The Beauty Beat

Hair Stories

Koryn — Mon, 31 Mar 2008 02:39:02 +0000

If you ask Vinnie Calluchio how many women in New York City dye their hair he’ll tell you half. One out of every two women you pass on the street dyes her hair he says, “and I’m not exaggerating.” He should know. He’s a colorist.

A Brooklyn native with a wide, stocky body and striking blues eyes, Vinnie looks more like a construction worker than like a hairstylist. His hair is closely cropped and colored a deep chestnut—his own invention.

Vinnie’s obsession with hair dye began early when, as an adolescent, he took his mother’s store-bought dyes, mixed and matched and created new shades of “natural” blonde. When his mother realized he had a talent for color-balancing, she became his first client. Vinnie wasn’t even in high school.

For anyone who has never dyed his or her hair, it’s hard to appreciate the effort it takes to maintain a color or how satisfying it feels to achieve the perfect one.

Maintaining requires commitment. It’s not a two-month fling with a glossy red shade or one-time highlights to celebrate the summer. It’s a conscious effort to keep the color you were born without but were meant to have. It’s allowing peroxide to burn your scalp in order to get that certain shade of blonde. It’s a willingness to spend $200 for a salon appointment when you can barely make the rent. It’s having your stylist whip up an extra batch of pigment so the rug will match the curtains. It’s loyalty.

Joan Magee is part of the dyeing half of New York City women. She has thick, tightly curled hair and lots of it. It is unruly and can’t be hidden. It is her most distinctive characteristic. When she was 16 she went blond for the first time. She stayed blond for nearly a decade—until Vinnie urged her to go red.

Joan and I were standing in a CVS hair-coloring aisle. She was looking at a color named Egyptian Plumb and I was holding a box of Starry Night. I asked Joan what her natural color was and she said “something boring.”

“In my early 20s my identity was wrapped up in being blonde,” she admitted, pulling a chunk of hair over her shoulder. “You know how everyone says they were blonde when they were young? Blonde symbolizes youth. It’s associated with being fun and pretty. That’s what I wanted to project.” She paused for a moment. “But my color also had edge to it. I went platinum.”

For Joan the switch to red was major. People had identified her by her hair color; being blond was who she was. But a few months ago she suddenly felt the need to shake things up.

She bent forward to hold one of her thick curls next to a lock of red synthetic hair attached to the Clairol shelf. I wondered aloud when we would stop dyeing our hair.

“When it doesn’t matter anymore,” she responded. “When we’re 75 and it’s all white anyway.”

We cruised a couple of blonde shades before leaving the store. Boxed blonde never comes out blonde. If you really want to dye your hair—any color—steer clear of the drugstore completely. To do it right you have to have it done professionally.

Unable to fit me into his schedule at the salon, I met Vinnie in a Brooklyn coffee shop for a consultation. He reached across the table and rubbed a lock of my hair between his fingers, evaluating the color and texture. He asked me what I wanted, and I told him: a slightly different color, but not too different. While we talked shades, light and skin tone, a woman with glossy brunette hair passed our table. “Not natural,” he said, nodding his head in her direction, “definitely not natural.”

Cha-ching! Medicine and money-making

Koryn — Wed, 26 Mar 2008 03:33:50 +0000

One of my colleagues, Kamelia Angelova, brought the following New York Times article to my attention. It discusses the competitiveness of the dermatology field due to, of course, some major money making.Enjoy:

March 19, 2008

THE PRICE OF BEAUTY

For Top Medical Students, an Attractive Field

By NATASHA SINGER

BOSTON — March Madness has a different meaning for Thomas Hocker and Meena Singh, a married couple in their final year at the Harvard Medical School, who are waiting to learn Thursday if they have been accepted into their residency programs of choice.

Already saddled with about $330,000 in education loans, they borrowed $20,000 more so they could fly around the country this winter for about two dozen residency interviews each. All told, each applied to 90 such training programs.

