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Silicone valley.

Guess who has more plastic surgeons per capita than Beverly Hills?

That's right. It appears the state of Utah is booming in the business of elective surgery.

"I'm as busy as I want to be," says Murray surgeon David Clayton. "I'd say we're typically scheduled three or four weeks in advance, and that's quite a bit better than it was 10 years ago."

Bradford Rockwell, chair of the division of plastic surgery at the University of Utah Medical Center, doesn't know quite why the state has more plastic surgeons per capita than other metropolitan areas -- more than 75 listed in the Yellow Pages alone.

"Maybe it's residents who train here and decide to stay. Maybe it's just that this is a nice place to live," he says.

But certainly the profession is growing. Rockwell says 30 years ago, plastic surgeons could only be found in Salt Lake City. "Now a number are in places like American Fork, Layton and Bountiful," he says. "You figure those cities will need primary care doctors and pediatricians. You might not think they would have the population to support a plastic surgeon, but (the doctors) are surviving."

Not all cosmetic surgeons say business is brisk, but most believe the industry follows the ups and downs of the economy.

When the state is prosperous and its residents have some extra income, they spend it on breast augmentation, liposuction and facial cosmetic surgery -- the procedures most common in Clayton's practice.

Salt Lake City is also home to iEnhance.com, a website for prospective patients, that boasts over 40 million hits annually. CEO Gene Erickson says Utah's interest in elective surgery is mirroring national trends.

"The age of the target market is spreading," he says. "It used to be 30 to 55, and now it's 25 to 60."

That's good news for business -- and so is the fact that plastic surgery is no longer reserved for women. "Men are getting involved -- in liposuction quite a bit, but also in face-lifts," Erickson says.

The American Society for Aesthetic Plastic Surgery says that in 1999, 11 percent of cosmetic procedures were performed on men. The ASAPS says that in the West, procedures like chemical peels and collagen injections are still much more common than surgeries. But those less invasive procedures often give patients the courage to try something else.

At iEnhance.com, information about cosmetic dentistry and LASIK eye surgery is listed alongside rhinoplasty and face-lifts.

"We are trying to accomplish some cross-channel marketing," says iEnhance spokesperson Tenna Cooper. "Someone may get their teeth outfitted for bleaching trays, and then take a look at a page about tummy tucks. It's curiosity," Cooper says.

Studies indicate much of the stigma surrounding cosmetic surgery has diminished.

The ASAPS says a recent survey showed 82 percent of women and 72 percent of men said if they were to have cosmetic surgery in the future, they would not be embarrassed if people outside their circle of family and friends knew about it.

Aggressive marketing -- on radio, television and magazines, not to mention the Web -- certainly make the topic less taboo.

But there's still some apprehension, according to Cooper.

"I think a woman might look at a lady at the gym, and wonder if she's had breast augmentation, and she wants to ask her, but she's afraid," she says. "That's why the website is good. It has stories from other patients, and people can read about the procedures in the privacy of their own homes."

Cosmetic surgery is always an individual decision, says Clayton.

"Some patients don't want their husbands to know what they've done, and others, I think, would be willing to flash their friends at the grocery store," he says.

Susan, a 50-year-old Salt Lake woman who asked Utah Business magazine not to use her real name, says she's not ashamed of her facelift, "but it's not something you want everybody to know about." The end of her 27-year marriage was a tremendous blow to her ego and the main reason for her facelift last November.

"I'm back on the market, so to speak, or I probably wouldn't have done it. I still think I'm a person with pretty high self-esteem," she says. "But after almost 30 years of marriage, it's such a blow to have that person, that person who is your rock, tell you you're not attractive."

Susan had what her local surgeon calls a mini-lift -- the skin around her chin and neck were tightened. "And they also fixed my jowls. I have my father's jowls," she says.

The five-hour procedure wasn't painful, "but knowing that they peel your skin back, that's really creepy." There was some swelling for a few days, but Susan has no regrets.

I had to pay two weeks in advance, and I admit there were some moments when I wish I'd gone on a diving vacation instead" she says. "But I did this for myself." The cost was $8,000. A full face-lift would have been much more costly.

