In this time of COVID-19, face masks have become an accessory we don’t leave home without. Over the summer, that led to a rise in requests for aesthetic procedures that address the eye area (think: blepharoplasty, brow lifts, under eye filler). While experts predict those procedures will maintain their popularity in 2021, plastic surgeons and cosmetic dermatologists are also noticing increased interest in more invasive surgeries and treatments that can be concealed by face coverings.

“Due to the pandemic-related need for masks and a lack of socializing, many people are using this as an ideal opportunity to have some ‘work done,’” explains Andrew Frankel, MD, a double board certified facial plastic and reconstructive surgeon in Beverly Hills. “The masks camouflage much of the face and can allow someone who just had a procedure to be productive without drawing any attention to themselves.”

So, how exactly are face masks changing the aesthetic procedure and surgery landscape? And what’s it like to have a procedure under or above your mask? We’ve asked top plastic surgeons what procedures are trending because of mask-wearing and have spoken to two patients who had procedures in the last few months to find out what it’s like.

Popular Aesthetic Procedures During COVID-19

First and foremost, patients are seeking aesthetic treatments and procedures that are going to provide a boost. “Patients are embracing anything that will make them feel better,” shares Dendy Engelman, MD, a board certified dermatologist in New York City. “That includes IPL for brighter skin, filler and tightening devices for lower face and neck, and dermal filler and neurotoxins to enhance facial contours.”

These trends can generally be split into two distinct categories:

  • 1. Above the Mask: Procedures to enhance areas you can see with a mask on
  • 2. Under the Mask: Procedures that can be hidden with a face mask

Needless to say, so-called ‘above the mask’ procedures remain very popular. “With a face mask on, our eyes and brow area are highlighted most, making them the focal point and center of attention when talking with other people,” says David Shafer, MD, a double board certified plastic surgeon in NYC. “Because of this, we have noticed a sizable increase in cosmetic eye and brow procedures like fillers, blepharoplasty, and brow lifts.”

But ‘under’ the mask’ procedures are going strong, too. “At the same time, many patients are coming in for bigger procedures that they had been putting off for a while — like facelifts and neck lifts, chin augmentations, and neck liposuction — because they can all be covered with a fask mask following the procedure,” Dr. Shafer notes.

More invasive skin resurfacing procedures have also enjoyed a surge. “I have seen an uptick in laser treatments,” Dr. Engelman says. “Where a patient would not have had four days to recover from a more intense, yet more effective procedure like fractionated CO2 laser before, they now have the time and don’t have to worry about seeing people.”

Unsuprisingly, this category of treatment is very much influenced by concerns patients have noticed during increased screen time. “With more people working remotely now than ever before, there’s no question that there’s been an increased use of video conferencing platforms like Zoom and, as a result, an increased amount of time staring at oneself during daily calls,” Dr. Shafer says. “People are starting to see themselves in a whole new light, and it has caused an increased demand for procedures like neck contouring, buccal fat pad excision, and chin enhancements.”

And then there are the tried-and-true requests. “There has also been a continued desire for smoother skin with Botox® and jawline strengthening with dermal fillers such as Juvéderm® Voluma,” he adds.

What’s Driving Interest in Aesthetic Procedures?

Whether it’s the ability to recover more discreetly at home, the impact of watching yourself on Zoom all day, or a shift in discretionary spending habits, the COVID-19 pandemic has undoubtedly shifted the way we think about aesthetic treatments and cosmetic procedures. “With the explosion of video conferences, people are hyper aware of their appearance,” Dr. Engelman explains. “The additional lifestyle changes since the pandemic — more downtime and savings from not dining out or vacationing — has created the perfect setup for cosmetic interventions.”

The lifestyle we’re currently experiencing is ideal for people to recover from procedures, no matter how invasive they are. “Patients are not missing any social or business functions,” Dr. Frankel says. And, if they do have to go out in public, face masks can conceal quite a bit. “Patients have been more inclined to opt for invasive facial procedures during the pandemic, as face masks are helping them camouflage and hide in plain sight while running errands out in public or on their daily video calls for work,” Dr. Shafer adds. “They can now cover up the swelling, stitches, needle marks, and bruising from surgeries like facelift and chin augmentation.”