Ms. Singh, pregnant during interview season, gave birth to their second daughter in early January. Three days later, she flew to Miami for an interview.

The search has been difficult not because they are mediocre students; indeed, each has a brand-name education, academic honors and published research on disease. No, it has been hard because they aspire to be dermatologists.

As thousands of medical students await word this week on residency programs, two specialties concerned with physical appearance — dermatology and plastic surgery — are among the most competitive.

Only 61 percent of seniors at American medical schools whose first choice was dermatology received a residency in that field last year, compared with 98 percent for those whose first choice was internal medicine and 99 percent for those seeking family medicine, according to a report by the Association of American Medical Colleges and the National Resident Matching Program, which pairs candidates and programs. Although there are far fewer positions in dermatology (320 residencies in 2007) than in internal medicine (5,517) and family medicine (2,603), the field is attracting some of the best and brightest future doctors.

Seniors accepted in 2007 as residents in dermatology and two other appearance-related fields — plastic surgery and otolaryngology (ear, nose and throat doctors, some of whom perform facial cosmetic surgery) — had the highest median medical-board scores and the highest percentage of members in the medical honor society among 18 specialties, the report said.

The vogue for such specialties is part of a migration of a top tier of American medical students from branches of health care that manage major diseases toward specialties that improve the life of patients — and the lives of physicians, with better pay, more autonomy and more-controllable hours.

“It is an unfortunate circumstance that you can spend an hour with a patient treating them for diabetes and hypertension and make $100, or you can do Botox and make $2,000 in the same time,” said Dr. Eric C. Parlette, 35, a dermatologist in Chestnut Hill, Mass., who chose his field because he wanted to perform procedures, like skin-cancer surgery and cosmetic treatments, while keeping regular hours and earning a rewarding salary.

Medical school professors and administrators say such discrepancies are dissuading some top students at American medical schools from entering fields, like family medicine, that manage the most prevalent serious illnesses. They are being replaced in part by graduates of foreign medical schools, some of whom return to their home countries to practice.

“We have a shortage in America of primary-care or family-type doctors,” said Dr. Joel M. Felner, a cardiology professor who is the associate dean for clinical education at Emory University School of Medicine in Atlanta. Last year, the school enlarged its incoming class, hoping more students would specialize in the major diseases and preventative care, he said. “We do need dermatologists, but I am more worried about the really sick people and dermatologists aren’t taking care of them,” Dr. Felner said.

Until recently, saving skin did not have the cachet of saving lives. Doctors in other fields jokingly dismissed dermatology as a province of red-spot diseases that could not really be cured, but weren’t going to kill patients. Twenty-five years ago, the fiercest competition among medical students was for internal medicine and general surgery.

But dermatology’s status is rising, not just for the pay, hours and independence, but also because of the growing variety of treatments and devices in this fast-developing field that can help people in a looks-obsessed world. At a time of increased discussion of enhancing beauty, as well as narrowing standards for skin perfection, the public has a newfound esteem for doctors who treat appearance.

“People greatly value the skin because it is what is on the outside that is the face you present to the world,” Mr. Hocker said one evening last month after coming off a hospital shift in which he dealt with afflictions like heart failure and kidney failure. “Most dermatological diseases won’t kill you, but they can greatly affect your quality of life.”

Some dermatology professors said the growing allure of their field among medical students has raised the bar for applicants over the last decade. “Dermatology has always attracted bright students,” said Dr. Harley A. Haynes, a dermatology professor at the Harvard Medical School who has been mentoring medical students there since 1970. “But now we are getting more of the brightest and the best.”

Dr. Haynes likes to joke that even faculty members might not be accepted for a residency if they applied today.

A Psychological Lifeline

For an idea of the competition facing dermatology aspirants, consider the application numbers. Last fall, 383 people applied for 6 places — an average of about 64 applicants per spot — in Harvard’s dermatology program. By comparison, Harvard College received an average of 11 applications per offer of admission in the class of 2010.

