The last eight years have been illuminating for all those involved in aesthetic practice, with the dramatic changes we have seen in the economy. Unusually in medicine, it is an area where the patient has a major say in treatment. As surgeons, we concentrate on trying to prepare patients, with proper consultation, where, after careful consideration of their wishes and needs, backed up by careful examination, we offer advice and explain what surgery can and cannot do for that individual. We try to make sure patients are fully and properly informed, so that they can make a considered decision about any aesthetic treatment.
Aesthetic surgery is usually self financed and what we didn’t consider is how patients pay for treatments. Many clinics enticed patients in with financial deals, most hospital groups offered finance for those that enquire and major banks advertised loans for cosmetic surgery. Younger patients rarely have wealth. What quickly became apparent was that that most relied on finance to pay for their treatments. When the recession hit, that finance dried up.
Clinics that relied on bringing in patients with financial incentives struggled. Some of the well known ones needed bank support themselves. Hospital finance schemes were withdrawn. Patients with savings still presented for surgery, as did those with the “bank of dad”, but the numbers of procedures carried out on younger patients plummeted.
Whilst the recession had a profound effect on younger patients, the measures put in place to manage the recession had a major impact on older patients. Interest rates in the UK were dropped to 0.5%. People that used to have investments, now, just had money in the bank. As it wasn’t appreciating, many felt it was an opportunity to consider using it for things to help themselves.
It is interesting that recession can be positive for some businesses. Companies selling luxury goods usually do well. People, who have money buy goods to cheer them up. This effect was increased by the changes in interest rates. Surgeons with a mixed practice and those with a significant proportion of rejuvenation procedures were protected from much of the pain in the economy.
Younger patients tend to undergo surgery to change appearance, having been born with or developed a feature that creates physical or emotional distress. As a group they have proved a sensitive barometer to how the recession has progressed. That they were unable to afford treatment did not lessen their desire to have something done. Its impact was on the timing of surgery.
At the outset, not only did the numbers of younger patients being treated fall, but, the timing of those treatments changed. January, often a busy month, became quiet and the operating lists just before Christmas became busier. The explanation for this can only be attributed to job security. Many people have extended Christmas holidays as many businesses close for two weeks. When the recession hit, patients used their holiday period to recover from surgery and minimized extra time off work.
As the recession progressed, the numbers coming forwards for treatment slowly increased. Presumably, they had saved up for surgery or made other financial arrangements. January 2013 saw a change back to a busier January. Pre Christmas remained busy, but more patients booked treatments in January. The explanation is in improved job security, where some patients felt comfortable to take their Christmas holidays and then take extra time off, in what is often a quiet month for business.
2014 saw a return to a much more usual pattern of timings. Whilst the recession wasn’t over, the light was at the end of the tunnel and patients presented willing, again, to spend on procedures of choice with few worries about job security. 2015 has seen an increase in numbers. For this group of patients, considering surgery to change their appearance, their problems did not disappear with the recession: Their ability to fund them was returning.
Living in a young society, where we are fitter and healthier to an older age and where people now retire to start new lives, we have seen an increase year on year of patients wanting rejuvenation surgery; to restore the ravages of life and sunshine exposure and to put the building blocks back to where they were, before gravity took its toll. The recession, though, has been eye opening to the sensitivity of treatments on younger patients, to changes in the economy.
Banking practices have changed, not to where they were before the economy slumped, but credit is easier to obtain. We have not seen the return to pre-recession levels of treatments in this group, but we should all have learnt lessons.
As clinicians, we should try and keep some width to the range of treatment options offered to our patients. Being too specialized can leave you exposed to outside events. Patient’s problems do not disappear with financial restrictions. The numbers coming forward for treatment lessen. Make sure your reputation is good and make sure your name is known. Aesthetic treatments are becoming more popular, but financing them has to be balanced with all the other financial commitments individuals face. Hopefully the troubles of the last few years will not be repeated, but aesthetic surgical procedures in this younger group have proved a sensitive barometer to the state of the British economy.