Cosmetic surgeons have few better customers than reality television star Heidi Montag. The 23-year-old star of the recently canceled series The Hills revealed to People magazine this year that she’d undergone 10 plastic surgeries in a single operate-a-thon day last fall.
　　Her operations included a (mini) brow lift, liposuction and surgery to pin her ears back. Montag had revisions done to previous breast implant and nose job surgeries, both among the five most popular cosmetic surgical procedures in 2009. She also indulged in wrinkle-smoothing Botox treatments, the most requested nonsurgical cosmetic procedure.
　　Yahoo! BuzzFour of the operations she had were among the top 10 performed last year, according to new data from the American Society for Aesthetic Plastic Surgery. (For the record, the ASAPS urges careful planning when considering multiple surgeries, but did not directly address Montag’s case).
　　Too bad other plastic surgeons aren’t doing as well as Montag’s doctor. The recession has hit the cosmetic surgery business in a big way. The number of major cosmetic surgeries plummeted 17% last year to 1.5 million from 1.8 million in 2008, according to an annual survey by the ASAPS based on data from 928 board-certified physicians. The two biggest declines were in facelifts (down 28.9%) and forehead lifts (down 30.7%). More than 90% of all cosmetic procedures were performed on women.
　　Cheaper nonsurgical cosmetic procedures held up better--8.5 million such procedures were performed last year, up less than 1% from 2008. This category includes Botox, smoothing fillers like Juvederm and Restylane, and microdermabrasion, a technique that scrubs the face with tiny crystals. But these procedures only cost a fraction of what the big-ticket items do.
　　It’s no surprise that people are choosing more affordable alternatives to surgery, says Renato Saltz, president of the ASAPS. The average cost of a facelift is $6,881 vs. just $397 for one round of Botox. Saltz says that patients these days seem far less eager to pay for surgeries with credit and are nervous about taking time off from work after an invasive procedure. Recovering from a facelift requires two weeks, a nose job seven to 10 days. With unemployment levels high, taking this much time off for an optional operation is a risk that many people can no longer afford to take.
　　Saltz, a plastic surgeon in Salt Lake City who specializes in facial surgeries, liposuction, breast surgery and reconstruction after cancer, experienced the trends personally. Last year he says patients wouldn’t even bother to apply for the credit lines available through the office for major operations. But he says they were happy to pay for cheaper things like Botox with credit cards.
　　Saltz predicts that business will rebound once the recession ends, and historical data shows that he may be right. Since the ASAPS started collecting statistics in 1997, the number of cosmetic procedures shot up 147%, from 2.1 million to 10 million. There was a significant dropoff in 2002, at the height of the last recession. But business peaked just two years later when 11.9 million procedures were performed.
　　Patients between ages 35 and 50 accounted for nearly half of all procedures. Overall, Americans spent $10.5 billion on cosmetic procedures in 2009.