Men seeking help to look younger, fit: cosmetic surgeons see increase in patients.

MD. GRAHAM NEEDED AN edge.

The Little Rock actor, who declined to give his age, said he was competing for roles with people who were 10 to 15 years younger than he is. So about six months ago, Graham had a Juvederm treatment, similar to Botox, to eliminate the wrinkles around his mouth and nose.

And so far, Graham is happy with the procedure and will consider having more cosmetic treatments done.

"I just wanted to look younger more than anything else," he said. "I feel young, I act young, and I wanted to look a little younger than my actual age."

Graham is not alone. The number of cosmetic procedures shot up 65.2 percent between 2002 and 2006. In 2002, 6.9 million surgical and non surgical cosmetic procedures were done in the United States, and in 2006, 11.4 million were performed. The high-water mark was in 2004, when 11.8 million procedures were completed, according to the American Society for Aesthetic Plastic Surgery of New York.

In 2006, the society reports, Americans spent $12.2 billion on cosmetic procedures. Although numbers for Arkansas are hard to come by, several doctors confirmed that the nationwide trend holds for the state, as does another: More men are undergoing cosmetic procedures.

In 2006, men had nearly 8 percent of the cosmetic procedures done nationwide. Since 1997, surgical procedures on men in the United States fell 2 percent, but nonsurgical procedures jumped 722 percent.

Dr. Rhys Branman, a partner with the Cosmetic Surgery Center of Little Rock, said he's seen a 20 to 30 percent jump in the number of men who come in to have work done.

Younger men come in for nose, chin and ear surgeries, while older men are having eyelid surgery and some facelift procedures, said Branman, who has been in business since 1990. Another top requested treatment is liposuction to remove the "spare tire" around the waist.

"As the baby boom generation continues to get older, they are not going to accept the aging process like the parents did," he said. "I think you're going to see more and more procedures done on this group of individuals."

Despite the increase in his male patients, Branman said, they still make up only 10 to 15 percent of his practice.

Dr. Suzanne Yee, owner of the Cosmetic & Laser Surgery Center in Little Rock, said she, too, has seen an increase in patients, both male and female. She recently moved out of her 2,000-SF quarters into a new 6,500-SF medical office to keep up with her growing practice.

Yee said she's had patients come for surgeries to help them land a job.

People aren't so quick to retire, "and so you're competing against younger people," Yee said.

But most people are looking to freshen themselves up, she said.

Other doctors, however, haven't seen cosmetic procedures as a revenue geyser.

Dr. Verona Brown, a family practice doctor in Batesville, said she would rather do nothing but cosmetic procedures, but there aren't enough patients in Batesville to support it.

Insurance doesn't pay for cosmetic procedures so patients have to pay cash for the procedure or finance it like they would a new car.

"It's expendable money that people have [for the procedures]," Brown said. "It's pretty dependent on the economy. I've seen a difference in my business when gas prices go up."

Brown said she performs her cosmetic procedures only one day a week and family practice medicine the other four days.

Under the Knife

After graduating from the University of Arkansas for Medical Sciences in 1989, Yee was on a path to be an ear, nose and throat doctor.

And when she was in her own practice, Yee did a combination of ear, nose and throat procedures and cosmetic surgeries. But then she started performing more and more cosmetic procedures and realized that was her calling.

"It's my passion," Yee said. "My job is to help a person feel good about themselves and their self-esteem, and that's what I try to do. I like them to leave here feeling better than they did when they came in."

What has helped her practice--and other cosmetic surgeons, too--is that plastic surgery has become more mainstream through exposure on television shows like "Extreme Makeover" and "Dr. 90210."

People now realize that having some work done isn't just for the rich and famous.

"Not all of our patients have a ton of money," Yee said. "They are patients that work every day."

Still, the prices can be steep. The Cosmetic Surgery Center charges $270 per area for a Botox injection, $4,500 to $6,000 for breast augmentation, $4,000 to $7,000 for a facelift, and liposuctions can run anywhere from $3,000 to $7,000.

Yee said her goal is to try to make her patient look good for his age and not 30 years younger, which would make him look freakish.

"If you look good for your age and you feel good about yourself, it gives you a lot of self-confidence," Yee said. "Then you can compete against anybody at any age."

With all the attention paid to cosmetic procedures, some family practice doctors, like Brown in Batesville, are starting to offer nonsurgical treatments.

The start-up costs, however, can be high. A laser runs anywhere from $40,000 to $80,000, and then a doctor may have to hire someone to operate the laser.

"You may break even or you might lose money if you really don't have your numbers in a row," Branman said.

Regulatory Questions

Regulatory issues surround laser procedures. The Arkansas Medical Board said that if the laser light penetrates the skin, then it's a medical procedure and subject to regulation by the medical board.

"We don't regulate the procedure. What we regulate are the physicians that should be doing the procedure," said Peggy Cryer, the executive secretary of the board.

The board looks at the procedure and the type of laser used for the treatment to determine if medicine is being practiced.

Cryer didn't have a list of examples of what is or isn't considered medicine.

"It depends on what they are using," she said.

But if it's not medicine, then laser procedures would fall under the jurisdiction of the Arkansas State Board of Cosmetology.

Kathy Wittum, the director of the board, said a committee will start meeting in July to determine what procedures the board should regulate.

She also couldn't say what procedures would or wouldn't fall under the board's jurisdiction.

And Insurance Issues

Although insurance carriers refuse to cover someone's liposuction, that might change.

The American Cosmetic Surgery Network, which is a division of the Baton Rouge, La.-based United Networks of America, said that while it doesn't provide insurance, it does offer its members who pay the $180 yearly fee a discount on cosmetic procedures if they use the 400 or more surgeons in its network.

Francesco Ciccone, executive vice president of the network, said he's made 13 contacts with surgeons in Arkansas and none of them would join the group. So Arkansas is one of the handful of states that isn't covered by the network.

He said he didn't know why the doctors refused to join.

"There is no cost to the surgeon to be part of our network; we absorb all of that," Ciccone said. "We can increase the flow of traffic into their office 15 to 20 percent."

Ciccone said he's also enrolling health insurance companies to be part of the network, so it can be an added benefit included with the cost of insurance.

Branman said he doesn't see Arkansas insurance companies adding discount networks to their plans anytime soon. The insurance companies have a hard enough time covering the things they need to cover, he said.

By Mark Friedman

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Plastic Surgery

Top 5 Cosmetic Surgeries for Women 2006

Breast Augmentation       383,885

Liposuction               350,420
(lipoplasty)

Eyelid Surgery            182,397
(blepharoplasty)

Tummy Tuck                164,800

Breast Reduction          145,822

Top 5 Cosmetic Surgeries for Men 2006

Liposuction                53,263

Rhinoplasty                33,143

Eyelid Surgery             27,602

Male Breast Reduction      23,670
(gynecmastia)

Facelift                   14,051

Source: The American Society for Aesthetic Plastic Surgery