Just a couple of comments on the recent stats published by The American Society for Aesthetic Plastic Surgery (ASAPS). Full report is available at http://www.surgery.org/press/statistics-2008.php. There is also a good post at the Aesthetic Medicine News.

The report reaffirms our opinion that in tough economic times, small aesthetic luxuries are still in demand. ASAPS’ report, 2008 Statistics on Cosmetic Surgery, outlines that 8,491,861 non-surgical procedures were done in 2008. This is a reduction of 11.7% over 2007, and interestingly the only three growth non-surgical procedures were Calcium hydroxylapatite (Radiance) injections (up 3%), chemical peels (up 2.9%) and laser skin resurfacing which had increased by 12%.

Another important conclusion in the report: many of the non-invasive non-surgical treatments are being preformed by professionals outside the membership of the ASAPS. The public can now get many of these procedures in medical spas and physicians’ offices, i.e. not in operating rooms.

“However, it is clear that the economy is having an impact on the aesthetic medicine industry: its the “Lipstick Effect” in Aesthetic Medicine, a phrase coined by Leonard Lauder, Chairman of Estee Lauder, who saw a huge jump in lipstick sales after September 11th. During times of economic uncertainty, consumers load up on affordable luxuries as a substitute for more expensive items. For physicians in Aesthetic Medicine, the lipstick effect manifests itself in patients choosing laser lipolysis over surgical liposuction or dermal fillers over face lifts.”

Aesthetic non-invasive medical offerings represent the perfect storm between the current economy, medicine and profitability. Dr. Jason Pozner’s comments support this assertion. “Patients aged 35-50 continue to dominate [the cosmetic surgery market], having 45% of the cosmetic procedures, and most commonly getting liposuction and Botox. After the age of 51, the top procedures were blepharoplasty and Botox (32% of the total patient population). For the 19-34 set, the top procedures were breast augmentation and laser hair removal, and for everyone below 18, it was rhinoplasty and laser hair removal.” Even within cosmetic surgery practices, non-invasive procedures are more than competitive in all segments with cosmetic surgery offerings.

LaserOffers.com comment

Regardless of the economic outlook, the top five non-surgical procedures, as reported by the ASAPS for 2008:

• Botox
• laser hair removal
• hyaluronic acid dermal fillers
• chemical peels, and
• laser skin resurfacing

These are the treatments that will continue to offer physicians in aesthetic medicine the best options for profitability in 2009.

Today we would like to address the issue, which was covered by CNN in November 2008. The report stated that nearly half the respondents in a survey of U.S. primary care physicians said that they would seriously consider getting out of the medical business within the next three years if they had an alternative. What are the reasons for such an exodus among family doctors and internists, widely known as the backbone of the health industry?

Here is the data from the survey:

• Questionnaires were sent to more than 270,000 primary care doctors and more than 50,000 specialists in the U.S.
• Of the 12,000 respondents, 49 percent said they’d consider leaving medicine
• A shortage of 35,000 to 40,000 primary care physicians by 2025 was predicted

Reasons:

• Overwhelmed by red tape generated from insurance companies and government agencies
• Rising cost of malpractice insurance
• Shrinking reimbursements
• Declining income

Dr. Alan Pocinki has been practicing medicine for 17 years. He began his career around the same time insurance companies were turning to the PPO and HMO models. So he was a little shocked when he began spending more time on paperwork than patients and found he was running a small business, instead of a practice. “I had no business training, as far as how to run a business, or how to evaluate different plans,” Pocinki says. “It was a whole brave new world and I had to sort of learn on the fly.”

We hear from many health professionals that it’s no longer worth running a practice and that they want to change careers. Just like for Dr. Pocinki, it will be very difficult to start a successful career outside of the medical field. Physicians go a long way to complete their training, licensing requirements, pay the loans and set up their practice. Medicine is what they chose to do in their lives.

LaserOffers’ panel and in-house discussions have helped us realize that the fee-for-service based anti-aging and aesthetic field can be one of the better alternatives for family doctors and internists. There are plenty of examples to demonstrate that the transition is fairly painless and can be accomplished in a short period of time. Training is quick and easy. In most cases capital expenditures, such as buying laser equipment, can be financed, and the demand for anti-aging and rejuvenation treatments is standing strong even during the recession. Baby boomers want to look young and they have discretionary cash to spend. People on the job market need to look fresh and young during the interviews and are willing to spend about $1000 on their looks.

