The Dow is up and so is demand for plastic surgery.

Last year Americans spent $6.6 billion on breast implants, liposuction and tummy tucks — a 9 percent increase over 2009. Meanwhile, demand for cheaper, nonsurgical procedures fell 9 percent.

"No doubt a big part of the rebound is the economic recovery," said Felmont Eaves III, president of the American Society for Aesthetic Plastic Surgery (ASAPS) in Garden Grove, Calif., which published the national survey of 938 physicians.

Utah's major hospital chains, including Intermountain Healthcare, University of Utah health centers and MountainStar, report no significant change in any types of surgeries. But plastic surgeons in the state say they're seeing an upswing.

"The majority of my patients are postpartum and professional women who have decided their personal finances and the economy are now secure enough to get the work done," said Brian K. Brzowski, a plastic surgeon in South Ogden. "I've certainly seen a nice little bounce."

The beauty industry is especially susceptible to swings in fortune, and last year's rebound — 1.6 million cosmetic surgeries in all — may bode well for consumer confidence. A 2009 study by The Cleveland Clinic charted a direct correlation between reconstructive surgeries and three major U.S. stock market indexes, the Dow, S&P 500 and NASDAQ.

And there's been speculation nationally that out-of-work, middle-aged men and women are going under the knife to remake themselves into attractive job prospects.

Eaves believes that's "an urban myth" and attributes consumer interest to pent-up demand. "In the last 15 years I've only had one or two patients mention work as a motivating factor, although it may be a consideration for some," he said.

Practitioners in Utah agree and say people put off desired surgeries during the recession.

Face-lifts surged 35 percent nationally last year, driven in part by more interest from men. It is one of the more costly procedures, averaging $6,629 nationally for just the surgeon fees.

Topping the list for men is liposuction, though the procedure has been waning in popularity for some time.

"That could be because we're doing less lipo as nonsurgeons get into the business," said plastic surgeon Angela Keen, in Cottonwood Heights.

Brzowski said breast implants at his South Ogden practice are up 80 percent from a recessionary lull. That's in contrast to the national numbers, which show breast augmentation holding steady during the downturn.

The procedure surpassed liposuction in popularity for women in 2008 and gained just 2 percent in 2010, says ASAPS.

The report underestimates nonsurgical treatments, because ASAPS polled only plastic surgeons, dermatologists and head and neck surgeons.

The society then used the data to project rates of cosmetic surgery for the nation's 24,500 physicians who are board certified in these specialties.

Keen suspects the downturn has caused patients to forgo small-dollar beauty treatments for the long-term benefits of surgery. "There is no alternative to good quality surgery. You can't just laser away your wrinkles or saggy skin," Keen said.

Consumers are getting choosier too, skipping complex multi-site surgeries for the isolated tummy tuck or nose job, said surgeon Marcus L. Peterson, in St. George, who says his practice draws a lot of patients from Las Vegas.

Salt Lake City recently topped Forbes magazine's list of vainest cities in America, based on the number of plastic surgeons for every 100,000 people. Surgeon Renato Saltz, who has offices in Salt Lake City and Park City, said that's probably because surgeons train at the University of Utah's Medical School and decide to stay.

"We have some very good surgeons here," said Saltz, past president of ASAPS. "Also, our fees are lower than, say, in New York and along the West Coast."

Business for Saltz picked up last year and remained brisk the first quarter of 2011. "My surgical and nonsurgical procedures match the first quarter of 2007, which was my best year in practice," he said.

Some of the demand could be due to promotions and discounts that surgeons started offering in 2008. Many Utah practices had to cut staff and really struggled during the downturn, said Saltz, who is unaware of any that were forced to close.

"I'm not sure one or two quarters is proof of recovery. I'm just happy to see business return," said Saltz.

kstewart@sltrib.com —

Cosmetic surgery census

Americans spent $10.7 billion on cosmetic procedures last year, including surgeries. Seventeen percent of the procedures were surgical, which accounted for 62 percent of total expenditures.

People between age 35 and 50 accounted for 44 percent of all procedures; people 19 to 34 had 20 percent of procedures; 51 to 64 had 28 percent and 65 and older had 7 percent.

Last year, 4,153 of the 166,174 women who had their breasts enlarged were under age 18. About 47 percent of the teens said their procedures were purely cosmetic.

Source: American Society for Aesthetic Plastic Surgery