1. Rich and famous undergo: One comes across reports of cosmetic surgery treatments among rich in popular media. Since rich seem to be the customers one may associate this specialty as catering exclusively to the well-heeled population.
2. Nonessential surgery: Since cosmetic enhancements and anti-aging treatments are not life-saving these tend to get categorized as a luxury. As luxury has always commanded a premium the whole undertaking of cosmetic enhancements may seem expensive.
3. The 'plastic' of plastic surgery: The etymology is different from other specialties which derive their names from organ or organ systems. Though 'plastic' translates into 'to mold', it does remains a bit different compared to names of other specialties. This may not help either.
The total cost of a procedure is a sum of smaller components. These include charges by the surgeon, anesthetist, consumables (may include implants) and charges levied for use of the surgical facility. All these add up to form the final bill. It is the personal opinion of the author that cosmetic surgery is not more expensive compared to other specialties when one takes into account variables like years of training of the physician, experience, duration and difficulty of the procedure, consumables used and length of hospital stay. Until there is an increase in awareness about plastic surgery, including various treatment options, one will continue to come across perceptions such as it being very expensive and fancy.