What will happen to all the faces?

In late June, Holly Aubry, who owns a public relations firm in New York, got the first aesthetic treatments she’d ever had in her life: Botox, filler and a brow suture lift.

She had never spent much money or time on beauty treatments; she had had few facials, and shopping at Sephora was rare. But when Dr Lara Devgan, a plastic surgeon in New York, reopened her office last month, Aubry went in for a consultation and got treated the same day. That office visit was one of the few outings she had taken since March.

Aubry, 40, could pinpoint her unease: “Hearing the sirens from my apartment. Being constantly terrified of getting sick. Having my kids home, compromising my ability to run my company. Seeing what the pandemic has done to the economy. All of it made me stressed, and I started noticing that I was aging rapidly.”

Throughout the lockdown, waitlists for nonessential, noninvasive skin-care appointments — those laser procedures, fillers and Botox injections — grew. Dr Ben Talei, a plastic surgeon in Los Angeles, reported that he and his colleagues are seeing people who are clamouring for care now, especially for anything that has healing time.

“They want to do it now while it’s not interfering with their work and social lives,” Talei said.

A surge of catch-up appointments was probably predictable. But what will the aesthetic world look like after an initial surge? Will more of us have a list of things we’d like to fix after becoming better acquainted with our features over innumerable virtual meetings?

Or, after a long break from a doctor’s office and a reliance on at-home skin care, will we realise that we don’t need medical intervention after all?

Then there’s the most important consideration of all: How do we do any of this safely?

The pandemic will change how we look.

With masks covering most of our faces, we’ll likely turn our attention to our eyes, doctors say. Devgan expects more requests for under-eye filler, Botox brow lifts and eyelid surgery.

“I also think that as we cover our faces, we’ll reveal more of our bodies,” she said. “That will create an emphasis on the aesthetics of the torso, buttocks and legs.”

As practices reopen, doctors are indeed seeing an increase in requests for body treatments. Typically, summer would be a slow time for surgeries as people plan for beach vacations spent in revealing clothing. But these days, said Dr Sachin Shridharani, a plastic surgeon in New York, “because the pandemic has limited travel, they’re doing these procedures now.”

According to the Aesthetic Society, a professional organisation and advocacy group for board-certified plastic surgeons that gathers data from plastic surgery practices nationwide, liposuction and tummy tucks made up 31% of total procedures in June, up from 26% in June 2019. Breast procedures were up 4.3% over last June.

“In my own practice, if you take into account the time that we were closed, breast augmentations and breast lifts are up significantly when compared to last year,” said Dr Herluf Lund, a plastic surgeon in St Louis and the president of the Aesthetic Society.

Nonsurgical body treatments, particularly injectables, are in demand as well.

“We’re seeing a lot of interest in what can be done with a syringe instead of a scalpel,” Shridharani said. Injectables, typically approved by the Food and Drug Administration for use in the face, can be effective at tackling body concerns.

For instance, Shridharani treats patients with Kybella, an acid that is injected to dissolve a double chin, to melt fat in the abdomen, arms and thighs. He also has been injecting small amounts of diluted Sculptra, a product that stimulates the body to produce more collagen, into arms and thighs to help smooth crepey skin. (Shridharani is compensated financially for work with the companies that manufacture Kybella and Sculptra.) What may be on the wane are the excessive fillers and Botox that we’ve grown used to seeing on celebrities and influencers. Steven Pearlman, a plastic surgeon in New York, said that he expects the baby-smooth, motionless foreheads and overfilled lips and cheeks — already diminishing in popularity — to retreat even more rapidly now.

“People have seen their faces relax into something more natural during the lockdowns,” Pearlman said. “And because of all that’s going on in society, too, they are going to realise it’s not important to have that extreme look.”

Social media habits will change, too.

It’s tough to say whether or not we’ll be sharing (or oversharing) scenes from our Botox appointments on Instagram. In a climate of coronavirus concerns, economic suffering and mounting national unrest, posting one’s very expensive cosmetic procedures on social media could, and arguably should, invite criticism.

At the end of May and the beginning of the Black Lives Matter protests, aesthetic doctors noticeably paused their streams of striking before-and-after shots. “We wanted to be sensitive, of course,” Pearlman said. “Everyone was considering, ‘What is the right thing to post at this moment, and should we be posting at all?’”

On the other hand, social media has been an essential mode of connection during monthslong lockdowns. People have grown comfortable sharing life’s details with their followers. Perhaps we will land in a middle ground where instead of posting about procedures on their own social media feeds, more patients will allow their doctors to share their procedure photos.

“I wouldn’t have given my permission to post before going through this experience,” Aubry said. “But I wanted other women who were feeling as I did to know that there are options, and they shouldn’t have any shame in pursuing them.”

But is it safe to have aesthetic procedures right now?

In medicine, everything is about risk-benefit,” said Dr Adolf Karchmer, an infectious disease expert and professor of medicine at Harvard Medical School. “Some people feel they need these procedures for psychological or even professional benefit.” The risk of getting the coronavirus when out in the world will never be zero, but offices should enact safety protocols to reduce the risk to a negligible level, he said.

Karchmer served on a task force that developed Project AesCert, safety guidelines for reopening. For patients, there are a few main lessons.

First, safety begins before you arrive at the office. Practices will be screening patients based on presence of symptoms, potential exposures and preexisting conditions. Some practices may turn away individuals at high risk for COVID-19.

“The first thing the patient should be asking is, ‘What is this practice saying about their safety protocols,’” Lund said. “When you call, can they describe without hesitation what they’re doing? Is it on their website?”

When you arrive, you’ll have your temperature taken. Paperwork will have been handled online before your appointment. Everyone should be in masks. The doctor will have on personal protective equipment, likely an N95 mask, face shield, gown and gloves.

Doctors are in agreement that many consultations and follow-ups will by default be done virtually to keep traffic in office to a minimum.

“Because of the risk of coronavirus exposure, the stakes are higher than ever for aesthetics,” Devgan said. Medical resources are still not optimal, she said, making it a bad time to have a complication from a procedure.

c.2020 The New York Times Company