The cosmetic surgery industry is in need of a lift. Soaring unemployment, high gas prices and the mortgage crisis have left consumers with less discretionary income. For plastic surgeons, that means fewer patients are coming in for elective procedures.
"I think that people are scared. Everything's going up. Costs are going up. People are watching their pennies," says Dr. William Rassman, a surgeon for the New Hair Institute in San Jose and Los Angeles.
Business is down 30 percent to 40 percent, Rassman says.
In 2007, the number of surgical procedures performed remained steady compared with the year before, and nonsurgical procedures rose 9 percent, according to the American Society of Plastic Surgeons.
This year, many plastic surgeons say they are booking fewer surgical procedures, such as face-lifts and breast augmentations. At the same time, nonsurgical procedures – which are less expensive – are gaining in popularity, including microdermabrasion and injectable toxins such as Botox.
While a face-lift can cost $6,000 to $15,000, a single shot of Botox costs $125 to $400 and doesn't require the patient to take time off from work to recover.
"You see it in the number of patients scheduled in advance. It's the difference between being scheduled one month instead of three months in advance," said Dr. Shahriar Mabourakh of the Folsom Plastic Surgery & Laser Center.
According to a June survey by the American Society for Dermatologic Surgery, 51 percent of respondents said their patients were more concerned about the costs of cosmetic-related procedures than they were six months before.
That has meant an increase in time between visits, bargaining and price comparisons.
"A lot of people are shopping the Internet more now and just being wary of prices," said Kimmie DelAndrae, marketing manager for the Folsom center.
Because elective procedures, as opposed to reconstructive procedures, are not covered by insurance, patients usually pay out of pocket or through a financing company.
The Aesthetic Facial Plastic Surgery Medical Clinic in Oakland began offering financing to its patients for the first time in May. The clinic says surgeries have decreased 20 percent compared with this time last year.
"It's the economy. The number of patients who had scheduled for a while ago say they can't afford it now and want to defer for the future," said the clinic's Dr. Sheldon Kabaker.
Although most plastic surgeons offer financing options, the housing bust has meant that patients often no longer have the equity to justify a loan.
"Now financing (companies) are becoming more difficult in who they approve," said Mabourakh.
The Folsom doctor started seeing a decrease in calls from prospective patients in December. Since then, the center has been promoting its referral program more aggressively.
"We're just trying to be a little bit more proactive (by) utilizing past patients as referral sources and offering specials to our patients who refer friends," Delandrae says.
Other surgeons have stepped up their advertising efforts.
"If you look across the board, you're seeing a lot more advertising in this field," says Dr. Terry Zimmerman, president of the Greater Sacramento Plastic Surgical Society.
Many surgeons say they have yet to see a gap in actual work.
"The spendable income on luxury items … seems to continue for several months after there are signs the economy is bad and the increase back to normal levels doesn't take place until several months after the economy has corrected itself," said Dr. Peter Panagotacos, a hair transplant surgeon in San Francisco.
"This seems to be a matter of money set aside for such a luxury," he said. "The nest egg is still there a few months after the bad times come but takes a few months to build back up again after the good times arrive."
Despite the economic downturn, the $12.4 billion plastic surgery industry is expected to grow, driven by the growing popularity of nonsurgical options. The ASPS predicts that by 2015, plastic surgeons will be performing more than 55 million procedures a year, up from almost 12 million in 2007.