LaserOffers comment

We see a clear trend towards anti-aging and preventive treatments in today’s medicine. Physicians in general will need to move from the current perception of their mission in treating symptoms to preventing their occurrence,  from using drugs to extend patients’ life to making them more active and happy. Aesthetics will definitely play a major role in the process. We will come back to the subject periodically in our future posts.

Today, people are doing all they can to ensure their job security. Taking prolonged periods away from their job could result in termination: if a company can get along without you for a couple of weeks then you obviously aren’t that valuable.

Thus the cosmetic surgery industry has seen a significant increase in the non-invasive and less costly procedures including Botox, other injectables and aesthetic laser treatments. The reasons for this increase is because these types of procedures are extremely effective but require less or no downtime and allow the patient to return to work quicker, sometimes literally after lunch.

Cosmetic procedures are becoming an integral part of employee’s routines to look their best for their jobs. Looking young and feeling young can be a strong component to get or keep a job – that is why more people are seeking affordable but effective cosmetic procedures.

During this harsh economic time, it is important to realize all the great things cosmetic surgery and aesthetic clinics can offer. There are at least three key factors that will drive the aesthetic demand and cosmetic surgery industry in 2009.

First is the new, emerging technology within the industry. There is the advancement of laser technologies and the prolific results new lasers can provide to the patients. Laser get safer, more versatile and provide much better results.

Second is the great push with gynecologists and some forward-looking family physicians pursuing cosmetic surgery. The scientific research incorporating the two has created the cosmetogynecology specialty. This specialty is fast growing and includes some of the best OB/GYNs practicing and continuing the education of cosmetic surgery. As medicine transforms into anti-aging more physicians will add aesthetic treatments to their core practices.

Third are the declining costs of highly effective cosmetic procedures. There is a strong demand for dermal fillers and lasers – and the cost of treatments and the downtime for recovery continue to drop. The patient is saving some money and is able to return to work quicker. If the patient is happy – she or he will come back to the practice for more. It is a win-win situation both for the patient and for the aesthetic practice.

The American Academy of Cosmetic Surgery is a professional medical society whose members are dermatologic surgeons, facial plastic surgeons, head and neck surgeons, general surgeons, oral and maxillofacial surgeons, plastic surgeons, or ocular plastic surgeons — all of whom specialize in cosmetic surgery.

The AACS has completed its annual Procedural Survey and the most notable finding is the shift towards non-invasive laser treatments.

Over the past three years, cosmetic surgeons have seen a significant increase in both males (456%) and females (215%) electing to have laser resurfacing. Laser resurfacing is performed with a carbon dioxide (CO2) laser that delivers short bursts of high-energy laser light to minimize wrinkles and lines on the face. In addition, laser hair removal has jumped to the overall number two most performed non-invasive cosmetic procedure.

“Cosmetic surgery technology is advancing at the speed of light,” states AACS President Patrick McMenamin, MD. “As we learn more about the cosmetic uses for lasers, the more patients benefit from effective results and quicker recovery time. It is an exciting time for both cosmetic surgery patients and physicians.”

Although the economy is struggling, these laser procedures seem to be recession resistant. For instance, laser resurfacing has seen an approximate $450 decline in price since 2002. “As long as these procedures are effective and affordable, their demand will continue to remain steady.”

Other notable findings from the survey include:

In 2008, cosmetic surgeons have seen a 29% increase in their female clientele. Despite the economy, women are continuing to invest in their appearances. In addition, cosmetic surgeons have seen a 2% decline male patients proving that when times are tough, cosmetic surgery is the one of the first things men delete from their wish lists.
The top three most performed invasive cosmetic procedures in 2008 include: liposuction, blepharoplasty and breast augmentation; while the most popular non-invasive cosmetic procedures were Botox(R) injections, laser hair removal and hyaluronic acid.

The 2008 Procedural Data is based on a survey of U.S.-based AACS members completed in December 2008. The entire report, conducted by RH Research, is available by contacting the Academy.

Related Documents

• AACS 2008 Procedural Survey Results
• AACS 2008 Procedural Survey Fact Sheet
• AACS Economic Fact Sheet