THE BLOG
12/07/2008 05:12 am ET | Updated May 25, 2011

Buddy Can You Spare Some Botox?

Botox is better than money in the bank for regular users. The wrinkle-reducing drug makes them look better and that makes them feel better and it's something they can control in a world where everything seems out of control. Attribute that to a global economy in distress and the longest presidential campaign in the history of the planet.

"But, gee doc, my 401K is a 201K, I can't sell my house and I could lose my job, can you cut me some slack on price"? Yes, believe it or not, some dermatologists are hearing this from patients sent into a financial tailspin by layoffs on Wall Street and Main Street. Dr. Debra Jaliman, with a practice on Manhattan's 5th Avenue says some patients have asked, "Which part of my face looks worse? Use the Botox there and let the other areas slide for awhile." Dr. Jaliman says the new economic reality has forced some patients to cut back on treatments and stretch out the interval between them.

This seems to fly in the face of a just-released survey by the American Society of Plastic Surgeons (ASPS), which says use of Botox, chemical peels and fillers is up by 73%. The same survey shows 48% of women considering cosmetic surgery are less less likely to schedule a consultation because of the bad economy.

On the other hand, patients not looking at surgery in the first place have to make tough choices on the relative value of anti-aging treatments versus other expenditures. Dr. Alan Gold, President of the American Society for Esthetic Plastic Surgeons, says prevailing economics has been a hot topic at this week's national conference of plastic surgeons in Chicago. However, he says doctors quickly dismissed discussion of discounting services. Instead some physicians indicated they might be forced to lay off staff and court fewer "guaranteed paying patients" as opposed to "growing" patient numbers.

Botox consumers can become their own best advocates if they know what questions to ask according to Dr. Mitchell Chasin. The New Jersey plastic surgeon says patients never ask "how" they're being charged, just "how much." Chasin says many doctors price by the area, the forehead, the frown lines between the eyebrows, and the crow's feet around the eyes. He says even when that means less Botox is used; the customer pays the same price. Chasin recommends patients ask whether a doctor charges by the area or by each unit of Botox used. Paying by the unit can prove less expensive in many cases. He also says patients should inquire about other fees and add ons, such as whether a consultation fee is charged for every visit or just the first.

There is hope in the year ahead. A new injectible battle may be shaping up, the likes of which has not been seen since "Godzilla versus Mothra." The Food and Drug Administration is expected to grant approval for "Reloxin" made by the Scottsdale Arizona based Medicis Pharmaceutical Corporation. Doctors are hoping "Reloxin versus Botox" will put downward pressure on price--something that's gone up each year for Botox. Industry insiders consider a price war a long shot, but increased competition may change how these drugs are bundled for doctors and that could have some benefit for the consumer.

For some regular Botox consumers, none of this will matter. They will find a way to pay lest those wrinkles reappear on that roadmap of time known as the face. Park Avenue dermatologist Dr. Neal Schultz says he always cautions first-time patients with a warning that few would believe. "Botox use is one of the most addictive legal things you will ever do."

www.nbcnewyork.com