Mr. Hocker and Ms. Singh were well prepared for the Darwinian process of landing a dermatology residency when they met as classmates at the Harvard Medical School in 2003. Mr. Hocker, 27, holds a graduate degree from Cambridge University and an undergraduate degree in chemistry from Yale, where he was a champion hurdler. Ms. Singh, 26, was in several honor societies as a biomedical engineering student at the University of Southern California.

During her senior year, she competed on an MTV reality show called “Sorority Life,” but was ejected midseason for being too studious.

“In one scene, you see her all happy getting the acceptance letter from Harvard and in the next scene, you see her crying up a storm because she has been de-pledged from the sorority,” Mr. Hocker recalled fondly.

Neither student had planned to become a skin specialist.

Growing up in Kansas City, Kan., Ms. Singh loved visiting the hospital with her mother, an internist with long relationships with a diverse group of patients. Ms. Singh said she initially planned to emulate her mother, a physician who focuses on treating major adult diseases.

A lecture on skin-pigment conditions like vitiligo changed her mind.

“Nobody can see if you have hypertension or asthma, but everybody knows if you have a pigmentary disorder and these changes are a lot more obvious and devastating to patients with skin of color,” Ms. Singh said. “Having something on your skin is not life or death for people, but it can be equally important for them emotionally as a life-threatening disease.”

Indeed, dermatology can be a psychological lifeline for people with severe skin problems. At pools or the beach, some people shun those with psoriasis who have scaly skin, fearing the condition is contagious, doctors said. People with deep acne scars say it affects their personal and professional lives.

Then there is the growing popularity among otherwise healthy people of tweaking one’s appearance with cosmetic treatments, from Botox injections to lip plumping and laser hair removal. Plastic surgeons, dermatologists and facial surgeons in the United States performed about 9.6 million such nonsurgical treatments in 2007, almost nine times the number a decade earlier, according to the American Society for Aesthetic Plastic Surgery.

‘Your Input Is Valued’

Mr. Hocker was finally sold on dermatology last year, while on a clinical rotation during which neurosurgeons called him and a dermatology resident to an intensive-care ward for a consultation. A patient, in a coma after surgery, was covered with mysterious red half-moon-shaped blisters. They could not determine the cause. Then Dr. Haynes of Harvard arrived.

“Dr. Haynes comes in and he is like a walking CAT scan, who eyeballs her from head to toe and has the diagnosis in 15 seconds,” Mr. Hocker said. The verdict: a rare blistering disorder caused by an allergy to an antibiotic.

Mr. Hocker said he liked the idea of drawing independent conclusions without tests or consultations with other doctors.

“The No. 1 thing that is going to save your life is the humdrum preventative stuff like blood pressure and cholesterol,” Mr. Hocker said. “But there is not a lot of respect for doctors who do that because anyone can get into it. But if you are an expert where no one else is, like the eye or the skin, your input is valued.”

Dermatology also attracts students like Mr. Hocker because of the potential for basic research on skin diseases that can lead to new treatments. Mr. Hocker said he plans to focus his career on researching the role of genetics in problems like skin cancer and abnormal scarring; he took a year off during medical school to conduct melanoma research.

While students like Mr. Hocker choose dermatology planning on research careers, others end up focusing on cosmetic treatments like skin tightening and resurfacing. Half of the dermatology residents graduating over the last five years from the program at the Boston Medical Center have chosen postgraduate fellowships that teach a combination of skin-cancer operations and cosmetic procedures, according to Dr. Barbara A. Gilchrest, the chairwoman of dermatology at Boston University School of Medicine.

Work Less, Earn More

Dermatologists say they enjoy the variety of a specialty that encompasses serious illnesses like skin cancer and psoriasis as well as conditions like uncombable hair syndrome.

