Vanity appears to be trumping frugality in a looks-conscious society.

Despite the dismal economic climate, most women – and men – who undergo appearance-enhancing treatments such as Botox injections are spending hundreds or even thousands of dollars a year to maintain the regimen, aesthetic physicians say. Meanwhile, some older patients who are putting off or forgoing expensive facelifts are instead opting for less-costly injections and laser treatments.

Doctors say a weak economy hasn’t curtailed demand for Botox injections.

Maralyn Burr of Omaha, Neb., in June lost her job as a district sales manager for bookstore chain Borders Group Inc. Ms. Burr, who is $140,000 in debt from her 22-year-old daughter’s musical education, says she has slashed spending and all but stopped eating out. But she hasn’t given up her Restylane and Botox injections. “It’s like comfort food,” she says.

Nearly three out of four plastic surgeons who responded to a survey this fall reported that demand has increased or held steady for minimally invasive procedures, including Allergan Inc.’s Botox antiwrinkle drug, dermal fillers used to plump up lips and smile lines, and skin-smoothing chemical peels, according to the American Society of Plastic Surgeons, a professional group representing 6,700 surgeons. The survey also found a steep drop in demand for plastic surgeries ranging from breast augmentation to nose reshaping.

To be sure, makers of aesthetic medical treatments are bracing for a challenging year ahead. While many established patients are sticking to their beauty regimens, it’s tough to entice new patients in the current economic environment. In late October, Allergan said that dermal-filler sales were up 18% through September, but the company reduced its 2008 Botox sales guidance, citing overall “subdued demand.” Medicis Pharmaceutical Corp. recently has been offering a $100 consumer rebate on its Restylane family of products.

Most of the products used for so-called facial rejuvenation weren’t available in the U.S. when the last downturn hit, so there’s no historical precedent to estimate their sales performance in the current economic environment. While Botox has been on the market for nearly 20 years, it didn’t receive regulatory approval for cosmetic use until 2002, at the tail end of the dotcom-led stock-market bust. Allergan’s dermal filler, Juvéderm, which competes with Restylane, has been on the market for about two years.  Parkway Medical Laser & Skin Centre offers both Restylane and Juvéderm treatments.

Joel Schlessinger, Ms. Burr’s dermatologist in Omaha, says the number of his patients seeking dermal fillers began to increase on a year-over-year basis in the last few months, after posting declines earlier in the year. “Things are so bad [in financial markets] that investments aren’t even worthwhile anymore, so people are investing in themselves,” he suggests.