Feb. 9, 2011 -- The number of Americans voluntarily going under the knife for a nip and a tuck has grown along with the economy. It begs the question: could plastic surgery be a sign of better economic times?
According to statistics released today by the American Society of Plastic Surgeons, 13.1 million minimally-invasive and surgical cosmetic surgeries were performed in the United States in 2010, up 5 percent from 2009. Along with many other industries, plastic surgery suffered in the economic downturn that began in 2008. The uptick in cosmetic procedures is the first since the recession began.
"People are reassured and more confident that we're not going to have a double dip recession," said Dr. Phil Haeck, president of the American Society of Plastic Surgeons. "This is just one more tiny sign that the economy is moving forward. It's slow, but it may be that we'll slowly pull out of this recession."
"It's reassuring we're not going to have a year like 2008, and I guess we're one more indicator of that," said Haeck. "People have taken care of their family, so now they feel they can do a little something for themselves."
Surgical procedures increased by 2 percent, totaling almost 1.6 million procedures in 2010. The top surgical procedure performed continues to be breast augmentation; 296,000 Americans underwent the procedure last year. Other top procedures included nose reshaping, eyelid surgery, liposuction and tummy tucks.
"The market has recovered, so people are feeling a little more comfortable to spend money," said Dr. Malcolm Z. Roth, director of plastic surgery at Maimonides Medical Center in New York.
Facelifts had not seen growth since 2007, but they rose 9 percent in 2010, with nearly 113,000 surgeries performed across the country.
All body-shaping procedures, including breast lifts, body lifts, upper arm and thigh lifts, saw an increase in 2010 as well.
"People have worked their way out of debt, so we're not only seeing normal activity, but also the pent up demand from the past few years," said Haeck.
Time Off for Surgery
But along with the actual cost of procedures, Roth said that the necessary time taken off from work -- even a single day of rest after an operation -- also deterred people from going under the knife in recent years.
"Those who are still employed have weathered the storm," said Roth. "They have assurances so there's a good comfort level that they'll continue to be employed by that job. A lot of people were afraid to miss a few days, but now they're willing to do that."
Botox and Fillers Popular Even During Recession
Minimally-invasive cosmetic procedures did not see as much of a dip with the bad economy, but the procedures still increased by 5 percent in 2010. Botulinum toxin type A (Botox) was the most in-demand of the group with 5. 4 million procedures performed in one year, followed by soft tissue fillers, chemical peels, laser hair removal and microdermabrasion.
"I haven't seen anyone back off financially from fillers and Botox," said Haeck. "I would think there must be a price point that is too expensive, but $500 for a Botox shot wasn't something that most people cut back on."
Minimally-invasive procedures require little or no recovery time, and Roth said plastic surgeons have become so well-versed in the procedures that some people can leave work on their lunch break for a filler and return that afternoon.
"We, as plastic surgeons with the use of injectables, might be able to restore a nice crisp jaw line on someone who might have been a facelift candidate only and buy them a few years, or perhaps give them a better outcome, by just injecting once or twice a year," said Roth.
Reconstructive surgeries, including tumor removal, laceration repair, scar revision, hand surgery and breast reconstruction, also saw a 2 percent boost in 2010.
Breast reconstruction was up a significant 8 percent in 2010, but Haeck said that might not only be because of the economy.
On January 1, 2011, New York State passed a law saying that all patients who undergo a mastectomy for breast cancer must be informed of their reconstruction options by the hospital staff.
"This might set a trend around the country," said Roth." In the past, many women were not being given the reconstruction option by their surgeon who was talking about their cancer."
"We are now working closely with our colleagues in breast surgery so they know we're available to try and restore and enhance that woman, so they can look at their bodies and feel whole again," said Roth.
Under the Women's Health and Cancer Rights Act of 1998, health insurance companies and self-insured group plans that cover mastectomies must also cover the cost of breast-reconstruction surgery.
"I think people are more aware of breast reconstruction," said Haeck. "There is a cause and effect not necessarily related to the economy, but the push for education. As more states enforce this, we'll see the numbers grow."
But Roth said that many people are unaware of the required insurance coverage that goes along with the mastectomy, and if they are aware, they may feel uncomfortable with their choice to get reconstructive surgery.
"Women have been told their reconstructive options, but then they're told, 'You don't need to do that,'" said Roth. "Although the doctor or family member may try to be giving a positive message to the patient, she may feel like she's being vain or narcissistic if she were to choose reconstruction."
By working directly with oncologists to help women understand breast reconstruction, Roth and Haeck say they hope all women will feel comfortable talking with a plastic surgeon about their options after a mastectomy.
"Maybe the woman would choose not to have a reconstruction," said Roth. "But rather than her hearing from her loved ones, 'You don't have to do that, we'll love you anyway,' she can at least talk to a board-certified plastic surgeon about options. Ultimately, it's the woman's choice."