Even in the most dire economic times, people will still find money to spend on improving their appearance, according to Cosmetic Medical News. In 2010, Americans spent $10.7 billion on cosmetic procedures.

According to the American Society of Plastic Surgeons (ASPS), “Cosmetic plastic surgery includes surgical and nonsurgical procedures that reshape normal structures of the body in order to improve appearance and self-esteem.”

Watch for these trends in plastic surgery:

• Nips and tucks will become even more popular.

• The selection of injectables continues to grow as research labs worldwide try to capture the fountain of youth and the dollars that will follow from individuals with the same goal.

• More men are undergoing liposuction and Botox (Bro-tox) injections.

• Topical use of Botox is being studied.

• You’ll see rebates, price reductions, specials and Groupon-type offers.

• Unfortunately, the number of reports of botched plastic surgery practiced by unlicensed and/or inexperienced persons is increasing.

• “Medical tourism” travel to other countries for aesthetic surgery and recovery at lower prices is gaining in popularity.

• New heat- or light-based technology and devices are under development.

• Testing of skin cells for wrinkled skin regeneration continues. Some surgeons are testing a mixture of fat and stem cells as well. Your plastic surgeon or dermatologist can keep you up-to-date on new products.

Note: Right here at Fort Sam Houston, a ReCell kit is being tested to treat second- degree burn victims, reducing chances of infection and pain in treatment of burn victims. Who knows? If successful, this kit or something similar may be used for cosmetic procedures in the future.

Injectable anti-aging treatments

For those who want to improve early facial aging without the expense and time required by more invasive surgeries, there is a rapidly growing number of injectable treatments available. More than 2.4 million people have received these injections.

There are two general classes of injectables:

Neuromuscular toxin — Appropriate for use in facial lines and shallower wrinkles around the mouth, forehead, neck and eyebrows, these temporarily weaken or paralyze the muscle that’s causing the wrinkle. Botox Cosmetic® and a newer version called Dysport are widely recognized and FDA approved.

Soft tissue fillers — The other class of injectable treatments for deeper wrinkling and lines. Your own fat can be used as an injectable filler. Fat from other places in your body is removed, then injected to replace volume in the face, lips and hands. The ASPS agrees that fat is a safe, long-lasting and natural-appearing filler. Other volumizing fillers include Radiesse and Sculptra Aesthetic. A newish hyaluronic acid filler believed to be ideal for under the eye is Bolotero. It has a thinner consistency than other fillers with no bluish undertone. Juvederm and Restylane are two other popular injectable fillers.

Selphl is a new FDA-approved product to smooth wrinkles, rejuvenate the skin and lower the chance of an allergic reaction. It’s referred to as the vampire facelift because one’s own blood is used for the platelet-rich plasma to inject back into the face or other areas of the body. Studies indicate new collagen, blood vessels and fat cells were observed within three weeks.

Note: Consult your physician for other FDA-approved fillers available.

Other methods to combat aging:

Skin resurfacing: Chemical peels, dermabrasion and lasers are described as “minimally invasive” procedures.

Chemical peels come in three categories: Superficial, medium and deep, depending upon the depth and severity of the burn.

• Superficial peels are used on all skin types to improve acne scars, mild sun damage and fine wrinkles.

• Medium peels are usually used to treat moderate wrinkles, long-term sun damage, pigment changes and precancerous lesions.

• Deep peels are used to treat more severe wrinkles, deep sun damage or pigment changes and lesions or other growths on the skin.

Peels are not for everyone. Results depend on your skin type and condition, your doctor’s level of experience and your lifestyle.

Dermabrasion (microdermabrasion) therapy is an effective way to remove dead skin, and improve your skin’s appearance. It can be used on the arms, back, buttocks, chest, face, hands and neck.

Lasers are used to remove hair, correct discolorations, remove tumors and birthmarks, perform eye surgery and for collagen stimulation and other aesthetic purposes. Just as with injections, there is ongoing research to invent the ultimate tool — the fastest, least intrusive and totally painless miracle treatment for face and body.

