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Beauty doesn't come cheap
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April 19, 2000: 10:57 a.m. ET
Paying for expensive cosmetic surgery can cut deeply into your budget
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NEW YORK (CNNfn) - So, you decided you want to look like Vanessa Williams or Mel Gibson. Or maybe you just want to do a little something about a receding hairline or the bags under your eyes, and you're ready to go under the knife to do it.
Cosmetic surgery, one of the fastest-growing medical procedures, is moving from a cash business into a credit/finance market, but it isn't getting any cheaper.
How can you resist it when you're asked, "Don't you want to be perfect?" But how will you pay for it?
Cash is king, but most plastic surgeons accept major credit cards, and finance companies are rapidly expanding in this field.
"There are an increasing number of businesses doing this kind of lending and financing," said Dr. Mark Solomon, a suburban Philadelphia cosmetic surgeon.
Solomon says that one-third of patients who come in for a consultation don't return because of the cost or because they cannot get financing.
If you choose the financing option, check out the money details as carefully as you scrutinize the surgeon and the surgery. Not all plastic surgery financing companies work the same way.
A lot of these companies are referral services and many can be found on the Internet.
"They hook you -- pre-qualify you -- and then they send you lists of doctors who are part of their program, who are often paying heavy subscription rates," said Dr. Bruce Cunningham, chief of plastic surgery at the University of Minnesota. "They are becoming the portal to receiving aesthetic surgery in the future."
Cunningham warns patients who use a financing company not to be any less thorough in checking out doctors, facilities or procedures simply because the company is involved.
Coverage not a clear-cut issue
Virtually no cosmetic surgery procedures are covered by health insurance because they are elective.
Cosmetic surgery is considered a choice, not a medical necessity. That means that even procedures you feel are essential to maintain or improve your quality of life -- such as the increasingly popular Lasik eye surgery, which costs anywhere from $1,500 to $3,000 per eye -- must be paid entirely out of your pocket.
For a few people, though, there may be some room to maneuver if the surgery falls between choice and necessity.
The American Society for Plastic Surgeons says there are "a number of gray areas" in coverage for plastic surgery that sometimes require special consideration by an insurance carrier. These usually involve surgery that may be reconstructive or cosmetic, depending on the situation.
For example, eyelid surgery (blepharoplasty), a procedure normally performed to achieve cosmetic improvement, may be covered if the eyelids are drooping severely and obscuring a patient's vision. Or, nose surgery (rhinoplasty and/or septoplasty) may be covered if it will correct a defect that causes breathing difficulties. Even penile enhancement might be covered if a dysfunction is diagnosed.
You may appeal your insurance carrier's decision if it determines you don't qualify for benefits for reconstructive surgery, or even if you feel the benefits they agreed upon are too small. You may argue an absolute medical need, and your doctor may support you, but be prepared for an uphill battle.
With elective cosmetic surgery, fees are the sole responsibility of the patient -- as are the sometimes heavy associated costs involved in any hospital stay or lengthy recovery program.
Like results, rates vary
Financing your plastic surgery is basically the same as looking for any other personal loan.
Depending on your credit history, a finance charge for cosmetic surgery can range from 9 percent to 19 percent, says Sonny de Rama, spokesman for Chicago-based Unicorn Financial, one of the largest consumer finance companies that deals with elective health-care procedures.
 Some doctors, such as Cunningham, feel that patients who have trouble paying for their surgery are also more likely to be unhappy with the surgery, and many doctors do not encourage patients to proceed with a surgery they can't afford.
However, a finance company's prime concern is your credit, not the surgery you choose.
"We are not a bank. We are a private company, so we can approve more people -- and people that banks won't touch," said de Rama, adding that Unicorn approves up to 80 percent of those who apply with good credit, and 40 percent of those with a marginal credit history.
Finance companies help both patients and plastic surgeons, says de Rama, by providing funding to those who would otherwise "walk away from the surgery," and allowing doctors to concentrate on their medicine as opposed to finances.
Do-it-yourself -- financing, that is
You could, of course, just pay for the surgery yourself.
"I wanted the surgery, and my insurance wasn't going to pay for it. So, I paid in cash, it's that simple," said Barbara W., 62, of Savannah, Ga., who saved up the $6,500 so she could get a facelift.
Judy C., 60, from Long Island, N.Y., held an inheritance aside "to do something for myself." She's using it for a partial facelift, $7,200 for the doctor's fee and $2,000 for the facility.
In addition to paying cash or letting the doctor swipe your Visa or MasterCard, you could ask your bank for a personal loan or even a home equity loan. At the very least, make sure you compare these loan rates and possibilities to anything offered by a finance company.
The American Bankers Association says loans for cosmetic surgery are similar to other personal loans.
"Consumers need to be aware of rates and they must be willing to pay those rates. Consumers are in the driver's seat as to the choices about how to pay for such surgeries," said ABA spokesman John Hall.
OK, so you know what it costs and you go to a finance company. Be absolutely sure about how much you are borrowing, the terms of the loan and the effective interest rate, whether it's a personal loan or a home equity loan.
Dr. Philip C. Bonanno, whose practice is in upscale Westchester County, N.Y., says 97 percent of his patients pay cash.
The other 3 percent, he says, pay by credit card or through a finance company. Paying by cash can save a patient an average of $500 and as much as $2,000.
"But that's changing, it's increasing slightly," he says. "Especially among younger people as cosmetic surgery becomes more popular."
As elective surgery becomes more popular, one surgeon suggests, "Banks are now realizing the revenue potential of loans for cosmetic surgery. That's going to be the next trend."
As for advice to potential plastic surgery patients, Bonanno says: "Their first consideration should be finding a good, certified doctor. The second should be payment."
(Before deciding on any elective plastic surgery it is essential to thoroughly check out any procedure you are interested in and any doctor you may wish to consider doing the surgery. Never proceed without complete confidence in both the procedure and the doctor. Remember, top quality board-certified plastic surgeons may have spent years developing their skills, but cosmetic surgery can be done by anyone with a medical degree. Never forget cosmetic surgery is "surgery" and comes with all the inherent risks -- decide with the greatest of care. The American Society of Plastic and Surgeons gives you an easy way to begin that that process.) 
-- by bankrate.com for CNNfn
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