According to the American Society for Aesthetic Plastic Surgery (ASAPS), breast enlargements beat liposuction as the top choice for women who went under the scalpel, though overall the demand for cosmetic surgery saw a decline.

In the 2008 statistics released today by the ASAPS a 12 % decrease in the number of surgical and nonsurgical cosmetic procedures performed in the U. S. were reported.

ASAPS President Alan Gold, MD said, "It's clearly the economy, and people's concerns about their future income, their time off from work to have a procedure, and recovery from that," referring to the reason for the slowdown in demand.

Gold added that he expects that when the economy recovers the number of cosmetic procedures will spike as people get the procedure they have been putting off. "Maybe not this year-- it might be next year," Gold said.

According to the ASAPS survey the top cosmetic surgical procedures for 2008 were breast augmentation with 355,671 procedures in 2008, down 11% from 2007, followed by liposuction with 341,144 procedures in 2008, down 25% from 2007. Eyelid surgery came in third with 195,104 procedures in 2008, down 19% from 2007 with nose reshaping (rhinoplasty) at fourth place with 152,434 procedures in 2008, about the same as in 2007. Tummy tuck (abdominoplasty) was fifth on the list with 147,392 procedures in 2008, down 20% from 2007.

In the non-surgical cosmetic procedures Botox injections led the list with 2.46 million procedures in 2008, down 11% from 2007 followed by laser hair removal with 1.28 million procedures in 2008, down 9% from 2007.

Hyaluronic acid (including Hylaform, Juvederm, and Perlane/Restylane) was in third place with 1.26 million procedures in 2008, down 13% from 2007 and chemical peel with 591,808 procedures in 2008, up 3% from 2007 followed it. At fifth place was laser skin resurfacing with 570,880 procedures in 2008, up 12% from 2007.

The biggest increase in 2008 among cosmetic surgical procedures was seen for hair transplants, which grew 10 % overall, with a 13 % increase among women and 10 % for men. Lower-body lifts fell by 37%, showing the largest decline and buttock lifts grew in popularity for men by 35%, while falling 37 % for women.

For men despite liposuction registering a 46 %drop it still held at first place while nose reshaping moved to second place and eyelid surgery fell to third. The fourth and fifth most popular surgical procedures for men were breast reduction and hair transplants.

Gold said the decline in the number of cosmetic procedures is not permanent and is due to people's general reluctance to spend in this economy. "These things tend to bounce back," he said.