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Cosmetic Surgery: Payment Plans Feed Boom

Posted - Mar. 23, 2004 at 8:20 a.m.



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Mar 23, 2004 (United Press International via COMTEX) -- Part 2 of 3

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CLEVELAND, March 23 (UPI) -- The word plastic comes from the Greek word plastikos, meaning to mold or shape, but in terms of plastic surgery it also could just as easily refer to the plastic found in most wallets -- credit cards.

About one-third to one-half of the estimated 8.7 million cosmetic surgery procedures done in 2003 were paid for with credit or debit cards.

Anywhere from 5 percent to 10 percent of procedures are financed much the same way that new cars are purchased, said Dr. Richard Greco, plastic surgeon in Savannah, Ga., and a spokesman for the American Society of Plastic Surgeons.

Greco said the use of credit cards -- as well as the growth of financing plans specifically designed to pay for cosmetic procedures -- is a significant reason for the boom in cosmetic surgery.

"Society has learned the value of credit -- to pay for things on payment plans. It used to be that we just financed cars and houses," Greco told United Press International. "But now, everything is on a payment plan."

Greco said 5 percent of his patients use a finance plan to pay for procedures. Patients are willing to buy cosmetic surgery on time plans or with credit cards because procedures rarely are covered by health insurance.

Also, the procedures are not inexpensive: A single Botox injection costs about $390, while liposuctioning of one body area costs $2,050. Breast augmentation costs $3,040 and a full face lift can cost $5,000 to $10,000, depending on the location of the surgeon. In general, procedures are most expensive on either the East or West coasts and slightly less expensive in the South and Midwest.

The exceptions to the no-coverage rule involve reconstructive procedures, such as breast reconstruction after breast cancer or procedures to correct damage and scarring caused by trauma.

The American Society of Plastic Surgeons reports the top five reconstructive surgeries performed in 2003 were tumor removal (4,463,500), laceration repair (406,184), scar revision (232,114), hand surgery (199,787) and breast reduction (113,140). Of these, the only procedure not always covered by insurance is breast reduction, which is allowed by some insurers but not by others.

Dorothea Odem's insurer was one that did not consider breast reduction medically necessary.

Odem, 55, is a retired foreign service professional who just completed graduate school and plans to start a new career as teacher. When she worked for the U.S. State Department in Switzerland, she developed thyroid disease, which went undiagnosed for many years.

As a result, she told UPI, "I gained weight even though I've always tried to exercise and watch my diet."

The weight gain left her with uncomfortably large breasts that her doctor said caused her back pain. Weight also accumulated around "my back, by the waist. I called it saddlebags," she said. In January 2003, she received liposuction by a technique in which fat is first liquefied and then suctioned away -- to remove her "saddlebags." The procedure was done by Dr. Patrick Hudson, a plastic surgeon in Albuquerque, N.M.

Odem said Hudson cautioned her that she might not have a good outcome because she is African-American, and African-Americans often are considered high risk for cosmetic procedures because they have a tendency to develop thick, keloid scars at incision sites.

Hudson was able to use very minimal incisions and thus, Odem said, "I had no problem with scarring."

That first procedure cost $5,000, which, Odem said, "I was able to pay for it myself out of my savings." But earlier this year, after continued problems with back pain, Odem decided to return to Hudson for breast reduction. When she learned her health insurance company would not pay for it, she turned to her credit union.

Because she was footing the bill, Odem decided to have "a little more done as well." She said she had "slight suctioning of my upper arms and inner thighs," as well as liposuctioning of her abdomen and the breast reduction. The total bill, including charges for anesthesia, was $12,000.

"I had saved $5,000, so I borrowed $7,000 from the credit union," she said. Now, Odem said she hopes to "pay off the credit union loan by the end of the year."

Even if Odem finds her monthly payments dragging on for longer, she said she has no regrets about going into debt for the procedures. Before surgery, Odem was "larger than a 40-D," and she had a constantly aching back. Now, she is "down to a 36-C, which is where I was before the thyroid disease."

Odem's story is not only fairly common place in the United States, it also is being replayed around the world. A quick search of online sources turns up a number of financing programs aimed specifically at the cosmetic surgery market. Some plans, for example, offer financing, not only for the surgery, but also for a trip to an exotic locale, such as Cape Town, South Africa, to have the surgery done.

One loan company, HealthReady, offers online applications, credit lines up to $25,000 and interest rates "as low as 9.9 percent."

Customers for these programs are not just Americans. Though Americans are most likely to go under the knife or needle in search of a better or younger face and body, cosmetic surgery also is a growing phenomenon in Brazil, where 66,090 surgeries were performed in 2000.

The business also is booming in the United Kingdom, with 24,336 surgeries in 2000; France, with 21,221 surgeries, and Mexico, with 16,957. Those numbers do not include injections of Botox to smooth wrinkles, or fillers such as collagen to fill in sagging cheeks.

Even with the growth of finance plans, some cosmetic surgery practices still rely on cash customers. This is true especially of practices located in exclusive areas such as the Park Avenue, New York office of Dr. Z. Paul Lorenc.

Asked about finance plans, Lorenc paused before telling UPI, "In some practices I think financing is an option, but not here."

Even Park Avenue practices, however, are attracting receptionists and construction workers as well as celebrities, Lorenc said. These patients, "might decide to pass on a new car or a vacation to spend the money, instead, on this type of improvement."

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Next: Weight reduction surgeries and the role of cosmetic surgeons in re-fitting the body

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Peggy Peck covers medical research and health issues for UPI Science News. E-mail sciencemail@upi.com

Copyright 2004 by United Press International.

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