It's no longer the exclusive realm of celebrities. It's no longer just for the wealthy. It's no longer the action of last resort. This is not your parents' plastic surgery.

Americans in 2001 have come to openly appreciate their looks and ways to keep or enhance them. More and more people have embraced what some members of the American Society of Plastic Surgeons (ASPS) call "defensive aging." This encompasses everything from exercise, healthy diet, skin care and plastic surgery to help them achieve the look they want.

"Plastic surgery is more popular than ever," noted ASPS President Walter Erhardt, MD. "It has become increasingly accepted as a reasonable and, in fact, desirable component to the total spectrum of a person's beauty regimen. This has become true for two reasons: the public's increasing use of plastic surgery as a way to maintain or enhance their appearance and our members' continual effort to advance the specialty of plastic surgery."

According to a Roper Starch Worldwide survey conducted for AARP in January:

• Plastic surgery no longer carries a widespread taboo. Three out of five Americans believe, in principle, that if someone is not happy with how they look, there's nothing wrong with their having elective cosmetic surgery;
• Nearly half of all Americans know someone who has had cosmetic surgery;
• Sixty percent of women and 35 percent of men would take advantage of the "cosmetic surgery deal of a lifetime" - surgery that was free, safe and done so well that no one could tell.

Statistics from the ASPS reinforce these findings. From 1992 to 2000, the number of cosmetic procedures performed by board-certified plastic surgeons increased 227 percent.

Advances in plastic surgery have played an important part in gaining wider public acceptance of the specialty.

"Today, there are many more options for a person considering plastic surgery," said Dr. Erhardt. "A person can choose something as innocuous as an injectible or filler, or opt for a more complex procedure like a breast lift or eyelid surgery, depending on the goal. The bottom line is that in the continuum of care provided by board-certified plastic surgeons, there is something for everyone."

Board-certified plastic surgeons work continually to refine surgical techniques to minimize the invasiveness of procedures, improve outcomes and reduce recovery times.

Skin resurfacing, electrical stimulation of the face and photo rejuvenation are a few techniques developed in answer to increasing demand for non-invasive ways to improve the look of rough skin and reduce signs of aging. Advances have been made also in more nonaggressive facelifts and browlifts resulting in less tissue trauma and recovery time to achieve a more subtle, overall natural look.

While not brand-new, the use of power-assisted liposuction is a major advance for patients and plastic surgeons, allowing a surgeon to perform more refined body contouring, while at the same time increasing efficiency and reducing surgeon fatigue.

Regarding breast enhancement, three innovations currently being studied are: the possible use of cohesive gel implants; mapping a patient's breast shape through the use of a CT scan for a more exact match to the patient's breast shape; and non invasive breast enhancement, in which a bra with a vacuum device provides constant, sustained tension (10 hours a day for 10 weeks) to stimulate cell reproduction resulting in long-term tissue growth.

"People are taking advantage of all these advances in plastic surgery to the degree with which they are comfortable," said Dr. Erhardt. "Plastic surgery, as an option, has become part of the lifestyle choices made by Americans who want to look as good as they feel."

ASPS, founded in 1931, is the largest plastic surgery organization in the world. It represents physicians certified by the American Board of Plastic Surgery (ABPS) or the Royal College of Physicians and Surgeons of Canada. To find an ABPS-certified plastic surgeon in your area or to learn more about cosmetic and reconstructive surgery, call the Plastic Surgery Information Service at 1-888-4-PLASTIC (1-888-475-2784).