Many Americans learned the hard lesson of "doing without" last year when the economy slipped on Wall Street's banana peel. For many that included crossing off some of life's luxuries from the list for a while: vacations, new cars, bigger houses. For some, cosmetic surgery.

Plastic surgeries, including nose jobs, eyelid surgeries, liposuctions, tummy tucks and breast augmentation, were off about 9 percent in 2009, according to a recently released report by the American Society of Plastic Surgeons.

"But the number of surgeries is already creeping up this year." says Dr. Peter McKenna of McKenna Cosmetic Surgery Center, in Montgomery.

Meanwhile, Botox and dermal filler injections, used to raise wrinkles and alleviate deep creases, remain the non-surgical choices and keep plastic surgeons busy.

"They are less expensive ways to make certain areas look good and are more economical than surgery," McKenna says. Botox injections to treat crow's feet for example may cost $200-$250 and last three to four months. A facelift or eyelift can cost $5,000-$5,500.

Requests for Botox, which relaxes muscles that cause creases, remained strong through 2009, he says. And it's ideal for crow's feet and lines between the eyebrows, McKenna says.

Fillers, materials that go in a deeper part of the skin to raise wrinkles, and known to the ad-savvy as Juvederm, Restylane and Radiesse, eventually absorb over time. These are best for the nasal labial fold (that line from the nose to the outer corner of the mouth), the lines around the lips or the line between the corner of the mouth and chin.

"Fillers can last four to six months, some over a year depending on how the body breaks them down," he says.

The most common surgeries for the 50-plus set not slowed by the economy continue to be facelifts and eyelid lifts, McKenna says. Used to alleviate bags and saggy lids, "the goal is to make you look like you've been on a vacation."

And the surgery will probably run you the cost of a nice trip. 

2009 Top Five Procedures
Minimally-invasive Procedures
1 Botulinum toxin type A (4.8 million)
2 Soft tissue fillers (1.7 million)
3 Chemical peel (1.1 million)
4 Microdermabrasion (910,000)
Surgical Procedures
1 Breast augmentation (289,000)
2 Nose reshaping (256,000)
3 Eyelid surgery (203,000)
4 Liposuction (198,000)
5 Tummy tuck (115,000)