But students interested in such work also often factor in personal benefits. Internists, for example, worked an average of 50 hours a week in 2006 while dermatologists worked about 40 hours, according to an annual survey by Medical Economics magazine. Dermatology also offers more independence from the bureaucracy of managed care, because patients pay up front for cosmetic procedures not covered byhealth insurance.

And while an internist earns an average of $191,525, a dermatologist earns an average of $390,274, according to an annual survey conducted by the Medical Group Management Association, whose membership includes more than 21,000 managers of medical practices. Dermatologists who specialize in cosmetic treatments or in skin-cancer operations can earn much more.

For thousands of medical students nationwide, especially those trying to enter the most competitive fields, this week — when residency acceptances are announced — has been fraught with tension. The National Resident Matching Program uses an algorithm to pair applicants with the one program they have ranked highest that also preferred them, a system that leaves some applicants disappointed.

Mr. Hocker and Ms. Singh face even longer odds because they entered the match process as a couple, seeking positions at the same program, or at least in the same region.

On Monday, when applicants learned whether they had been paired with a program at all, Mr. Hocker and Ms. Singh found out they will each obtain a residency. Thursday, they find out where.

“My friends going into general medicine and general surgery pretty much have an idea that they are going to be at their No. 1 or No. 2 school,” Ms. Singh said. “But we really could be anywhere in the country, together or not together.”

She added: “We would have a better chance of winning ‘American Idol.’ ”

Labiadoctor.com

Koryn — Tue, 25 Mar 2008 02:54:42 +0000

I’m currently working on two stories, one dealing with the ugly problems of botox and another on elective genital surgery. I was a bit torn about taking on genital surgery, but it has become one of the fastest growing trends.

And personal taste aside, I want to know what’s entailed, who’s getting it done and why. I tried to dig up some facts a came across labiadoctor.com.

This is taken from the about section :

“At the Labiaplasty Master Surgery Center of New York, Dr. Robert Rho performs expert hymen repair surgery, hymenoplasty, or restoration of the hymenal ring, and he has had excellent results.

The hymenal ring normally gets disrupted after a woman has had sexual intercourse or even after strenuous physical activity or tampon use. Sometimes, for cultural or other personal reasons (for example, an upcoming marriage), a woman would like to restore a more intact, tighter hymenal ring and experience vaginal bleeding and pain with the “first” sexual intercourse. Using a special surgical technique, our expert cosmetic and board-certified gynecological surgeon, Dr. Robert Rho, with over 14 years experience, performs hymen repair surgery to tighten and restore the hymen to a more intact, virgin-like state. Laser is available as an option. Because of a wide variation among hymenal and vaginal states, Dr. Rho customizes the hymen repair surgery or hymenoplasty to the individual needs and expectations of the patient, as are discussed during the required pre-surgical consultation and thorough gynecological examination. In most cases, the hymen repair surgery or hymenoplasty is virtually undetectable after complete healing, and our patients have been extremely pleased with Dr. Robert Rho’s amazing, very natural-looking hymen repair surgery results.”

What?

Warming Up to Hot Wax

Koryn — Fri, 21 Mar 2008 17:29:50 +0000

New York City’s Male Population Dives into the Beauty Pool

Last summer Giovanni Grella took a risk. He dropped his pants, lay down on his back, raised his knees to his shoulders and, with more than just a little doubt and fear, allowed a female spa technician to put the cold metal tip of a white laser hair-removal gun where the sun don’t shine.

“The next thing I heard was this heavy Russian accent saying, “Van, two, tree…” said Grella, 27, an architect’s assistant who lives in South Brooklyn. “The implication was basically, ‘Listen, this is going to hurt.’”

Grella was prepared to suffer. For the past five years he has been seeking out various hair-removal methods in order to achieve what he considers the right amount of masculine hairiness. While women have been removing unwanted body hair for centuries, men have generally limited their grooming rituals to the morning shave. But a new a day is dawning, as more and more men join women on the beauty bandwagon, taking their grooming into uncharted territory.

