title: Cosmetic surgery volume and its correlation with the major US stock market indices.
abstract: BACKGROUND
  As a consumer-driven industry, cosmetic plastic surgery is subject to ebbs and flows as the economy changes. There have been many predictions about the short, intermediate, and long-term impact on cosmetic plastic surgery as a result of difficulties in the current economic climate, but no studies published in the literature have quantified a direct correlation.
  
  
  OBJECTIVE
  The authors investigate a possible correlation between cosmetic surgery volume and the economic trends of the three major US stock market indices.
  
  
  METHODS
  A volume analysis for the time period from January 1992 to October 2008 was performed (n = 7360 patients, n = 8205 procedures). Four cosmetic procedures-forehead lift (FL), rhytidectomy (Rh), breast augmentation (BA), and liposuction (Li)-were chosen; breast reduction (BRd), breast reconstruction (BRc), and carpal tunnel release (CTR) were selected for comparison. Case volumes for each procedure and fiscal quarter were compared to the trends of the S&P 500, Dow Jones (DOW), and NASDAQ (NASD) indices. Pearson correlation statistics were used to evaluate a relationship between the market index trends and surgical volume. P values <.05 were considered statistically significant.
  
  
  RESULTS
  Three of the four cosmetic surgery procedures investigated (Rh, n = 1540; Li, n = 1291; BA, n = 1959) demonstrated a direct (ie, positive) statistical correlation to all three major market indices. FL (n =312) only correlated to the NASD (P = .021) and did not reach significance with the S&P 500 (P = .077) or DOW (P = .14). BRd and BRc demonstrated a direct correlation to two of the three stock market indices, whereas CTR showed an inverse (ie, negative) correlation to two of the three indices.
  
  
  CONCLUSIONS
  This study, to our knowledge, is the first to suggest a direct correlation of four cosmetic and two reconstructive plastic surgery procedures to the three major US stock market indices and further emphasizes the importance of a broad-based plastic surgery practice in times of economic recession.
authors.affiliation: Department of Plastic Surgery, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. gordonc@ccf.org
authors.forename: Chad R
authors.initials: CR
authors.lastname: Gordon
authors.forename: Landon
authors.initials: L
authors.lastname: Pryor
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Afifi
authors.forename: Paul X
authors.initials: PX
authors.lastname: Benedetto
authors.forename: C J
authors.initials: CJ
authors.lastname: Langevin
authors.forename: Francis
authors.initials: F
authors.lastname: Papay
authors.forename: Randall
authors.initials: R
authors.lastname: Yetman
authors.forename: James E
authors.initials: JE
authors.lastname: Zins
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005544:Forecasting; D006801:Humans; D007449:Investments / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000191:economics* / Q000639:trends; D014481:United States