People are cutting back on cosmetic surgery and other elective surgeries in response to the dismal economy, reversing the booming popularity of tummy tucks, eye lifts, and breast implants, which have soared in popularity in recent years, particularly among the middle class.

When polled in October, 62 percent of members of the American Society of Plastic Surgeons said their business was down 20 percent or more from the year before. “I expect it’s more than that in some areas, a 40 or 50 percent decrease,” says Michael McGuire, president-elect of the ASPS. That’s particularly true in areas like New York, California, and Florida, which led the surge in popularity. A small survey by the society in October found that 60 percent of respondents said the economy had had an impact on their plans for cosmetic surgery. That’s not surprising, given that cosmetic procedures aren’t covered by insurance.

People may be shunning surgery not only because of the cost but because of the downtime for recovery. “Now, you just even don’t want to take the time off [from work],” says Alan Gold, president of the American Society of Aesthetic and Plastic Surgeons, a group of doctors who specialize in cosmetic surgery.

The demand may be deferred, not denied. Alan Gold, who says he saw a similar downturn after 9/11, predicts that business will revive with the economy. Those who desire cosmetic procedures “are people who are concerned about their appearance or are concerned about age-related changes,” he says. “They may defer that desire, but the desire isn’t lost.”

As a contrast to the surgery statistics, it appears that non-invasive treatments, like injectables and laser rejuvenation, are still on the rise. Hair removal and photorejuvenation are value offers for consumers. In most cases these procedures are cheaper than Botox but may provide a much longer lasting result with no downtime.