As the economy has sunk in these past couple of years, the billion-dollar cosmetic-surgery industry has experienced a dip in sales, sparking a new trend in discount plastic surgery.

Billboards advertising $2,999 bargain boob jobs from a “surgeon to the stars” have sprouted on the California 405 Freeway, while many other signs found throughout the country proclaim you can “Buy One Implant, Get One Free,”  or receive “$8 Botox” injections.

While these catchy campaigns may seem appealing to the frugal customer, horror stories like that of former Miss Argentina, who died at age 38 following a butt augmentation, prove that some bargain-basement procedures have their price.

“To get the cost down, they could be cutting back on things like general anesthesia. They make you feel like the procedure must be easier and not so serious if you’re just getting local sedation. Nothing could be further from the truth,” says Long Beach, Calif., plastic surgeon Dr. Marcel Daniels.

In fact, The New York Times recently published an investigative piece on the increase in doctors offering breast augmentation without anesthesia. The doctor featured in the story, Dr. Robert L. True of Colleyville, Tx., props up locally sedated patients halfway through surgery so they can confirm that they like the size of their implant before he stitches their breasts closed. What most patients don’t know is that Dr. True is actually a gynecologist.

This type of foray into plastic surgery by a doctor who studied an entirely different branch of medicine is part of what is fueling the cheap-surgery trend, since many physicians not trained as plastic surgeons can legally perform a surgical procedure in their office. Patients pay in full up-front, so these physicians don’t have to deal with health insurance and hiring staff to process billing and claims.

Beverly Hills plastic surgeon Dr. John Anastasatos says that these physicians often claim they can do the same procedure as a plastic surgeon under local anesthesia, and may even claim they are more scientifically advanced. “The truth is that they don’t have surgical privileges at hospitals and surgery centers because they simply are not surgeons and never trained as surgeons.”

Yet surgeons want to make it clear that even paying top dollar for plastic surgery doesn’t guarantee the best results.

“Bad plastic surgery is not always price sensitive. It’s just that cheap and discounted surgery is often the first sign of a desperate surgeon whose skills alone don’t sustain his or her business. If you want to save money, do it when buying a car, an airline-travel package, or clothes. Never do it when purchasing a plastic surgery operation.” Says plastic surgeon and CellCeuticals skin-care creator Dr. Garth Fisher, who performed a reconstructive face-lift on Olympian Bruce Jenner.

So how does one find out if an estimate is too cheap or a professional opinion not up to par?

“Get at least a couple of opinions, if not more. No one should get just one opinion,” says Dr. Daniels. Consumers can check any doctor’s board qualification for free at the American Board of Plastic Surgery Website. If the doctor isn’t listed, call the organization to double check a status.

Or try the American Board of Medical Specialties to see if the doctor is board-certified in another field. Many surgeons claim to be a board-certified plastic surgeon, when in fact they’re board-certified in something else entirely and practice plastic surgery on the side.

It is also a good idea to ask for before-and-after photos of the doctor’s work for your particular procedure; you want to make sure there’s evidence of good work from the doctor you’re seeing. If no before-and-afters are available, that’s your red flag that it’s time to walk.

And Dr. Daniels has some time-tested advice for all patients considering cosmetic surgery. “It all comes back to what P.T. Barnum said: ‘There’s a sucker born every minute.’ Don’t be the sucker. If a doctor has significantly different methods and prices from other opinions you’ve received, get another professional’s opinion or just get out of there.”

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