Post-op downtime used to mean taking time off from work, but patients are now finding themselves able to recuperate without much impact on their day-to-day life. “There is less hesitation from patients about the post-procedure recovery process now that most of them are working from home and can still work their full-time jobs,” Dr. Shafer says. Another big shift during the pandemic? Spending habits. “Because people are not spending money on traveling or dining out, they have available funds to direct towards self-care,” Dr. Frankel shares.

And while facial procedures may address concerns that are visible during video chats or while wearing a mask, some patients are using this time to plan for the future. “Patients are planning ahead for the post-COVID era and dreaming about beach vacations and summer parties,” Dr. Shafer notes. He says CoolSculpting®, EmSculpt, body liposuction, tummy tucks, breast augmentation, and butt and thigh lifts are more popular than ever.

Patient Perspective

We spoke to two patients (names have been changed) who had cosmetic procedures during the pandemic to find out why they took the plunge now and what their experiences were like.

ANDREA, 57, LONG ISLAND, NEW YORK
Andrea had been considering having some minimally invasive facial rejuvenation procedures. Once her social calendar cleared up due to the pandemic, she decided to go ahead with a facelift instead. She had her surgery when elective surgeries resumed in late spring.

THE AEDITION: How did COVID-19 impact your decision to have a facelift?

ANDREA: Awful as it is, it was perfect for me to have some downtime and treat myself to a facelift. I had nowhere to be over summer, so I had a clear period to recover without risking my recovery or having to go out and be seen with any signs of surgery.

THE AEDITION: How did you find the process of having surgery during the pandemic?

ANDREA: It was a little more stressful than it may have been during normal times. I had a couple of extra tests, and I did face some kickback from my family. I went over which precautions my surgeon was taking and asked whether any patients had contracted the virus in the facility where the surgery took place. I was of the opinion that having surgery at any time carries a level of risk and the medical staff would do what was needed to keep me as safe as they could.

THE AEDITION: Did wearing a face mask make recovery any easier for you?

ANDREA: It did make it a little easier once swelling subsided around my eyes and I was able to wear my hair down. It meant I could easily go to the store and bump into people I knew without revealing the tightness and swelling that was below the mask. It certainly shortened my downtime. I also found that the top half of my face settled and started looking natural more quickly than the lower half, so covering that for a while was helpful.

JAMIE, 32, MANHATTAN BEACH, CA
Jamie, who works in luxury real estate, had a brow lift to enhance how her face looks with a mask on. She was interested in the procedure pre-pandemic, and, after seeing how much more important her eyes became while wearing a mask every day, she decided to go ahead with it.

THE AEDITION: How did wearing a mask influence your decision to get a brow lift?

JAMIE: I think it made me hyper-focused on the upper half of my face. I’m naturally a very expressive person and wearing a mask kind of limited how much my facial expressions would come across. I noticed my brows were making me look a little downtrodden, and I wanted to widen my eye area somewhat. It was a procedure I’d been vaguely thinking about having, but it wasn’t high on my priority list. When I had to start wearing a mask all the time, I figured I might as well spend some money on the part of my face that you can see.

THE AEDITION: Did having the procedure during lockdown change your recovery?

JAMIE:It gave me some extra downtime without having to justify it, for sure. I’m usually very social and go out for dinner with my friends at least a couple of times every week. In normal times, I would have had to miss out on that while my face settled. With things as they were, it meant that I didn’t miss out on anything because I could just join calls without switching on my video for a few days.

THE AEDITION: What would you say to other people considering having a cosmetic procedure to look better in their mask?

JAMIE: I’d recommend it. It’s something that will still be there once we can stop wearing masks, so it isn’t a waste of money. As long as you can find somewhere that is practicing safely and you’re happy to have the procedure for yourself, go for it. I don’t think there should be pressure to change your face just to wear a mask. But, if you want to enhance something about yourself to feel good, then why not.

The Takeaway

For patients and providers following all necessary COVID-19 protocols, the pandemic has proven to be a unique time to go under the knife or needle. From face masks to video calls, the so-called ‘new normal’ has had an impact on the types of the aesthetic procedures patients are most interested in for both the face and body. Consulting with a board certified dermatologist or plastic surgeon will ensure you receive the best treatment for your concerns and goals.

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