The Brilliant laser is said to be safe for all skin types and to stimulate collagen production. Matrix lasers are suitable for those ages 35 to 45 who want to treat beginning lines and wrinkles. ePrime lasers are advertised to give a “nonsurgical facelift” because in one treatment they take care of deep lines, wrinkles and acne scars and also tighten, add volume and elasticity to skin.

Some other newsworthy treatments include Cryolipysis, which chills the fat to almost freezing, causing the fat to “explode” and then be absorbed into the body for elimination.

Viagra! It may be that a cream or gel form of this well-known little blue pill will be the product our cellulite has been waiting for. Theoretically, it will have the same effects in the area where the cream or gel is placed — improved microcirculation, fat breakdown and blood oxygenation — as it does for men now. This product is still in the development stages. CAUTION: Do NOT use the current pill version of Viagra or other similar product for cosmetic purposes.

Venus Freeze™ is a body-contouring treatment that uses radio frequency to build collagen in the arms, legs and tummy area or to tighten skin and reduce wrinkles on the face. Exilis is a machine with an ultrasound “guidance system” to deliver powerful radio waves directly into the dermis for precise lifting and tightening. Thermage also uses radio frequency energy, originally for skin rejuvenation, and now to tighten, tone and contour the body. Clear + Brilliant™ is a relatively new noninvasive laser, which is desirable for treating age spots and fine lines and wrinkles on the face.

Laser liposuction, just as its name implies, is a combination of a laser to liquefy fat cells and a cannula (small tube) to remove them. This technique provides greater flexibility for hard-to-reach or more sensitive areas, such as the neck and under-chin area and some body contouring in areas of the “spare tire,” male breasts and the arms. NOTE: This procedure does not replace traditional liposuuction for larger areas or for more extensive body sculpting surgery.

Liposonix® is a high-intensity ultrasound device designed to improve body contour and remove unwanted localized fat pockets from the body. Ultrasound waves target the fat tissues underneath the skin’s surface; then fat is liquefied and removed through the body’s lymphatic system.

Cosmetic lifts from head to toe

• Acupuncture “facelift” — Over a series of about 10 visits, improved appearance and health of your skin and health can be noticed. In Chinese medicine, your skin is believed to reflect your overall health. The acupuncturist will determine which of your internal organs, systems and functions might also need help. You can find a good cosmetic acupuncturist through the American Cosmetic Acupuncture Association website.

• Brow or forehead lift minimizes forehead creases/frown lines across the forehead.

• Eyebrow transplant — There are several transplant techniques available. One very popular method involves taking hairs from the back of the head, separating them and then implanting them, one at a time.

• Body hair transplants — Some men might want to have more chest hair or sport a thicker moustache or goatee.

• Ear surgery (otoplasty) can improve the shape, position or proportion of the ear, correct a defect in the ear structure or treat misshapen ears resulting from an injury.

• An earlobe lift will correct those saggy or wrinkled earlobes resulting from the aging process or all those fab heavy earrings. This will give you a plumper, more rounded earlobe, which will make you appear younger. An alternative to the surgery would be to have a filler injected to smooth and plump the earlobe.

• Cosmetic eye surgery (upper and/or lower blepharoplasty) is a relatively painless and fast-healing surgery for a fresher, tighter, more natural and youthful appearance. Hyaluronic acid filler injections can have good results as well, but must be repeated annually.

• Nose surgery (rhinoplasty) is performed to improve the appearance and proportion of your nose or to correct a breathing problem associated with the nose.

• Facial implants can be used in the cheeks, chin and jawline to bring structural balance and proportion to your face.

• Chin surgery — In addition to adding implants, this surgery can include the reduction of the chin for structural proportion.

• Neck lift surgery is an option if your neck has aged before your face or you have lost quite a bit of weight or those darn genetics have kicked in. Your neck muscles might need some altering, or you might just need to get rid of some excess fat or skin. Botox injections or liposuction will do the job.

• Arm lift (brachioplasty) reshapes the under portion of the upper arm from the area underarm to above the elbow. The underlying supportive tissue is tightened and reshaped, and then the skin is smoothed over the new contour of your arm. Liposuction may be used in the surgery procedure.

