The pandemic cosmetic surgery boom is old news, but lately, surgeons say that interest and demand have only grown. Americans spent over $9 billion on cosmetic surgery in 2020, according to The Aesthetic Society, despite about an eight-week elective surgery shutdown across the country. And 2021, surgeons say, far surpassed that revenue baseline, with one cosmetic surgeon even calling 2021 the “heyday” of cosmetic surgery. Historically, Halloween through Christmas is the busiest time of year for cosmetic surgery for many reasons, including insurance deductibles being met to parents having time off from work. But for many surgeons, the past year-and-a-half has passed at that same hectic, rapid-fire pace.
“This tends to be a huge time to get things done, but because of COVID and people working from home, the entire last year and a half has been kind of crazy for cosmetic surgery,” says New York City-based double board-certified cosmetic surgeon Melissa Doft, M.D.
As we’re entering 2022, we’ve asked cosmetic surgeons for their thoughts and forecasts — although all of them mused whether anyone could predict the future anymore — for the upcoming year in aesthetics.
Cosmetic Surgery’s Ebbs and Flows Will Reflect COVID Outbreaks
The last two years have been filled with twists and turns, and the common denominator is the pandemic. “From what I’ve seen in my practice, so much of the want and desire for surgery has followed COVID trends,” says Washington, D.C.,-based board-certified cosmetic surgeon Troy Pittman, M.D. “Whenever there was a spike in COVID and things looked like they were shutting down more, we saw more patients coming in for procedures.”
Yet when the vaccine rolled out, Dr. Pittman says he saw “a real dip” in late summer, as vaccinated people started to pack their schedules with trips, hobbies, and friends — and delayed their surgeries in a rush to return to their former lives. Dr. Pittman says that “a lot of patients” who were booked for an August surgery “ended up postponing to November and December.”
COVID’s definitely not over, and Dr. Pittman doubts that the world of cosmetic surgery will ever go back to how it was pre-COVID. “We used to be able to kind of predict our year,” he says. “There were chest augmentations ahead of spring break, and there were times when kids were out of school so parents would get surgery.” And now, with hybrid work schedules, people are finding more ways to squeeze in procedures by taking a few days off and going back into the office if they need to, Dr. Sieber says of his recent patients.
Now, the only wise prediction may be to not make one at all. “Because the way that people do business, the way that they go to work, the way that they travel through time and space — particularly in 2022 — is going to be altered, we’re going to see that reflected in cosmetic surgery.” But how will it be altered in 2022? No one’s quite sure.
Facial Procedures Are Waning
Both 2020 and 2021 were pivotal years for facial cosmetic surgery. Despite the national pause on elective procedures in 2020, three of the top five most performed surgeries were on the face, according to data from the American Society of Cosmetic Surgeons. Rhinoplasties, eyelid surgeries, and face-lifts topped the list, conquering the former and longtime number one procedure: breast augmentation.
But in 2021, requests for facial surgeries began to dip in favor of body procedures. Even injectables, some of the most accessible and popular aesthetic treatments available, have declined, according to San Francisco-based board-certified cosmetic surgeon, David Sieber, M.D.
Overall, his best guess is that “the pendulum is swinging back” to a more even split of face and body procedures. “Life didn’t stop in the pandemic, people still had babies and COVID weight gain is a real thing,” he says. “There’s still a desire for tummy tucks and short downtime procedures.”
Body-Contouring Procedures Are Surging
For those of us who have found ourselves a few pounds heavier during the past two years, we’re not alone. According to a research study by the Journal of the American Medical Association and the University of California San Francisco, Americans gained an average of two pounds per week during a four-month period — from April 1, 2020 to June 1, 2020 — the most intense phase of lockdown. Given the limited ability to do much of anything in the spring of 2020 — let alone be active — this weight gain isn’t surprising, and it’s spurred more interest in liposuction and other body-contouring procedures. (An important reminder here: weight gain is natural and isn’t something that needs to be rectified.)
