Cosmetic surgery on a budget

Sometimes frugality takes a backseat to vanity. Despite unemployment hovering close to 10%, people are still willing to open their wallets for cosmetic surgery.

"Especially during troubled economic times, patients become even more concerned about their physical appearance, as a way to remain marketable and viable in a tough job market," says Dr. Andrew Jacono, a dual board certified facial plastic and reconstructive surgeon based in Great Neck, N.Y.

According to the American Society of Plastic Surgeons, cosmetic procedures increased by 3% in 2008 compared to 2007. Still, people are more selective about what they're having done, opting more for minimally invasive procedures (up 5%) over surgical ones (down 9%).

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In fact, $10.3 billion was spent on cosmetic procedures in 2008, down 9% from 2007. People are clamoring for fillers like Botox and Restylane, laser skin resurfacing and laser treatment for leg veins and forgoing liposuction, tummy tucks and face-lifts. Here are six procedures you may actually want and can actually afford:

1. Spider vein laser treatment

Blast these unsightly problems away with the Cynosure Synergy Multiplex, which combines two proven laser treatments into one laser to shrink them. Dr. Anthony Youn, a board certified plastic surgeon based in Michigan, likes this technique because it doesn't require needles, so there's little pain. Another plus: the quick recovery time.

But one visit won't be enough. "Even though it's double the power because it's two lasers in one, it still takes several treatments to eradicate spider veins," he cautions. It could take two to four 20-minute treatments to get the desired results, at $250 per visit. The other alternative, sclerotherapy, in which a solution is injected into the veins, can run $400 to $600 per session. Patients on average will require four visits.

2. Micro-hair grafting

When topical treatments like Rogaine and Propecia aren't enough, it's time to turn to micro-hair grafting, says Dr. Luis Zapiach, a board certified plastic surgeon at Art Plastic Surgery in Paramus, N.J. Originating from Brazil, the technique allows surgeons to plant units as small as one hair follicle to the desired site. The five-hour in-office procedure produces a natural-looking hairline. Just don't panic if the hair falls out. "All the hair shafts will fall out, then, in the next few months as hair goes through its natural growth cycle, it grows back," he says.

The price tag has come down to $5 a shaft, but some patients may need to return up to two more times.

3. Facial spot removal

If your aim is to get rid of red or brown spots on your face, Jacono recommends the LimeLight Facial, which uses a light laser to target problem areas. "It's a non-invasive procedure that requires no downtime," he explains. The laser delivers a pulse of light and, within one to three weeks, the treated spot will flake off or fade.

One drawback is that you may need up to three treatments, spaced four to six weeks apart. Each visit will take a $500 bite out of your wallet. More invasive laser treatments, he says, can cost up to $4,000.

4. Earlobe lift

Expressing yourself through large piercings in your ears may be cool when you're out with your friends, but it may not be so cool with prospective employers, as one of Youn's patient discovered. "He had these huge earrings that stretched his earlobes, and he couldn't get a job," explains Youn.

As a result, the patient came in for the 45-minute Pac-Man earlobe lift, a minor in-office procedure that corrected his lobes. The lift can also correct skin split by heavy, dangling earrings. While it leaves a noticeable scar -- "like a closed Pac-Man mouth," describes Youn -- there is little downtime, and patients can re-pierce their ears within six months. Cost: $700 for both ears.

5. Fat removal

Nothing beats liposuction when you want to get rid of fat fast, but if you're afraid of surgery, Zerona could be the answer for you. Youn likes this new technique, because it "is the only minimally invasive laser that has proven inch loss with no pain, no needles and no downtime."

The laser helps the fat cells release their contents, and, by spacing the treatments every other day, the fat is removed naturally by the body instead of being taken back up by the cells. Results may vary, with patients on average losing three to four inches, a modest loss compared to lipo, which can translate into a six- to seven-inch loss. The price: $1,800 to $2,000 for six treatments. However, if you don't lose three inches, Youn says he will credit you $1,000 for the procedure of your choice.

6. Eyelash thickener

Ready to toss that tube of mascara? All thumbs when it comes to gluing on fake lashes? Then cast your peepers on Latisse, approved by the Federal Drug Administration to thicken upper eyelashes and brows.

Brush the bimatoprost ophthalmic solution on once a day and watch those hairs grow longer and thicker after eight to 12 weeks. But the result is not permanent, so keep your plastic surgeon, dermatologist or ophthalmologist on speed dial to renew that prescription. In rare cases, Latisse can permanently change the skin color around your eye, cause unwanted hair growth if used on the lower lids, and forever darken the irises of light-colored orbs.

If $120 per month seems a bit hefty, Zapiach says a less expensive alternative could be MD Lash Factor. "I am excited about this one," he says. "It's not a prostaglandin, so it doesn't have the same side effects. You can use it on the upper and lower lashes. And it's about the same price, but lasts four to six months."

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