The economy isn't the only thing that's sagging — so are faces, breasts and bellies as would-be cosmetic surgery patients increasingly opt against costly nips and tucks because of tough financial times.
Anecdotal reports and a recent unscientific survey from an industry trade group suggest many cosmetic surgeons have been seeing a drop-off in costly operations, some by as much as 30 percent or more.
Diane Lawyer, a software company manager in Atlanta, said belt-tightening has made her put off getting her eyes done, a procedure that would cost a few thousand dollars.
"I just can't justify that right now," she said.
Lawyer, 55, has started shopping at a discount grocery, rarely drives to save on gas, and loaned money to help keep her sister out of foreclosure.
"I lost $15,000 in the last two weeks on the stock exchange," she said, referring to her dwindling 401K plan.
Dr. Alan Gold, president of the American Society for Aesthetic Plastic Surgery, said that for the past year, sagging business has been the talk of cosmetic surgeons.
"Everybody talks about it, nobody really has any numbers, so we polled our membership," said Gold, whose suburban New York office is on Long Island.
Of about 700 doctors who responded to the April-May questionnaire, 53 percent said business is down, some by as much as 30 percent.
Dr. Patrick McMenamin, president-elect of the American Academy of Cosmetic Surgery, said he's in regular contact with cosmetic surgeons who complain that business continued to slide through the summer — even before Wall Street's recent nosedive.
"With this latest fiasco, many are probably down closer to 40 percent," said McMenamin, a Sacramento, Calif., cosmetic surgeon who specializes in faces, breasts and liposuction.
For him, August "was terrible. I just did a lot less surgery."
September's always a slow month for cosmetic surgery, he said, so the economy's impact was less palpable. "I have no idea where October is going."
To attract patients, "We've reworked our mailing list and Web site, all facets of the business," McMenamin said. He hasn't lowered prices for procedures but says some doctors have.
While surgeries are down, McMenamin said he's noticed an uptick in cheaper, less invasive options, including Botox injections and wrinkle fillers. So instead of shelling out $7,000 for a facelift, patients spend $1,000 for less dramatic results.
However, many Botox and filler patients are waiting longer than the usual three to four months between treatments, said Dr. Robert Singer of La Jolla, Calif.
Singer was reluctant to quantify the drop in his business, but said any cosmetic surgeon claiming business is great "is spinning and marketing."
"There's no question about it" that cosmetic surgeons around the country are feeling the pinch, said Dr. Edward Lack, who works in Chicago's tony northern suburbs.
"We're doing less invasive things and things that are less expensive," Lack said.
And some who invested in office upgrades are worried. Cosmetic specialist Dr. Jim Matas of Orlando, Fla., said he took out a $100,000 mortgage last year to plushly renovate his condo-office. He's been able to make the payments, but notes, "I still have that as an overhead cost that I didn't have" before the economy's big slide.
Orlando real estate appraiser David Ritter has been considering getting a $6,400 forehead lift from Matas. But Ritter was recently laid off and said he can only afford the surgery if he gets a sizable severance package.
"It's a double-edged sword," he said. "I need to do this because I'm 45 and competing with younger people" in a tough market.
Reliant in the past on Botox and wrinkle fillers, he feels pressure to look more youthful. "I always say it's better to look good than to feel good, sometimes," Ritter said.