Most plastic surgery procedures are considered non-essential, or elective. When the economy's shaky and money is tight, it makes sense that fewer people elect to spend out of pocket for boob jobs, facelifts, and the like, mostly because they don't have the money to spend. The fact that elective cosmetic procedures rose by 5% last year could be viewed as an indication that the economy is recovering.
Also: stuff you should never pay for, including certain insurance policies, brand-new technology, checking accounts, and ridiculous plastic surgeries. Cankle liposuction anyone?