“I laid there with my pants still bunched around my ankles for about 45 minutes while she proceeded to laser my shoulders, back and ass,” said Grella, as he searched for the words to describe the experience. “I felt this dual sense of gratification and humiliation.”

Now seven months later Grella doesn’t even remember the name of the spa he’d found on the back pages of the Village Voice. The ad promised the cheapest laser hair removal in New York City: $299 for a “session.” After spending $700 a pop for a back and shoulder laser treatment at Columbia Presbyterian Hospital, Grella figured $299 was a steal. But when it comes to beauty, Grella says it’s best not to cut corners.

“I was afraid she was going to burn me,” Grella said. “It was the kind of place where you bartered — that’s a red flag. I don’t think that session worked, but at least I walked away without any permanent damage. When someone is using a laser on your body, choose reputation over price.”

When he booked his first laser treatment, Grella was already a dedicated waxer, spending between $25 to $50 a month. During a waxing treatment, hot wax is smeared over the skin and patted down with a thin strip of cotton material. When the wax dries and cools, it grips the hair, so that when the cotton is quickly ripped off, it takes the hair with it.

While waxing has existed in some form since ancient Egyptian times, its popularity surged more than a decade ago when the J Sisters Salon introduced a waxing treatment to New York City women called the Brazilian bikini wax, a procedure that leaves the pubic area completely bare. J Sisters now charges between $65 and $85 for the Full Monty.

Grella has adjusted to shelling out top dollar for similar procedures, but he’s less comfortable with anyone knowing about his hair removal habits. Even though Grella, who is gay, says self-maintenance is the norm in his community, he still feels a sense of shame when approaching the salon receptionist to announce his arrival for a 4 p.m. back and ass wax – something he still does between laser treatments.

Howie Goldman, 46, a CPA from Long Island has the same problem. Both Goldman and Grella are customers at the Randee Elaine Salon in the West Village, a two-floor beauty emporium offering everything from discounted tooth whitening and skin spot removal to skin tightening and a cheap $20 wax.

“There are mostly women at the spa and not a lot of privacy when you’re at the desk – everyone hears what you’re there for,” said Goldman who spends about $30 a month on waxing. “It’s kind of embarrassing when you have to walk up to the receptionist and ask for a Brazilian wax.”

Unlike Grella, Goldman is straight and part of a whole new group of men taking the plunge into beauty and grooming – one that’s extending beyond the shallow waters of the metrosexual and into the mainstream. This group includes David Robles, a 25-year-old entrepreneur who has his legs waxed three or four times a year during his cycling season; Alexander Santi, 31, a vice president at a fashion conglomerate, who regularly waxes below the waist; Mike Jacobsen, 30, a financial analyst from New Jersey who hits his salon every month; and Armando, who declined to give his last name, 25, an international finance executive who has his eyebrows and chest waxed every two weeks, throwing in an occasional manicure. For straight men, the glass ceiling on male vanity has been shattered.

Last Saturday the receptionist at Shobha Soho, a spa located on Broadway near Houston Street, looked over her appointment book and said six men had come in the day before for waxing appointments alone. In fact, waxing has become so popular among men that most salon and spa menus include a separate list of services just for them —often at a premium .

In beauty parlor parlance, male waxing below the waist is referred to as the “ass, crack and sac” waxing, the equivalent of the women’s Brazilian, where the genitalia, buttocks and pelvic area are stripped of hair. The cost ranges from between $25 at Randee Elaine and upwards of $75 at Shobha, with results lasting from three to six weeks.

Based on the menus of a dozen New York City spas, including Shobha, the J Sister Salon, an Upper West Side spa called Wanda’s European Skin Center and the men’s-only Why Not Men’s Spa on West Fourth Street, the average price for a back waxing is approximately $55, the chest will run you $60 and the full buttocks about $45.

Santi, who has been waxing since he was 21, estimates that he spends close to $350 a month on grooming. His girlfriend convinced him to get his first Brazilian in college and he has faithfully maintained the style for the past decade.

