Cosmetic plastic surgery increases 32% nationwide

Aging baby boomers, reality television helps result in quick growth

by Jill Henry

SBJ Reporter

jhenry@sbj.net

Baby boomers and television shows are putting a new face on cosmetic plastic surgery.

Cosmetic plastic surgery was performed on 8.7 million patients in 2003, an increase of 32 percent from 2002, generating $8.4 billion, according to a report from the American Society of Plastic Surgeons.

The number of surgical procedures increased 5 percent, and minimally invasive procedures grew by 41 percent compared to 2002.

Dr. Keith LaFerriere of The Facial Plastic Surgery Center in Springfield has seen an increase in procedures for older and younger patients.

"We're entering some very interesting times now because every eight seconds a baby boomer turns 50. We're seeing a generation that is getting into an aging area where some of the minimally invasive things don't work anymore and you have sagging and bagging that really needs to have a little bit more extensive procedure done. You have to couple that with the popularity in the media of cosmetic surgery," LaFerriere said.

Shows like "Extreme Makeover," "The Swan" and "I Want a Famous Face" have generated interest in facial plastic surgery.

Dr. Michael J. Harl of The Center for Plastic Surgery at Ferrell-Duncan Clinic, said that reality TV doesn't provide a good impression of the plastic surgery industry.

"That's not the kind of image we want or the kind of advertising we want. We don't want to portray ourselves as a used-car dealership. The majority of our patients would not go to a practice that had that image. We're more sensitive to that. In some ways we want to maintain a low-key, discreet presence because that's what our patients would expect," Harl said.

Demand rises among men

Men accounted for 14 percent of all cosmetic plastic surgery patients in 2003, according to the American Society of Plastic Surgeons. More than 1.2 million men underwent procedures, a 28 percent increase compared to 2002. Rhinoplasty (nose reshaping) was the most popular surgical procedure for males, with 129,774 procedures performed.

LaFerriere saw an increase of 12 percent in face-lifts for men in 2003.

"We're in a very competitive environment from a job standpoint. We're in a youth-oriented society. Men have been certainly slower to embrace the procedures, but when they do, it's frequently occupationally related," LaFerriere said.

Harl estimates his male patients make up 20 percent of the rhinoplasties and 20 percent to 30 percent of blepharoplasties (eye lid surgeries) he performs.

"Men seem to be as concerned about their image as women are," Harl said.

"I guess men seem to be less concerned about maybe the effects of age on their face, so maybe the face-lift type procedures aren't quite as prominent as they are in the female population, but the rhinoplasties and blasperoplasties are still fairly common."

Neal Wright, an independent media producer, is one of LaFerriere's patients. Over the last 13 years, he has undergone several procedures including rhinoplasty, a forehead lift, blepharoplasty, Botox and a face lift. As a business owner, Wright said he found himself in competition with people 20 to 25 years younger.

"Sometimes people will not look at your young ideas if you don't have a young presence," Wright said.

"I'm not saying dress like a 20-year-old if you're 50, but you need to have a more youthful appearance. You're categorized immediately, as soon as you step in the door. That was my motivation."

Minimally invasive procedures

Minimally invasive procedures were up 43 percent nationwide from 2002, with 7 million procedures performed in 2003, according to American Society of Plastic Surgeons. Botox injections were the most popular minimally invasive procedure for both men and women, with 2.9 million injections performed.

"There have been a lot of procedures and things that have improved over the past few years for the younger patient that are less invasive, that sometimes don't even require any time off work," LaFerriere said. "Things like the fillers that are available now and Botox for hyperactive muscles and hyperactive wrinkles. Someone can come in and do it on their lunch hour."

More than 6.2 million people underwent reconstructive plastic surgery procedures in 2003, reflecting no change compared to 2002, according to American Society of Plastic Surgeons. The most common reconstructive procedure performed was tumor removal with 4.5 million procedures performed.

Reconstructive plastic surgery, Harl said, makes up about 30 percent of his practice. "We do reconstruction following cancer operations on the head, neck and breast. We do reconstruction following trauma. We do burn. We take care of some hand injuries. A lot of patients have skin cancer, and we take care of those as well."

Connecting with the surgeon

Viewing albums of before-and-after photos is now restricted due to the Health Insurance Portability and Accountability Act of 1996 and computers can generate images that surgery can't guarantee, so Harl said feeling comfortable with a surgeon is vital. "Most of the time, good communication and speaking with your patients gives them an appropriate idea of what to expect," he said.

The goal is to make the patient feel comfortable with the process.

"It's very important that a patient feel comfortable with the surgeon and the procedures that are being contemplated. I certainly would recommend if there is any question at all that someone get a second opinion if they aren't comfortable," LaFerriere said.

Outpatient trend

Not all plastic surgery procedures are performed at hospitals, according to American Society of Plastic Surgeons. In 2003, 56 percent were done in an office, a 6 percent increase from 2002; 28 percent were done in a hospital, a 4 percent decrease from 2002; and 16 percent were done in free-standing surgical facilities, a decrease of 1 percent from 2002. Fifty-one percent of reconstructive plastic surgeries were performed in an office, 36 percent in a hospital, and 12 percent in freestanding surgical facilities.

Harl recommends that patients ask about a physician's credentials prior to undergoing any procedure.

"Anyone that has a license in medicine can call themselves a plastic surgeon, and if they have their own outpatient surgical setting, they can pretty much do anything they want.

"However, hospitals regulate very strictly who can do plastic surgical and cosmetic surgical procedures.

"Even if you're going to have a procedure done at a physician's office or surgery center, it's best to find out if they have credentials to do that same procedure at a hospital they're affiliated with. If they don't, there may be a reason behind it. It could be that they just never applied for those credentials. It may not necessarily be scandalous, but that's a good way of checking," Harl said.