A panel of aesthetic practitioners talked-up the popularity of facial rejuvenation in a down economy at the recent meeting of the American Society for Aesthetic Plastic Surgery (ASAPS), which was held this month in Las Vegas. What downturn? Americans pay $12 billion to look good:

Americans spent nearly $12 billion on cosmetic procedures last year—much of it on breast implants, surgical facelifts, and Botox injections, but sought out hyaluronic acid injections, fractional resurfacing, and especially nonsurgical options, according to Trevor Born, MD, a plastic surgeon from Toronto and New York City. Results from volumizing agents, or fillers, can be fabulous, he said.

Paul Lorenc, MD, of New York City said cosmetic surgery has become more popular today because it's much easier to perform, there's less downtime for recovery, and it's well-exposed in the media.

"Ultimately, we're doing a better job for our patients with less recovery time," he says. "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, says Barry DiBernardo, MD, FACS, of Montclair, NJ. 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. The top nonsurgical procedure was Botox injections (2.46 million), at an average cost of $443 per treatment.

Facelifts are still the main component of cosmetic treatments, with 132,000 procedures performed in 2008 at an average cost of $6,728.

While we're on the subject of the ASAPS meeting, The New York Times offered an interesting closing statement about the state of the plastic surgery field, in its article, Hurt by Economy, Plastic Surgeons Find Hope in New Products:

Doctors at the conference hoped to get out the message that they were far from the stereotypes of predatory practitioners who take advantage of patients’ insecurities. They resent portrayals like that from a “Sex and the City” episode in which Samantha Jones, played by Kim Cattrall, is worried about aging and wants a small operation but is told by a physician that she ought to consider several other procedures. She eventually decides on “aging gracefully.”

Of the fictional surgeon’s behavior, Dr. Robert Singer of San Diego said, “That never happens.” Dr. Singer added: “I generally will turn that question in a different way when a patient asks me what I think she needs done. It’s not a matter of what I say. It’s what bothers you.”

Dr. Singer said that part of the challenge was managing patient expectations.

“The public wants something that has essentially no down time, that has maximum improvement, that is non-invasive, that has no discomfort and that has no cost,” Dr. Singer said. “They want magic. That magic pill doesn’t exist.”