An annual survey released Tuesday by a plastic surgeons' association has revealed that the number of cosmetic-surgery procedures in the U. S. plunged for the second year in a row in 2009.

The figures claim 10 million surgical and nonsurgical procedures last year, outlining a 2% fall from 2008, according to a survey of 928 board-certified physicians by the American Society for Aesthetic Plastic Surgery, a Garden Grove, Calif., group of plastic surgeons specializing in cosmetic surgery.

"People just couldn't go for the big items", said Renato Saltz, the association's president.

Modern procedures as tummy tucks, facelifts, liposuction, Botox, collagen implants, breast reduction or enlargement, eyelids and brow lifts - are easily accessible, a quite a bit affordable, however, still involve some pain. Breast reduction or implants can cost $16,000, eyelids $13,000, liposuction $20,000 and a tummy tuck $23,000.

Dr. Haeck, a plastic surgeon in Seattle, suggested that the scenario outlines a transformation from last year when consumers cited cost as a primary hurdle. This year, "job priority is number one, cosmetic surgery is number two", he added.