A look at how COVID-19 disrupted facial plastic surgery & aesthetics

The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), the world’s largest association of facial plastic surgeons, has released its 2020 member survey results.

Over the past few years, use of non-invasive procedures to forestall the signs of ageing have been steadily on the rise. The pandemic flipped the switch, creating a surge in surgical demand not seen in recent years. Despite the fact that many non-essential surgeries and aesthetic services were put on hold for months during the pandemic, AAFPRS members note that demand is now higher than ever.

A full 70 percent of AAFPRS surgeons report an increase in bookings and treatments over the course of the COVID-19 pandemic, with 9 in 10 facial plastic surgeons indicating an increase of more than 10 percent. Surgical procedures are the most common procedures as part of this upsurge, perhaps cancelling out any decreases that might have resulted from the economic crisis and lockdowns. The AAFPRS members who experienced higher patient volume almost unanimously (96 percent) indicate that it is because men and women have more time and flexibility to recover from treatments due to social distancing and the benefits of working from home. Rhinoplasty (78 percent), facelifts (69 percent), eye lifts (65 percent) and neck lifts/treatments (58 percent) have increased most notably, likely due to more time spent on digital devices and an unprecedented virtual lifestyle.

Interestingly, and not necessarily correlating to the Australian experience, for the first time in years, AAFPRS members reported non-surgical treatment demand decreasing in 2020. The average amount of minimally invasive procedures was down by 9 percent compared to 2019, driven by a decline in skin treatments (down 29 percent) and fillers (down 8 percent). Neurotoxins, however, remained consistent with 2019 demand. Supporting this, three-quarters of the work done by AAFPRS members in 2020 was facial plastic surgery.

Zooming in on self-scrutiny

AAFPRS members point to the ‘ZOOM effect’ as a major contributing factor in changing behaviours (according to 83 percent of respondents), while patients having more disposable income due to not spending it elsewhere is a strong second (64 percent) in patients changing behaviours.

As the first organisation to identify the ‘selfie-awareness’ trend highlighted from previous annual surveys, the AAFPRS is now spotlighting an evolution of this hyper-awareness of one’s own on-screen image; only this time, it’s live and via video. Deemed ‘ZOOM dysmorphia’, the pressures of a virtual lifestyle had a huge impact on the way we view ourselves, according to AAFPRS surgeons.

From students stuck at a computer all day to adults working and socialising from behind a screen, the constant bombardment with one’s own image was responsible for significant self-perception shifts and could account for the intensified demand for facial plastic surgery. The number of teens seeking rhinoplasty is up from 2019, with 41 percent of surgeons identifying this as a rising trend along with the desire to look better on video conferencing (a new trend, reported by 16 percent of AAFPRS members).

‘Real-time video cannot be FaceTuned or photoshopped to smooth out a bump on the nose, crow’s feet or a sagging neck,’ says AAFPRS President, Paul J. Carniol, MD. ‘Unlike selfies and video editing apps like TikTok and Reels on Instagram, the video conferencing used for school, work and ZOOMing with family and friends does not allow for filtering capabilities, making it a particularly easy lens for self-scrutiny.’

While staring at yourself on screen all day became normalised in 2020, it follows that people asking for eyelid procedures to look less tired was highlighted as trending by 56 percent of surgeons.

ASPS 2020 Annual Statistics

Findings from American Society of Plastic Surgeons (ASPS) statistics 2020 align with the experience of AAFPRS members in the US. The world’s largest plastic surgery organisation recently released the results of its annual procedure survey.

Surgeons reported they stopped performing elective surgical procedures for an average of 8.1 weeks in 2020 due to COVID-19, or 15 percent of the year, which mirrors the decline in the total number of procedures performed last year.

The consequences of these sweeping halts on the aesthetics field need to be kept top of mind to properly evaluate the 2020 findings, says former ASPS president Alan Matarasso. ‘You’ve got to remember, in places like New York, we took at least a quarter of the year off, so if you [adjust for] a full year, [the numbers] wouldn’t be that far off,’ he told Allure.

Rhinoplasty takes top spot as #1 cosmetic surgical procedure

Nose reshaping replaced breast augmentation as the #1 cosmetic surgical procedure. A total of 352,555 rhinoplasty procedures were performed in 2020, toppling breast augmentation from pole position — a title breast augmentation has held since 2006.

However, some experts aren’t ready to forecast 2022 predictions just yet: ‘We’ll see if this popularity continues, or whether this was a difference due to our COVID lifestyle and looking at our faces all day on a big computer screen,’ plastic surgeon Lynn Jeffers, immediate past president of the ASPS, told Allure.

The pandemic also shifted the pecking order of several other cosmetic surgical procedures, elevating eyelid surgery (352,112), and facelifts (234,374) to the second and third most-performed procedures, with liposuction (211,067) and breast augmentation (193,073) rounding out last year’s top five cosmetic surgical procedures in the US.

Minimally invasive procedures drop first time in 4 years

In 2020, minimally invasive cosmetic procedures, such as fillers and peels, decreased slightly more than surgical procedures (16% vs. 14%) during the pandemic, dropping for the first time in four years.

Injectables, however, continued to be the most sought-after treatments in 2020. ASPS member surgeons cited a significant uptick in demand during the coronavirus pandemic with current patients eager to reschedule missed neurotoxin and filler appointments, and new patients motivated for the first time to pursue the minimally invasive facial treatments they’d been considering – some even before last March. AMP