Ouch!

Even in Los Angeles, the capital of looking good, the recession is taking a bite out of the nip-and-tuck profession and it hurts.

Plastic surgeons and other “aesthetic specialists” have seen a one-third or more drop in business by some estimates.

Consider the case of Dr. Michael Persky.

He invested more than $150,000 nearly a year ago to become one of the first U.S. doctors trained to perform Fraxel Laser therapy, which is said to achieve close to the same results as a surgical face lift but at half the usual $15,000 cost.

But offering what amounts to a cut-rate nip and tuck without the scalpel hasn’t shielded Persky from the loss of wealth experienced by the plastic surgery set.

“I’ve had some of my actress clients ask for deals on their Botox,” said Persky, who caters to a large professional and entertainment industry clientele. “Even some of my wealthiest patients are hesitant, either because they aren’t sure where things are going or they feel guilty about having surgery when others are suffering.”

And when patients do opt for treatment, they are trading down in the same way many have dropped Saks for Target; seven in 10 surgeons surveyed by the American Academy of Cosmetic Surgery reported more patients opting for cheaper wrinkle-relaxing Botox and injectable fillers instead of surgery.

That has prompted established plastic surgeons who haven’t had to focus on marketing to try a little harder. For example, Persky ran a Fraxel promotion earlier this year, and Irvine plastic surgeon Donald Altman generated publicity when he pegged his Botox fees to the rise and fall of the Dow Jones index.

Altman, who had been charging $14 per Botox unit or about $350 for a standard treatment, is now charging $1 per unit for every 1,000 points on the Dow.

Last week, with the Dow dipping under 7,000, that same treatment was going for less than $175.