Cost outcomes of facial plastic surgery: regional and temporal trends.

OBJECTIVE To describe the geographic and temporal trends in cosmetic facial plastic surgery procedure costs and frequency during the last decade and to evaluate factors that may influence changes in the demand for cosmetic procedures. METHODS A survey sent to every (N = 1727) active fellow, member, or associate of the American Academy of Facial Plastic and Reconstructive Surgery assessing the costs and frequency of 4 common cosmetic facial plastic surgery procedures (ie, face-lift, brow lift, blepharoplasty, and rhinoplasty) for 1999 and 1989. RESULTS The annual frequency of the aging-face procedures (ie, face-lift, brow lift, and blepharoplasty) have increased 41% over the last decade while rhinoplasties have declined slightly (18%). Each of the procedures studied have increased in cost since 1989; however, only face-lifts have increased at a rate greater than inflation during this period (average surgeon's fees, $3154-$4582). Although the average cost of each of these procedures is stable across US geographic areas, there seem to be fewer aging-face procedures being performed in the East (represented largely by New England and the northeastern states) compared with the Midwest, South, and West (P< or = .03), while rhinoplasty frequency across these regions is essentially unchanged. In addition to variables such as age, years in practice, and degree of marketing, the strongest correlates with increased cosmetic procedure frequency were the costs of these procedures (P< or = .008). CONCLUSIONS Although the cost and frequency of cosmetic facial plastic surgery procedures continues to rise across the United States, there are interesting differences in these trends between different regions and procedure type during the last decade. There also seems to be an association between increased cost and increased frequency of these cosmetic procedures.