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The healthy recession in cosmetic surgery

[2008-4-9]

If your local real estate agent's face is hanging low these days, it might be more than sadness. The recession's latest victim is cosmetic surgery. "Plastic surgeons from the Southland to South Florida said some colleagues are struggling to stay in business," Ricardo Alonso-Zaldivar reports in the Los Angeles Times. A breast implant company disclosed a decline in surgeries late last year; a laser eye-surgery firm has lowered its forecast based on a similar trend early this year. A professional breast augmenter frets that in January and February, business for some of his colleagues was off 30 percent to 40 percent.

It's not the suffering that gratifies me. It's the reaffirmation of the distinction between necessary and unnecessary procedures. People have always practiced medicine, albeit clumsily. And they've always adorned themselves, to the point of reshaping their heads and bodies, as the Mayans and Chinese did. (Even the Bush administration has yielded to nipple rings.) But despite the occasional overlap, medicine and body art remained two different things. One aimed at health, the other at beauty. One was necessary, the other elective. If your treatment looked really cool but all the patients died, it was a failure.

Modern cosmetic surgery has challenged that distinction. It has done so not in theory but in practice, by making aesthetic procedures so safe and lucrative that people who would otherwise have devoted their careers to medicine turned instead to cosmetic work.

Depending on how you count it, on an annual basis, the cosmetic-surgery industry—subset of the "luxury healthcare sector" and parent of the "facial aesthetics market"—is now worth $12 billion to $20 billion a year. Two weeks ago, the New York Times reported that last year, among 18 medical specialty fields, the three that attracted med-school seniors with the highest medical-board test scores were the most cosmetically oriented: plastic surgery, dermatology, and otolaryngology.


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