• Breasts – bigger, smaller, rounder. Women have them. But we may not be entirely happy with ones we have. Well, we can have a …

Breast lift, using a variety of techniques based upon breast size and shape, degree of sagging, skin quality, elasticity and excess. The underlying breast tissue is lifted and reshaped for contour and firmness; excess skin is removed to compensate for the loss of elasticity.

Breast augmentation uses breast implants for fuller breasts, to restore breast volume after weight loss or pregnancy or for medical reasons, such as the loss of a breast resulting from cancer or an accident.

• Tummy tuck is the only way to permanently restore firmness to the stomach and get rid of loose skin. Your supporting stomach muscles will be tightened, fat removed by liposuction and excess skin removed. The scar will be hidden when wearing a swimsuit.

• Liposhifting is a surgery designed to move the body’s fat around from within to improve shape and contour. No fat is removed; the fat cells are combined with another medium so that they can then be “shifted” to the desired location, using special tools. As this is a new procedure, it is critical to choose a surgeon who is highly experienced.

• Thigh lift will reshape the thighs by tightening the tissue and reducing excess skin and fat, resulting in smoother skin and better-proportioned contours of your thighs and lower body. Liposuction may also be used.

• Gynecological cosmetic surgery is fairly new in the aesthetic surgery arena. This type of surgery can be used to reconstruct genitalia after childbirth or other medical situations as well as for a more youthful appearance.

• Spider vein treatment (sclerotherapy) is an effective solution for those of us who avoid baring our legs because of those small clusters of red, blue and purple veins on our thighs, calves and ankles.

• Body lifts include breast lift surgery and a complete lower body lift (buttocks, abdomen, waist, hips and thighs) plus liposuction in one procedure.

• Foot lifts include narrowing of the foot to better fit high heels! The surgeon shortens the second toe so it’s not longer than the big toe and makes the little toe shorter and skinnier. Note: The American Orthopedic Foot and Ankle Society warns patients to avoid this type of cosmetic surgery since the risks are much greater than the benefits.

• Permanent makeup (micropigmentation) can include eyeliner, lip liner, full lips, full blush on cheeks, full eye shadow, eyebrows and eyebrow touch-ups. The procedure involves a hand-held device, which uses a tiny needle that punctures the skin hundreds of times per minute to push the pigment into the desired area. Caution: You must choose a qualified, very experienced and health-conscious person for this procedure to avoid complications.

Candidates for cosmetic procedures should be healthy and have a positive outlook and realistic expectations. Procedures should always be a personal choice, done for yourself, not to fulfill someone else’s desires or to try to fit an “ideal” image.

Safety before beauty

Warning: The world’s largest organization of board-certified plastic surgeons is taking action to warn patients to investigate their doctor’s qualification before undergoing plastic surgery procedures. The organization says there is a misconception among consumers that as long as a doctor is certified in a medical field, he or she is qualified to practice plastic surgery.

Choosing a surgeon requires homework before undergoing cosmetic surgery. Look for certification in aesthetic procedures with experience in your area of interest. The surgeon should operate in accredited medical facilities and adhere to a strict code of ethics. Board certification can be from one of the following:

ASPS — American Society of Plastic Surgeons

ASAPS — American Society of Aesthetic Plastic Surgeon

ABPS — American Board of Plastic Surgeons

Expert Injectors are board-certified plastic surgeons, facial plastic surgeons, dermatologists and oculoplastic surgeons who demonstrate due diligence regarding patient safety, reliable results and consumer education. Fewer than 7 percent of U.S. doctors are properly qualified to perform injectable procedures, using only products approved by the FDA for aesthetic use.

Costs for elective cosmetic surgery are always a consideration since most health insurance does not cover cosmetic surgery or its complications. Some variables to costs include:

• Surgeon’s fee — may vary based on experience, type of procedure and geographical location

• Hospital or surgical facility costs

• Anesthesia fees

• Prescriptions

• Post-surgery garments

• Medical tests