If the number of plastic surgeons per capita in Utah is any indication, Sleeping Beauty's wicked queen isn't the only one reflecting on ways to maintain a youthful appearance.

The ratio of plastic surgeons to less-than-perfect people in Utah is second only to Washington, D.C. an indication that Utahns, unlike the vain villainess of storybook fame, aren't content to simply fret in front of the household mirror.In fact, there is a bona fide boom in business for surgeons specializing in tummy tucks, face lifts, breast augmentations and other aesthetic procedures.

"The sheer numbers would indicate that cosmetic surgery is more popular than it was before," said Dr. David L. Dingman, associate professor in the Division of Plastic Surgery at the University of Utah. "All types of body enhancement, whether it be surgical or activity related, is more popular than it was 10 years ago."

Statistics prove that Utahns and their physicians are more sophisticated and more aware today than ever before of the importance of overall good physical and mental health.

"Due to an increased awareness in all areas of health and preventive medicine, we see more people out jogging; people taking better care of their skin; people eating correctly - keeping their weight down. Cosmetic surgery is a natural extension of this," said Dingman, a plastic surgeon on staff at Holy Cross Hospital. "With more and more media exposure, people are taking more pride in their appearance, which shouldn't be considered frivolous. Pride in one's appearance is the most visible indicator of good self-image and good mental health."

A person's appearance may also be his or her "bread and butter" and help extend his or her career - whether it be in show business or shoe sales.

When several candidates with equal qualifications are vying for a position, personal appearance is too often a deciding factor. The unfortunate reality is that qualified people may be passed over for jobs because a potential boss doesn't like their looks.

A plastic surgeons' skill can solve that problem. In addition to removing sagging tissues and unseemly wrinkles, the surgeons can, by various surgical techniques, help bolster the psychological images of both young and old, men and women. Once considered the exclusive domain of women, aesthetic surgery is now in demand from men who recognize the benefits it can bring.

"Psychiatric problems can't be treated by cosmetic surgery," said Dr. Larry G. Leonard, clinical associate professor of plastic surgery at the U. "There are times, however, when aesthetic surgery can be an adjunct to helping people with a self-image problem."

Utah's plastic surgeons, whose number has doubled in the past five years, have geared up to meet the demand.

To facilitate the influx of cosmetic surgery patients, the U. Medical Center is transforming the former American Red Cross building on Foothill Blvd. into a free-standing surgery center.

Holy Cross Hospital is opening a new short-stay surgery unit in March to accommodate the the increasing number of outpatient procedures, including cosmetic surgery.

Specialists at established free-standing centers - Intermountain Surgical Center, South Temple Surgical Center, Salt Lake Surgical Center, Doxey-Hatch, Alta View and Cottonwood Hospitals - are also performing all forms of plastic surgery from rhinoplasty (nose jobs) to otoplasty (ear reconstruction).

LDS Hospital has expanded its services to include a cosmetic surgery information center, enabling prospective patients to consult with a surgical nurse free-of-charge. The center features brochures and video tapes on each cosmetic procedure.

"Physicians update their education on a regular basis. We have a keen responsibility to get more education to the public so they can make more informed, proper decisions," said Dr. Thomas Ray Broadbent, director of the information center and a cosmetic surgeon on staff at LDS Hospital.

Broadbent and his colleagues have also instigated an educational outreach program; they address civic, church and community groups on a regular basis.

Alta View touts a full-time "Exclusively You," program chief, who coordinates surgery from beginning to end.

Through free seminars at the various hospitals, the latest techniques and advances in cosmetic surgery are discussed regularly. And there are many advances.

"Surgery to forestall or camouflage the effects of aging, sun exposure or gravity has undergone a complete renaissance in the past 10 years," Dingman said.

The face lift is a case in point. Emphasis now is not only on the skin, but the supporting structures, the underlying muscles of the face. Today's surgery gives a more lasting, more natural result.

"Natural" seems to be the key word in cosmetic surgery.

"Because it has become more acceptable for people to maintain their ethnic characteristics, rhinoplasty surgery has even changed," Dingman said. "People once wanted the cookie cutter-type small nose. The emphasis now is not so much on making noses smaller, but making them more attractive, refined, while retaining ethnic characteristics."

The days of large breast implants are also fading. While breast augmentations continue to be popular, small implants to enhance a woman's figure are more in vogue.

Despite its popularity, aesthetic surgery still carries with it some taboos. People want their healthier appearances attributed to "Mother Nature," not Dr. Jones.

It's a goal shared by the surgeons.

"We are enhancing basic facial structure, not changing appearance," said Leonard, a surgeon on staff at both LDS and Holy Cross Hospitals. "We would like for the patients not to be recognized by their friends as having had cosmetic surgery. We want them to appear younger, but we are not changing the basic facial structure."

For the most part, today's refined cosmetic procedures can be done on an outpatient basis, ensuring better confidentiality, convenience and lower medical costs. Patients are in and out in a matter of hours.

Depending on the procedure, recovery time can range from 10 days to six weeks - unless there are complications.

All cosmetic surgery patients are at some risk, but certain factors can enhance the inherent dangers. Leonard said patients who smoke have a higher risk of problems. Certain medications, including aspirin, can increase complications.

"We are the only surgeons who take people who are healthy, and intentionally injure their health," Leonard said. "We put them through an operation that might cause complications in order to make them better. When you embark on cosmetic surgery, you are risking your health in order to become psychologically better."

Although satisfaction levels are generally high following cosmetic surgery, Leonard urges prospective patients to become well-informed before entering the operating room. Surgeons advise patients to carefully weigh the benefits against the risks.

And remember: Whatever your reasons for choosing aesthetic surgery, you have to have realistic expectations. Surgery can change your appearance. The rest is up to you.

***** (chart) Average cost of cosmetic surgery in Utah

Abdominoplasty: $2,000 to $3,000

Blepharoplasty: $1,500 to $2,500 (including implants)

Breast Reduction: $2,500 to $3,500

Facelift: $2,500 to $3,500

Otoplasty: $1,500 to $2,000

Rhinoplasty: $1,500 to $2,000

Suction-Assisted Lipectomy: $600 to $1,000

(per area)