The COVID-19 pandemic has brought along with it a whole lot of changes within the private and the public spheres. Among them: relaxed work-from-home guidelines, revamped restaurant experiences and an intense global dedication to personal hygiene.
But, perhaps most surprisingly given stagnant work, inevitable furloughs and hospitals’ focus on life-threatening medical procedures at the start of the pandemic, more Americans have been undergoing both invasive and non-invasive cosmetic procedures than ever before.
According to the Aesthetic Plastic Surgery National Databank, the top non-surgical procedures that Americans underwent in 2020 are neurotoxins such as Botox (2,643,366) and fillers (1,313,206). The former has increased by 54% since 2019 while the latter is up 75% in total. Overall, the industry’s revenue has increased exponentially, thanks to a vast variety of surgeries.
Conversations with plastic surgeons and skin experts confirm the statistics. “There’s been an explosion in the demand for plastic surgery,” said Jeremy Nikfarjam, a board-certified plastic surgeon and founder of New You Plastic Surgery. “You would think that in a pandemic, during which people have lost jobs, are furloughed, make less money or are stuck at home with the kids, they would consume less ― but there’s been an explosion in demand.”
Oriana Cohen, a clinical assistant professor in the Hansjorg Wyss Department of Plastic Surgery at NYU Langone Health, saw the same increase. “Initially, when there was a hold on elective surgery, things were obviously shut down and health care resources were conserved,” she said. “But once things opened up, the number of consults and surgeries increased significantly.”
Numbers don’t lie and neither do doctors, it seems: Americans have invested in plastic surgery during lockdown. But why?
The procedures people are having during the pandemic
As highlighted by the above-mentioned statistics, fillers and Botox are exponentially more popular than ever before. “I would say we’re up seven times our normal for Botox,” Nikfarjam said. “I can’t get Botox fast enough for most of the company to inject.”
“Neuromodulators like Botox and fillers have always been popular, but are even more popular now,” Cohen added. “And the area of focus may be more the eyes, whereas before it was also the chin. Now, that’s covered by masks.”
The changes have also been apparent to dermatologists. “People are coming in for things that occur below the mask ― like lip fillers, for example,” said board-certified dermatologist Marisa Garshick. “We’ve also seen a lot of Botox, essentially a wrinkle reducer that helps prevent expression lines. People are really focusing on their eyes even more than usual.”
Interestingly enough, surgical procedures involving body work are also on the rise, from liposuction to abdominoplasty. Mostly, the shift is thought to be due to the way the average American’s exercise and health practices changed in response to stay-at-home orders.
The variation in types of requests also points to a general change in attitudes. In fact, people seem to be more open to the idea of undergoing treatments simultaneously. “There has been a shift in patients being OK doing more procedures at once,” Cohen said. “Patients who might have wanted a breast lift and a tummy tuck, but may have separated the two procedures because they just couldn’t deal with a prolonged recovery, are now OK with doing them [all at once].”
That chasnge is directly related to the reasons behind the overall increase in non-invasive procedures.
How working from home has aided the boom in cosmetic procedures
Being able to work from home seems to be the top reason Americans are more willing than ever to undergo plastic procedures. “They are using their time as a means to recuperate after surgery,” Nikfarjam said. “I have tons of accountants and bankers as patients because they are now sidelined and can work and recover at the same time.”
As Cohen explains, the pandemic has allowed for the sort of downtime that these procedures necessitate. The time needed to inject Botox and fillers was never an issue for the average employee ― but being able to relax at home post-procedure would usually require having to take at least a couple of days off. That’s no longer the case.
Social distancing etiquette should also be mentioned. Not being able to meet others in person has allowed many to recuperate without having to worry about friends and acquaintances noticing fresh scars or swelling.
How masks have made us think differently about our faces
Masks seem to be at the center of this conversation. Perhaps even more importantly than work-from-home attitudes, the requirement to virtually always don a face covering has allowed Americans to feel comfortable undergoing certain procedures, given the mask’s ability to hide its immediate not-flattering after-effects.
“People who were not sure if they should do something prior to the pandemic now think, ’Why not? If I have a little bruising and swelling after, I have a mask to cover it up and no one will know,’” Garshick said.
Yet, these same masks tend to also cause potential patients to notice certain issues they never really paid attention to before. “Because of masks, people are animating a lot more with their foreheads and eyes and so people are noticing wrinkles and other things they would like to take care of,” Cohen noted.
Finally, the face coverings end up actually causing some problems. “The medical necessity for rhinoplasty has increased because of the constriction of the mask,” Nikfarjam said, explaining that people with deviated septums, for example, find the condition even more compromising given the need to wear a face covering at all times.
On a dermatological level, Garshick has noticed an increase in all sorts of “mask-related skin” issues, which are now generally referred to as “maskne.” From dermatitis (redness and flaking on the skin caused by the mask rubbing up against your face) to an actual allergy to a portion of the facial covering, these have caused plenty of people to embark on skin care journeys ― a fact also aided by the extra time that people have to actually indulge in new routines.
“Previously, people were concerned that they would forget to apply a serum every day, for example, while rushing to work,” Garshick said. “But now they are able to find time to focus on it because they’re home anyway.”
The Zoom boom
Overall, at least when dealing with non-invasive facial procedures, it seems it all comes down to people noticing more issues than they used to. That’s in large part due to the fact that we’re spending much more time looking at ourselves on screens, whether on Zoom or FaceTime calls ― now part and parcel of both our work and social lives.
“People are spending much more time looking at themselves on a computer,” Garshick said. “When you look in the mirror, you are usually stationary or sort of give yourself your best face forward. But when you’re talking, you start seeing things and moving things in ways you probably never realized so people definitely want to take care of it because they can’t stop looking at it.”
Cohen echoes those observations. “By spending time on Zoom and looking at their reflection, people are really critical in analyzing themselves and so they are coming in particularly looking for rejuvenation around the eyes because that’s the area that you see,” she said.
Connected to the prevalence of video calls, Nikfarjam notes a separate aspect of the story. “Prospective patients have become very aggressive with pictures,” he said, explaining that plenty of people take screenshots of actual video calls, forwarding the photos to him to ask what it is about their faces that he would work on. “I used to have to ask to send me a picture or a selfie and now they just do it,” he said.
But also… YOLO
Overall, doctors agree that Americans feel like now is the time to indulge in things they were holding off on before. The pandemic, after all, showed us that life is too short to postpone the kinds of things we’ve always considered doing.
Nikfarjam has noticed that exact trend when focusing on the nurses that visit his practice. “One third of my patients are nurses,” the plastic surgeon revealed. “One thing I’ve noticed is that they’re getting a lot of facial acne because they are wearing masks all day. But what I’ve also noticed is that they’re coming in for their bodywork. What is happening is that health care workers are now saying, ‘What about me? What about my lifestyle?’”
Calling it a “cultural shift,” Nikfarjam notes that the change is fueled by a cosmetic desire that nurses and other health care workers feel like they should indulge in after seeing the worst of the pandemic.
“I had a nurse come in that saw six people die in front of her in one day,” he recalled. “And she said to me: ‘You know what? I’m vaccinated. Life is too short. I want to do this [procedure] now and I don’t want to wait.’”
That “YOLO” attitude isn’t exclusive to medical personnel. “I think the past year and living with this pandemic has made people value the things that they can do for themselves when they’re not restricted,” Cohen said. “The mentality of ‘I want to push this off’ has given way to ‘I really should look into this now if it’s something that I want.’”