors to avoid one big expense.

Another thing Wojtanowski has noticed: A lot of people take comfort in making themselves look good when times are tough.

"With all the negative things in the world, I think people need a little bit of a boost," he said. "These things that we do are image enhancers; they're self-confidence boosters. These are the baby steps to sort of help people feel good. 'At least I can get my Botox.'"