The American Society of Aesthetic Plastic Surgery reports that the overall number of cosmetic procedures has increased 228 percent since 1997. The numbers are likely to rise as the population ages, prices drop, younger patients seek out surgery, technology and genetic engineering generate new techniques, and more doctors from various fields offer cosmetic surgical procedures. Surgical procedures will inevitably become less expensive, said Dr. Lloyd M. Krieger, a plastic surgeon who also has an M.B.A. from the University of Chicago, in part because procedures that 10 years ago took place in a hospital operating room and required expensive overnight stays now take place in a doctor's office. And, like any consumer product, as it becomes more popular, the laws of economics dictate that the price will come down. ''Usually that does not apply to health care, which is bound up with insurance issues, but in the case of cosmetic surgery, people are using their own money so the typical health-insurance restrictions don't apply,'' Dr. Krieger said. Consumers approach cosmetic surgery as a retail decision, ''as if they were buying a cruise, a vacation, a car.''