At iEnhance.com, prospective patients can actually calculate financing terms for their surgery. "It's great for people who say, wow, this is something I'd like to do, but I can't afford $5,000 to $10,000 all at once," says Cooper.

As for the surgeons who stand to benefit from these price tags and Utah's plastic surgery boom, it's not all good news. Bryan Sonntag, who has been practicing in Ogden and Salt Lake City for less than five years says, "This is not a great place for someone starting out."

Sonntag's tried magazine advertising and even radio spots to establish his practice. "None of it seemed to pay off," he says. "It's like you need to reach a point of critical mass, a number of patients large enough that their friends and associates will continue to build your practice."

Even his referral spot on iEnhance has not been as important as simple word-of-mouth. He also says 80 percent of his business is from out-of-state patients.

"The cost of our overhead is lower, and there are so many of us competing, that prices are driven lower," he says. "That makes it pretty advantageous for somebody to come from out of state and save a little money."

The costs for most procedures tracked by the ASAPS are a bit higher in the

western region than nationally. In the western region, breast augmentation goes for about $3,250, on average. A buttock lift averages $4,150. Facial cheek implants are about $2,200

Like Clayton, Sonntag says he's seeing more men in his practice -- men for whom plastic surgery is a business decision. More than in the past, men today see that they need to look good to be even more successful at work, he says.

According to the ASAPS, the surgeries that have grown most in popularity in recent years among men nationwide are liposuction, cosmetic eyelid surgery, facelifts and gynecomastia - male breast reduction, which is up more than 47 percent since 1997. Breast augmentation is far and away the most popular surgery among women, up 89 percent in the last two years, followed closely by breast reduction, tummy tucks and liposuction.

Maria Titze is a staff writer for the Deseret News.

DR. RENATO SALITZ, M.D., F.A.C.S., director of the Summit Plastic Surgery Center and spokesperson for ASPS (American Society of Plastic Surgeons) and ASAPS (American Society for Aesthetic Plastic Surgery) demonstrates a saline breast implant at a University of Utah Clinic.

He urges consumers to shop around. Because plastic surgery is a cash business, many are attrac"" to the ease of money-up-front tran""

"There is "" "" busy dentist in town who also "" some cosmetic surgery. If you want a dentist go to a board certified dentist. If you need plastic surgery find a board certified surgeon," he says.

Detailed informa"" about the benefits of certified aesthetic "" can "" on the web at www.surgery.org.

THE LASER'S EDGE

There's no embarrassment attached to what is arguably the fastest growing elective medical procedure in the country: LASIK, or laser eye surgery. Roughly a million Americans had the surgery in 1999 to correct nearsightedness, farsightedness or astigmatism.

The procedure takes roughly 15 minutes and is relatively painless. The surgeon peels back a flap of corneal tissue and reshapes the underlying tissue with a laser beam. The flap of skin falls back and adheres again naturally.

The work is permanent, in the sense that it can't be undone, although the eye could continue to change with age. Patients can chose another, less common procedure, called Intacts, which uses rings to shape the eye and is reversible.

LASIK has become more affordable in recent months, running as little as $1,000 per eye. In 1998, the average cost of LASIK surgery in the United States was $2,180 per eye, according to industry research group Market Scope.

The Laser Vision Institute in Murray advertises the surgery starting at $949, with financing available for $29 a month. "The price we advertise is a starting point," says center manager Vincent Ibarra. "Each price is prescription driven, so it's impossible over the phone to quote (patients) a price, unless they know their (eye glasses or contact) prescription." Initial consultations are free.

The institute - which opened its doors on Dec. 13 - does roughly 80 LASIK procedures every week. The surgery is quick, fairly noninvasive, and doesn't require much recovery time, Ibarra says, although there is some discomfort during and sometimes the evening after the surgery.

Insurance companies don't typically cover the procedure, but the IRS considers it an approved expense for flexible-spending accounts.

Researchers say the lowest prices for LASIK surgery can be found in Canada because its government approved the lasers used in the surgery earlier than the U.S. government did, and competitive pressures took effect sooner.
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Article Details
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Author:TITZE, MARIA
Publication:Utah Business
Geographic Code:1U8UT
Date:Feb 1, 2001
Words:1636
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