Plastic Surgery Industry Gets Lift


    GRAND RAPIDS — The American Society of Plastic Surgeons reported that patients spent $8.4 billion on surgical and minimally invasive cosmetic procedures in this country last year, an outlay that was up by $1 billion, or 13 percent, from four years earlier.

    ASPS also said Americans underwent 9.2 million cosmetic procedures in 2004, a jump of 1.8 million, or 24 percent, from 2000.

    “These statistics show a strong, continued and healthy increase in cosmetic surgery that mirrors the 4.4 percent economic growth of the United States,” said Scott Spear, M.D., ASPS president.

    What has led the push of a 24-percent hike in cosmetic procedures and a 13-percent gain in revenue for the industry over such a short period is Botox.

    Botox injections, a procedure ASPS classifies as minimally invasive, grew by 280 percent, from 786,911 treatments in 2000 to 2,992,607 in 2004. Last year, Botox was the No. 1 cosmetic treatment with women and the third most popular with men. (See related chart.)

    Spending on Botox went from $287.9 million in 2000 to $1.12 billion last year, a figure that rose by nearly 400 percent and one that nearly accounts for the industry’s four-year revenue gain all by itself. The average charge for a Botox procedure has remained steady, though. The ASPS said a treatment cost $366 in 2000 and $376 in 2004.

    The minimally invasive treatments that are led by Botox injections and include laser skin resurfacing and chemical peels grew by 36 percent from 2000 to 2004 and accounted for 81 percent of all cosmetic procedures last year, while surgeries such as breast augmentation and facelifts fell by 8 percent over those years.

    So, has the industry recently gone through its own facelift? Not necessarily.

    “There certainly is a demand for some of the newer minimally-invasive treatments, things like Botox and various fillers that are available to reduce wrinkling. These are not something that is a substitute for traditional cosmetic procedures,” said Steven L. Ringler, M.D., managing partner for Plastic Surgery Associates in downtown Grand Rapids.

    “But when you look at the statistics, there has been a huge growth in those areas — some in the neighborhood of 2,000 percent — and that’s because in prior years these didn’t exist. So it’s a little bit deceiving,” he added.

    Ringler explained the newer treatments were supplementing and not replacing the more conventional procedures. For instance, he said there are patients who get Botox or collagen injections with their facelifts. Still, Ringler said the minimally invasive procedures do offer new choices to those who are skittish about surgery.

    The most popular national procedures are also the ones that are most performed locally. It usually takes a little longer for cosmetic trends, like liposuction, to be accepted by patients here because of the conservative nature of the market. But that really hasn’t been the case for some of the more recent treatments.

    “As for the minimally invasive procedures like Botox, Restylane and collagen, we actually have as much or even more experience with that because they’re very popular,” said Ringler. “In fact, our personal practice is one of the largest clients for Botox in Michigan and, I think, even nationally.”

    Plastic Surgery Associates has been at 220 Lyon St. NW for 18 years. The firm, which established itself 49 years ago, has seven plastic surgeons on staff. And business has been good recently. Ringler said his firm’s revenue has grown by 20 percent each year for the past few years.

    “That includes factoring in procedures that are not reimbursed at full reimbursement, like trauma and cancer reconstruction, where reimbursement is going down because insurance companies don’t pay. So you’re basically making 40 cents on the dollar of what you normally charge. That’s going down, but our cosmetic surgery is going up, and that is clearly up 30 to 35 percent each year for the last two years, ” he said.

    An aging nation is one reason for the steady growth in cosmetic procedures. Another is that the baby boomers have embraced these treatments so strongly that the procedures have become mainstream. In addition, Ringler said clients perceive the newer treatments as being much safer than what was available 20 years ago.

    “I expect this trend to continue,” he said of the growth his firm has had. “We’re really just now entering the age of the baby boomers’ demand for cosmetic procedures. There are other people who have this demand, but the biggest growth area now is probably the baby boomers.” 

    Ringler said boomers, who are approaching 60, feel younger than the previous generation and they want their appearance to match their mindset. And that group includes mature business executives.

    “They’re seeing competition from younger individuals and they’re concerned that their appearance may limit their competitiveness. So it’s not uncommon to see people from that area, as well,” he said. “They’re bright, they’re active and they’re ready to work another 10 to 20 years. They see a young upstart coming in and they feel that competitive edge.”

    Men Are For Noses, Women Are For Botox

    For women, it was botox. For men, their leading cosmetic procedure gave them a new nose. U.S. women spent over $6 billion on their 10 most popular cosmetic enhancements last year, while men invested slightly more than $1 billion on theirs.

    The following chart ranks the 10 most prevalent procedures for men and women, the amount of money spent on each and the number of procedures done for each.

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