Micro- and Macroeconomic Trends Have Differing Effects on Surgical vs Minimally Invasive Procedures, Reports Plastic and Reconstructive Surgery

PHILADELPHIA —  For plastic surgeons, revenue from aesthetic procedures rises and falls with economic trends—with different types of procedures following different categories of economic indicators, reports a study in the June issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Revenue from cosmetic surgery procedures varies with stock market averages and other macroeconomic indicators, while revenue from minimally invasive procedures mirrors microeconomic indicators such as disposable income, according to the study by ASPS Member Surgeon Dr. Pierre B. Saadeh and colleagues of New York University Langone Medical Center. They write, "Plastic surgeons should note these trends and associations in order to make educated decisions regarding practice management."

Despite 'Economic Turbulence,' Growth in Revenue From Aesthetic Procedures

The researchers analyzed annual ASPS data on aesthetic procedures from 2000 to 2011—an economically turbulent time including recessions in 2001 and 2007-09, followed by a period of economic stagnation. The ASPS data included procedures performed by all specialties, not just plastic surgeons.

The review focused on revenue, rather than the volume or price of procedures performed. Trends in revenue were analyzed, including their possible relationships with several different economic indicators.

The data showed continued expansion of the market for aesthetic procedures. Total revenue for 2011 was $11.7 billion, representing a 20 percent increase from 2000. This was despite a net ten percent decline in revenue from aesthetic surgical procedures, such as breast augmentation or face-lifting.

Meanwhile, there was nearly a 200 percent increase in revenue generated by minimally invasive aesthetic procedures—especially injection of botulinum toxin (Botox) injection and soft tissue fillers. The market share for minimally invasive procedures increased from 30 percent of aesthetic procedures in 2000 to nearly 50 percent in 2011.

Different Types of Procedures, Different Economic Indicators

The two categories of aesthetic procedures were related to different types of economic indicators.

Revenue from traditional aesthetic surgical procedures was reflected by indicators of the macroeconomic climate, such as stock market averages. As the Dow Jones Industrial Average and the Standard & Poor's 500 index went up, so did revenue from aesthetic surgery. Conversely, as the unemployment rate went up, revenue from aesthetic surgery went down.

In contrast, trends in minimally invasive aesthetic procedures reflected microeconomic indicators. Revenue from minimally invasive procedures increased along with home prices, disposable income per capita, and real Gross Domestic Product per capita.

"Thus, as the productivity on a per person basis increased, so too did the revenue generated from minimally-invasive aesthetic procedures," Dr. Saadeh and coauthors write.

Especially with flat insurance reimbursement for reconstructive surgery, many plastic surgeons are shifting their practice to include more aesthetic procedures.

The new analysis shows net expansion in revenue from aesthetic procedures over the past decade, despite a fluctuating economy. The growth was driven largely by increases in minimally invasive procedures—especially Botox and soft tissue fillers—while revenue from aesthetic surgery has been "surprisingly stable."

For plastic surgeons seeking to stay competitive during uncertain economic times, the results suggest that a balance of the two types of procedures might be the best strategy. Dr. Saadeh and colleagues write:

"A purely minimally-invasive practice appears to be too vulnerable to changes in the population’s disposable income while a purely surgical practice would fail to take advantage of future economic windfalls."

Plastic and Reconstructive Surgery is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About Plastic and Reconstructive Surgery

For more than 60 years, Plastic and Reconstructive Surgery (PRS)® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, PRS brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.

About Wolters Kluwer Health

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About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. 

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