Natalie knew if her work bonus didn’t come through, she wouldn’t be able to pay for the cheek filler she wanted. At a medspa in her home state of Indiana, she had been quoted $2,160 for two treatments with Voluma, utilizing three syringes total. “Let me be clear, that charge would not have cleared my checking account at that time,” she says. But she wanted the filler then to feel more like herself — and she wanted it right away. “I gained over 20 pounds in a very short amount of time due to an issue with my thyroid,” she says. After losing more than 25 pounds over three months, she found her cheeks and face to look very hollow. “Instead of feeling better, I felt I had aged several years and constantly looked exhausted,” she recalls. “It’s all vain, of course, but how I looked on the outside didn’t match how I felt on the inside — young, outgoing, and well-rested.” So she booked the appointments and charged them on her personal credit card. Thankfully, the work bonus came through, and she paid it off.
But what if you didn’t need the money up front? Buy now, pay later methods have skyrocketed in usage in recent years, with companies like Affirm and Klarna leading the (literal) charge. But while those services can make it easier to, say, afford a pair of designer shoes by paying in monthly installments, they haven’t made their way into the world of aesthetics. That’s where PRIVI, which launched in June 2023, hopes to find their market.
More and more people are getting aesthetic procedures — in a 2022 survey conducted by the American Society of Plastic Surgeons, 76% of plastic surgeons reported seeing increased demand compared to pre-pandemic levels — but these pricey treatments are still far from democratized. “Cost continues to be the biggest barrier to meeting the interest and demand for aesthetic treatments and retreatment. In fact, 74% of patients say cost is the number one reason they do not move forward with treatment,” says Todd Watts, CEO of PatientFi, the parent company of PRIVI. (This number is based on a 2023 survey by PatientFi, which is up from the 71% of patients who said cost is the biggest barrier to moving forward with treatment according to a 2019 RealSelf Aesthetics Trend Report.)
PRIVI works to close this financial gap, making services and treatments more accessible by taking the total cost of a treatment plan and splitting it up into monthly payments. The idea is that it’s a win-win for patients and medical providers: Patients can get the services they want now and have a multi-treatment plan if necessary; providers can retain patients and keep them happy. Instead of quoting a treatment plan of two syringes of filler for $1,500, injectors can now quote the same treatment for $125 a month for 24 months. (PRIVI does not charge monthly interest.)
While that may prove useful for some, others are a bit skeptical of using a delayed payment option. “I think it can turn dicey very quickly,” says Natalie, who asked that we identify her by her first name only. “It’s very two-fold because it gives everyone the option to ‘afford’ it, but will it encourage your injector to suggest more treatments, more units, more products that aren’t needed?” Ben Paul, MD, a double-board certified plastic surgeon based in New York City, does not currently use payment plans – or at least, does not provide them proactively (his practice does accept credit cards). “A payment plan may open the door to plastic surgery for someone that could not otherwise afford a procedure,” says Dr. Paul. “[But] at the same time, a payment plan may create a situation where a patient falls into debt for an elective plastic surgery.” (Buy now, pay later programs have been "criticized for creating “phantom debt"and making it easier for consumers to overspend, especially those who are already “financially fragile.” Even if you’re not paying interest, the debt from BNPL could still affect your credit score.)
Speaking of plastic surgery, PatientFi has been around since 2017, offering financing for breast augmentations, liposuction, and the like. It wasn’t until the launch of PRIVI last year that aesthetic treatments like Botox and microneedling were eligible for financing. Because insurance can cover some plastic surgeries, payment is a little bit more complicated. Lucy, a 20-something based in Dallas, had thought about a breast reduction for years before talking to a surgeon. It was then that she learned that while breast reductions can be covered by insurance, these requirements are often very strict. (According to a 2023 statistical review, denial rates for breast reduction surgery range from 21% to 62% for private insurers.) Lucy, who asked that we identify her by her first name, was among the lucky ones approved right out of the gate: Her insurance covered 80% of her surgery. “I paid 20% out of pocket, which equated to about $3,000,” she says. “And I paid a hospital fee which was about $1,000.”
Lucy used CareCredit for these expenses, a credit card for health and wellness procedures. It offers a variable rate based on your credit score, and is accepted at over 260,000 locations, including medical specialists and dental offices. “I paid for 20% of my surgery over six months through CareCredit with zero interest, which was the payment plan option my surgeon’s office recommended,” says Lucy. “If it had taken longer than six months, I would have incurred a high interest rate on the debt.” (CareCredit’s APR, or annual percentage rate, is around 29.99% after the interest-free period, but can be different pending a person’s credit score and other financial factors.) Beyond a high APR, prospective patients need to understand the inherent financial risks of delayed payments. According to a survey conducted by Lending Tree, currently 8% of those with “medical” debt say cosmetic surgeries or procedures were solely to blame.
PRIVI notes that the max amount per aesthetic treatment transaction is capped at $5,000, but the annual total spend can be several times that. Since launch, a total of 6,750 members have signed up for PRIVI and more than 1,860 memberships have transacted, driving over $1.3 million in treatments funded to date. If a payment is missed, a patient will not be able to receive their next treatment until they are up to date on monthly payments owed. Some users, pending their financial status, may pay a one-time fee to cover the cost of their very first treatment and then pay a low monthly membership amount for the rest of the year. These patients can also take advantage of PRIVI’s Beauty Bank functionality where they can “bank funds with a provider and come in to get treated when they’re ready,” says Watts.
A helpful way to keep (financial) worries at bay is to make sure you understand the full financial picture of the procedure from the get-go. Ramtin Kassir, MD, a triple board-certified facial plastic and reconstructive surgeon who practices in New York City and Ridgewood, New Jersey, recommends requesting detailed quotes for the procedure or treatment. “This should include not only the surgical or treatment fees but also any additional costs such as anesthesia, facility fees, post-operative care, and follow-up appointments,” he says. Lucy admits she didn’t know she’d have to pay a hospital fee, and “as a recent college grad with limited funds, this unexpected expense was stressful for me and something I wish I had known about in advance,” she says. “The hospital fee was totally separate from the surgery fee and the hospital did not offer any kind of payment plan, so I had to pay the expense all at once and very quickly.” Consultations can sometimes be charged a fee and then that fee can be used towards the procedure, but that’s dependent on the provider.
To avoid financial worry over cosmetic treatments, delayed gratification rather than delayed payments may be a better answer. “I ask the cost up front and if I go to a new office and they start examining my face telling me what [else] I need I will say, ‘I’ll wait until next time’ and just do what I came in for,” says Loreen Hwang, a content creator based in Los Angeles, who has gotten “Barbie Botox,” microneedling, and laser treatments.
If you’re set on getting your procedure, like anything, make sure you have a plan to cover the costs over time. Of course, “the most economical way to pay for elective beauty procedures is to save up in advance and to pay for them upfront,” says Kimberly Palmer, personal finance expert at NerdWallet and the author of Generation Earn. Taking on debt for a procedure may not be on your bingo card, but it very much could happen.
“Plastic surgery and aesthetic treatments when done properly are fantastic and oftentimes life changing,” says Dr. Kassir. “So if that can be facilitated with any type of payment plan, that’s a big plus, as long as the patient understands the obligations of the payment plans just like they do with their credit cards.”
Read more about the latest news in aesthetics:
- Skinvive Is the First Injectable of Its Kind Available In the U.S.
- Is Everyone Abandoning Their Facial Filler?
- Cheek Implants Are Gaining in Popularity
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