“It hurt the first few times, but now I’m used to it. I have some scotch before I go in,” said Santi. “I just get the Brazilian, never the chest or eyebrows, because I don’t consider that manly.”

Straight Faced

Koryn — Wed, 19 Mar 2008 11:08:56 +0000

Here is the FDA’s fact sheet on botox. More info can be found on the homepage for the Office of Women’s Health.www.fda.gov/WOMENS/getthefacts

Botox™ is used to make lines or wrinkles between the eye brows look better. It only lasts for a short time.

What is Botox™?

• Botox™ comes from a kind of bacteria. The bacteria can make you very sick. But doctors have found that a chemical in Botox™ can also help treat some health problems. They have been using it safely for many years.

How was this found?

• FDA (Food and Drug Administration) approved Botox™ over 10 years ago to treat certain problems with the eye muscle. Doctors noticed that some wrinkles around the eyes looked better, too. The company that makes Botox™ tested it. They showed the FDA that Botox™ worked and was safe for treating some kinds of wrinkles.

How does Botox™ work?

• Wrinkles may be caused when a muscle tightens. Botox™ is injected through the skin into the muscle. The Botox™ keeps the muscle from tightening. When the muscle can’t tighten, the wrinkle doesn’t show as much.

You mean you can’t move your muscles?

• A doctor trained in the use of Botox™ will inject small amounts of Botox™ into the muscle. Only the treated muscle can’t move.

What happens over time?

Botox™ works for about four months. As the muscle returns to normal, you will see the wrinkle again.

Are there any side effects?

Yes

Side effects may include:

Droopy eyelids, which can last for a few weeks
Feeling like you have the flu
Headache and upset stomach
Risk of botulism (a life or death illness that makes it hard for a person to move the arms and legs or to breathe) is low with Botox™, if used the right way

REMEMBER- Botox™ is a drug, not a cosmetic.

What should I do if I want to try Botox™?

Ask about how Botox™ could help or hurt you
Make sure your doctor is trained in the use of Botox™
Make sure you get treatment in a doctor’s office or clinic
Emergency equipment should be on hand in case of a problem
Do not use if you are pregnant or think you might be pregnant
Do not use if you are breast feeding
Tell your doctor if you are taking antibiotics
Tell your doctor if you have any problems with nerves or muscles

Quick Facts About Botox:

Are “Botox parties” safe?No. You should only get Botox in a clinic or doctor’s office. You should never share a tube of Botox.

Can I use Botox on other wrinkles?Botox is only approved to treat wrinkles between the eyebrows.

Can I get Botox at any age?Botox is only approved for people 18-65 years old. It has not been tested on people under 18 or over 65.

Subprime Self-Esteem

Koryn — Fri, 29 Feb 2008 08:00:26 +0000

Lori Morgan-Brownell wants breast implants and she wants them bad. The 26-year-old who lives with her boyfriend in Carroll Gardens, Brooklyn, described herself as a confident and outgoing person. She is, by social standards, a pretty woman, still she believes her self-worth would dramatically improve with the body of her dreams. She is part of a growing population of Americans who don’t think they should have to settle for what Mother Nature gave them and are willing to go into debt for beauty.

The cosmetic surgery industry has exploded over the last decade. From 2000 to 2006 the number of patients undergoing elective plastic surgery jumped 48 percent, according to the American Society of Plastic Surgeons. When the total bill for 2006 hit $11.5 billion, companies willing to help finance such high prices also multiplied.

A Google search for “financing plastic surgery” produces a list of two million websites in under 0.3 seconds: LooksforLess.com, CareCredit.com and DoctorsSayYes.com show up alongside financing guides linked to sites with instructions on how to file Chapter 7 bankruptcy. In an economy on the edge of recession and in the midst of a credit crisis, taking loans out for plastic surgery has become much riskier. The average American is only making $45,000 according to the U.S. Census Bureau, a budget that leaves little room for extras.

