Hollywood stars are not the only people looking good these days.

More than 10 million cosmetic plastic surgeries were performed in the United States last year according to the American Society of Plastic Surgeons, which suggests that many people are starting to embrace cosmetic surgery as a way to slow down aging and achieve the aesthetic results they desire.

“I think plastic surgery is becoming recognized as a valid medical field,” said Mark Reece, a plastic surgeon in West Des Moines. “It isn’t just a Hollywood trend anymore.”

The Midwest accounts for one-sixth of this nearly $9.4 billion market and according to ASPS statistics, 1.77 million cosmetic procedures were performed in this region last year. Though liposuction, nose reshaping and breast augmentation are the top three surgical cosmetic procedures across the nation, Midwesterners are more concerned about their bottoms and ears than other regions, getting more buttocks implants (31 percent of procedures in 2005) and cosmetic ear surgeries (30 percent) than other regions in the United States.

However, minimally invasive procedures are becoming the most attractive type of cosmetic treatment, jumping up 13 percent from 2004 to 2005 to nearly 8.5 million procedures nationwide. Surgical cosmetic procedures increased by only 4 percent, with more than 1.8 million procedures performed in 2005, and reconstructive plastic surgeries decreased 3 percent from 2004 to 2005.

“I think that the trend is not to be as invasive or aggressive,” said Reece, “so people are seeking out types of procedures that will perhaps postpone things or improve things without being a major surgery.”

Facial rejuvenation is the biggest area of interest lately as procedures such as Botox, chemical peels and soft tissue fillers become more available. Although they are expensive, they are a fraction of the cost of a full face lift and require much less downtime, which are two of the most important factors for the majority of patients today.

Plastic surgeon Douglas Parks, especially has seen advancements in fillers. Whereas patients had to wait several weeks to learn if they were allergic to the cow-based products formerly used as fillers, new hyaluronic acid products are making the procedure faster, easier and less risky. Yet doctors warn that facial rejuvenation is not a cure-all.

“Face lift dropped off the top five [this year] because there’s a group that wants to try non-surgical first,” Parks said. “If doing non-surgical facial rejuvenation, you could delay a face lift for about five years.”

Botox, a substance that treats fine wrinkles by paralyzing the muscle underneath according to Parks, has become a $1.4 billion market that grew 28 percent from 2004 to 2005.

“I thought [Botox] was silly when it first came out,” Parks said, “but it turned out to be an outstanding improvement.”

Brenda Rowe, a registered nurse who has worked with plastic surgeon Eugene Cherny for 16 years, notices that European mini face lifts are still popular with her clients. “They’re done in the office,” said Rowe. “It pulls wrinkles off the cheek and jaw line areas and it’s minimal swelling with no downtime. It’s virtually pain free…and it’s a fraction of the cost of a face lift.

“[Clients] express that they don’t want the Joan Rivers overlooked overdone face lift, and they associate this with the coasts.”

On the surgical side, improvements in liposuction have helped maintain this procedure’s popularity. Surgeons are able to make incisions that are only a few millimeters as opposed to the half-inch cuts they made with the previous instrument.

“I think liposuction has come back to be more popular because it’s non-invasive,” Rowe said. “You still get your bang for your dollar but it’s a smaller localized area.”

Most patients get liposuction around their stomach, “love handles,” outer thighs or inner thighs. According to Parks, 90 percent of patients say they want liposuction not necessarily to go down in size but to make their clothing fit better.

According to ASPS, 55 percent of patients reported an average decrease in three dress sizes after liposuction (which Parks finds a little high in his practice), 33 percent reported exercising more and 44 percent reported eating a healthful diet.

Liposuction is just one of the procedures many women are having done after they have children. Parks lumps it with the “post-baby makeover,” which includes a tummy tuck, liposuction on the legs and a breast lift.

Instead of a vacation to the Caribbean, said Rowe, women are rewarding themselves by restoring their bodies.

Men are also using cosmetic surgery to reshape their bodies, including liposuction around the abdomen and chest, eye surgery or face lifts.

“It’s not that they want to go back to their 20s,” Rowe said, “They just want it so good at 30, 40 or 50. They want to look as good as they feel and think removing some of those factors – wrinkles, droopy eyelids – helps.”

An increase in cosmetic surgery may be attributed to more open communication about procedures.

‘With the Internet, differences, are going away,” Parks said. “All communication going on opens up more dialogue about things that in the past were not talked about, in all avenues of life.”

More women in particular, say Reece, Parks and Rowe, feel comfortable going to seminars or for consultations with their friends and will recommend procedures they’ve had done to friends or family members.

“There’s more openness with patients,” Reece said. “A lot of my patients are very willing to share what they’ve had done and talk with people about it. You sort of see the whole thing being embraced more than when I first started.”

New technological advances are likely to continue to fuel this field. Reece expects lasers will soon be able to help with facial rejuvenation, wrinkle renewal and scar improvement.

“I think that science in plastic surgery is cutting edge and always looking at different avenues,” said Reece.

Rowe also sees a continuing trend toward making procedures more affordable. Cherny recently had plans for an office-based surgery room approved, she said, which should be done by December.

“It’s been on the coast for a long time,” said Rowe, “Now the Midwest is starting to open up and building office-based surgery rooms, which will make the cosmetic work more affordable for working-class people.

“[Cosmetic surgery] used to be for the rich and famous or those in theater. Now it’s amongst the common working people and mostly restoration over reconstruction.”