As the recession affects more and more people in the U.S., its a safe assumption one will see increasingly peculiar behaviors, all in the name of saving a buck. Cosmetic surgery patients are certainly no exception. As the economy worsens, its natural for people to feel more concerned about everything, from job security to health and well being. Unfortunately, our physical appearance has a big hand in how we perceive ourselves and each other with regard to those aspects and, as we worry about our life circumstances, many will attempt to quell the feelings of hopelessness and confusion with things such as some cosmetic enhancement.

Mind you, this isn’t necessarily bad if one can afford to have their elective procedure(s) in the safety and comfort of an abundantly staffed and accredited medical facility, with a highly-skilled and licensed plastic surgeon. Many even see the opportunity to have the plastic surgery procedure of their choice as the cornerstone to reinvigorating themselves, ultimately excelling in the workplace and their personal lives. Someone like an out-of-work T.V. newscaster could find themselves in a better position to find work and more confidence, after a facelift, botox or eyebrow lift.

Others, however, succumb to the circumstances of their personal and professional lives, resorting to desperate and dangerous means to get their appearance up to their own standards.

Take the case of Korean pop singing sensation, Hang Mioku. Now age 48, she began a troubling pattern of behavior some 20 years ago, when she began seeking facial rejuvenation procedures. Still frowned upon by many cosmetic surgeons, she began silicone injection treatments (instead of traditionally accepted injectables such as collagen or Botox) and exhausted her ability to continue having the procedure in her home country! After moving to Japan and seeking more treatments, often from un-licensed practitioners, she illegally obtained medical supplies and began injecting cooking oil directly into her own skin. Citing paranoid schizophrenia, and “hearing voices” telling her to do it, Mioku couldn’t avoid her own ill intentions. She eventually sought psychiatric help and gifted surgeons, who could help begin the path to reconstructing her face.

This phenomena isn’t exclusive to the mentally distressed, or regions where “black market medicine” reigns supreme. New York resident Fiordaliza Pichardo, died at age 43, after recieving similarly controversial silicone injections in her thighs, hips and buttocks. Refered to a local New York woman, from a mutual friend, none of Pichardo’s family or friends believed this could happen, let alone in a country with such stringent medical regulation.

Health officials fears that the illegal use of silicone as an alternative to cosmetic surgery is on the rise. Many attribute this to growing economic problems, and a desire to get facial rejuvenation quickly and discreetly. Appanrently the injections, usually done in motel rooms, makeshift medical offices and even in-home “pumping parties” are most popular among Latina and transgender women, who may be unable to afford conventional plastic surgery and who tap into it through unlicensed practitioners working through word of mouth, New York city officials said.

In a recent New York Times article, Dr. Nick Gorton was quoted: “If you go to a pumping party, you can have it tonight. It’s a big temptation, especially among young people who, when you’re 20, you’re not thinking about your own mortality.”

The fallout from these illegal injections are certainly no laughing matter. Dr. Nathan Graber from the New York Department of Health and Mental Hygiene says that these products can get into the blood stream causing severe breathing problems, such as lung failure and worse. Silicone injections can embolize to the brain and cause seizure, coma, and of course death. Dr. Graber says if you have already had an illegal injection, see a doctor immediately.

Medical advisors strongly urge patients to never undergo a treatment outside of a licensed clinical setting. If procedures are offered at a home or in a hotel room or in a nail salon then you really have to think twice before you go ahead with that procedure.

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Despite personal views, plastic surgery has gone mainstream, and is obviously here to stay. The release of plastic surgery statistics has become an annual ritual, almost on par with announcing awards show nominees. Every year the numbers are analyzed to see what trends are revealed, and the 2008 data, released last month from the American Society of Plastic Surgeons (ASPS), provided a few surprises.

Paramount among these was the emergence of breast augmentation as the number one cosmetic surgery procedure, knocking off liposuction which has traditionally held the spot. Though cosmetic surgery overall declined in 2008 (which also happens to be a first), the surge in cosmetic implant use was mirrored by an increase of approximately 39% in breast reconstruction. This comes on the heels of FDA clearance for silicone gel breast implants 2 years ago, suggesting that the controversies that have plagued this breast implants type in the past have since faded.

A longer view reveals a more telling trend, however. While cosmetic surgery was down by a few percentage points, non-surgical and minimally invasive cosmetic procedures-Botox or dermal filler injections, lasers and the like-were up. One widely held interpretation of this is that people are shifting into “maintenance mode” by opting for more affordable procedures with minimal or no downtime until the economy improves and they can justify their facelift. Botox might be the new lipstick, a modern version of the historical increase in lipstick sales with every major economic downturn in the past.

Forecasting Plastic Surgery Trends

But broader analysis reveals that non-surgical cosmetic procedures have been increasing a lot more than surgery for several years. Although 1.7 million surgical procedures were done in the U.S. last year, non-surgical procedures checked in at more than 10 million. This is due, in part, to continually improving products and technologies, and with this has come greater social acceptance. Many of them are even household words now. Plastic surgeons have adapted by expanding their repertoires to include minimally invasive technologies and beauty services at their practices.

The big question on everyone’s mind is what all this means for the economy and where we are headed. One could easily subscribe to the theory that plastic surgery bookings anticipate an upturn, and if the first quarter of the year is an indication, then the economy is headed in the right direction. Some are freshening up their appearance as they change careers, others taking advantage of time off in between jobs. Either way, it is a vote of confidence; whether it is right for you, as always, is a personal choice.

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Despite being historically seen as a luxury, reserved for the wealthy, it doesn’t take a board certified plastic surgeon to tell you that appearances matter in our society. The emphasis on this popular notion, however, is being challenged by the economic restrictions many of us are now facing, during the recession.

The idea of foregoing cosmetic enhancement is starting to show, across the board, in the field. Recent national and regional surveys by the American Society of Plastic Surgeons (ASPS) shows a 62% decrease in overall cosmetic procedures of all kinds, since 2007. Invasive surgical procedures have shown a 44-64% drop, depending on the procedure, while 73% of ASPS-surveyed surgeons have shown an increased or stable demand for minimally or non-invasive procedures.

A fair amount of surgeons expressed cautious optimism amidst the downturn in business, noting that while business is definitely slowing down, the expectations are that it won’t be a permanent change in the field. Many surgeons are advocating that patients focus on only one aspect of their appearance to improve and then return when they are financially capable.

“Instead of getting their whole face addressed maybe they’ll narrow it down to the eyes or their lips”, says St. Louis plastic surgeon, Dr. Bruce White, M.D.

While some surgeons and practices opt to push less obtrusive procedures like Botox or fat grafting in lieu of procedures like a facelift and body contouring, others are taking a different approach to keep their business booming. Dr. White’s practice, for example offers 10-15% discounts for first time patients.

Says ASPS president, Richard D’Amico, M.D., “It is very clear the economy is affecting the demand for surgical cosmetic procedures. We are hearing that from consumers and plastic surgeons. And while ASPS Member Surgeons are feeling the impact of the economy, we anticipate the historic bounce when patients return as the economy improves.”

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