Morgan-Brownell has her heart set on breast augmentation, but as a full-time college student at Fordham University, with no disposable income, she cannot afford the nearly $10,000 it would cost. For her, applying for a cosmetic surgery loan was the light at the end of the tunnel.

“I knew I would never be able to pay out-of-pocket, so when I found out there was a way I could afford them — that’s when I went in for my consultations,” said Morgan-Brownell.

Morgan-Brownell was relatively content with her body until she began gaining weight after high school. In 2006, when she finally tipped the scales at 200 pounds, making her medically obese, she knew the weight had to come off. Over the next two years she managed to gradually shed 80 pounds, dropping from a size 18 to a size 6 and going from a 38DD bra size to a 34B. She is incredibly proud of her weight loss, but also thinks the dramatic change ruined the shape of her breasts.

“I feel like they need to perk up quite a bit,” said Morgan-Brownell, defending her decision to have cosmetic surgery. “I don’t want bigger, I just want them to look 26 not 36. I don’t think that’s unreasonable.”

Nor does she doesn’t find it unreasonable to pay off the procedure over the coming years regardless of the uncertainty of her financial future she said. For her, success is more accessible when fueled by confidence and that is priceless.

The ASPS claims that cosmetic surgery can improve self-esteem and alleviate symptoms of depression. In a study released in 2006, 17 percent of those in a control group who had cosmetic surgery were regularly taking anti-depressants. That number dropped by 31 percent after surgery, according to the study.

An independent study conducted by Clinical Assistant Professor Cynthia Figueroa-Haas of the University of Florida also found a direct correlation between self-esteem and breast enlargement surgery. On a 30-point scale Figueroa-Hass found that the self-esteem of women who had their breasts augmented increased an average of 20 percent, from 20.7 to 24.9.

Geography may also influence the desire to pursue surgery. Morgan-Brownell, who moved from Los Angeles to New York City a little over a year ago, found it easier to seek out surgeons in California compared to New York. She also believes New York City breasts may be pricier than those in Los Angeles.

“When I lived in California, I saw ads for breast implants for around $3,000,” she said. “The final costs I was quoted from doctors here in the city were between $9,000 and $11,000.”

Morgan-Brownell attributes this to slightly higher base fees along with additional costs, such as choosing silicon implants instead of saline – a $1,000 difference.

Surprisingly, New York City residents are some of the least cosmetically-enhanced urbanites in the county. At the lower end of the scale, women in New England and the Middle Atlantic states account for just 13 percent of the country’s breast enlargements, according to statistics compiled by the ASPS in 2006. By contrast, women in Pacific coast and Mountain region states, like California, Nevada and Hawaii, have the most breast enlargements, accounting for 36 percent of augmentation surgeries in the country.

Despite the staggering pricetag and the failing economy, Morgan-Brownell wants the surgery every bit as much as she did in 2006 when she first noticed her body’s shifting landscape.

“I’ve never really been an advocate of cosmetic surgery,” she said. “A lot of times I think it’s a temporary solution to a deep-seated issue. But on the other hand, at least in my case, I feel like it’s an investment in my self-esteem and a reward for losing the weight that I did.”

Looking to make a similar investment, Cara Gustman, 29, a dental assistant from Mill Basin, Brooklyn, had decided on having a nose job when the economy took a turn for the worse. The cost of rhinoplasty typically ranges from $4,000 to $12,000, with the average cost being $5,500, according to costhelper.com, a site that compares the prices of products or services across the U.S.

Like Morgan-Brownell, Gustman simply can’t afford the surgery with her current income. But unlike Morgan-Brownell, she decided her self-esteem might not be worth the debt load of paying for her new nose on credit

“Some people need a house,” said Gustman. “They need to know that they own that house. That’s important to them. Then, there are other people who are OK paying rent because they need to be beautiful.”