“In late 2021, there was an increase in liposuction procedures. People are wearing pants again, and they’re realizing, gosh, my pants are fitting a little bit differently,” says Dr. Pittman, who expects a continued uptick not just with liposuction, but many different types of body-contouring procedures as we head into 2022.
Ear Pinning Is on the Rise
Otoplasties, or ear pinning, are traditionally performed on middle school-aged children. (Ears become fully formed at this point, and the procedure can help boost self-esteem for children who have been bullied about their ears’ appearance.) But between awkward masks pulling on our ears and hyper-focusing on our appearance during Zoom calls, Dr. Pittman has seen more adult otoplasty patients in 2021 than ever before.
“I do think that there are enough people with ill-fitting masks that have really pulled their ears out and away from their head,” he says, adding that now they’ve noticed leading to a rise in adult ear-pinning.
In Silicon Valley and on Capitol Hill, More Men Are Joining In
As cosmetic surgery continues to evolve into a less stigmatized category, responsibly-reported news coverage has increased and whispered conversations about “having work done” are now discussed out loud and on social media for all to see. “What I think is interesting is there is a heightened awareness of cosmetic surgery,” says Dr. Pittman. “My experience is that whenever you have an increased awareness and whenever there is a lot in the media about cosmetic surgery in general, that’s when you start drawing in men.”
Gynecomastia correction, the reduction of breast tissue in males, has become increasingly popular according to New York City-based double-board certified cosmetic surgeon Adam Kolker, M.D. In fact, all five cosmetic surgeons noted a significant increase in gynecomastia procedures at their practices, especially Dr. Sieber, who says it’s been “a 100% total uptick, and a surprising one, too.”
But in 2022, perhaps gynecomastia surgeries won’t be so surprising anymore, at least not to Dr. Pittman. “I think we’re going to end up seeing more male consumers of cosmetic surgery,” he says, adding that everyone just wants to look and feel great. “It’s still a little bit more stigmatizing for men now, but as we continue to talk about it, it validates their need or want for surgery, and we’ll see a surge.”
And in cities with a young, competitive workforce like the Silicon Valley tech community close to Dr. Sieber’s practice, more men are seeking cosmetic surgery to look younger out of a fear of ageism. “There’s a desire for men who are just a little bit older to look younger, because those in their 40s and 50s are competing with younger men,” says Dr. Sieber. “In tech, the fear is that you’ll ‘age out,’ and so you have to keep up with the kids who come to work in hoodies.”
In Dr. Pittman’s Washington, D.C.,-area practice, the opposite is true: patients are wanting to look more serious in a bid to conceal facial expressions that could reveal their thoughts. “Everyone’s a lawyer in D.C., and I have so many male patients who get Botox treatments because they want to have a little bit more of a poker face in court,” he says, while his lobbyist patients tend to want a “‘never let them see you sweat’ type of look and mentality.”
All cosmetic surgery should be personalized to each patient’s specific goals, but a standout trend now is an ultra-customized surgery comprised of multiple smaller procedures so that a total rejuvenation can be accomplished in one fell swoop.
“Most patients want to have only one surgery,” says Dr. Doft, adding that a common perspective is if they’re going to go under anesthesia, they may as well get everything they want. “We’re often doing a combination of different procedures now, so where we maybe only could do one very aggressive procedure, we’re getting better at hitting a certain problem from multiple different angles.”
For example, Dr. Doft’s face-lift patients commonly tack on a mix of fat grafting, lasers, or a chemical peel, which she says doesn’t extend recovery time in these instances. Yet, she does concede that the first two weeks “might be kind of tough,” but “you’re getting a much better result from the new technology.”
Dr. Sieber’s San Francisco practice skews slightly more body-oriented rather than face-forward, so his patients often add on a skin tightening treatment or a tummy tuck to liposuction, or combine a chest lift with an augmentation or reduction. “The difference now is that patients are back to planning their surgeries a bit more thoughtfully,” he says. “They can’t be as spontaneous about it as they were a year ago when they had lots of free time.”
Social Media Continues to Heavily Influence Patients
Thanks to the abundance of spare time during lockdown, coupled with the accessibility of social media, people are hyper-aware of their bodies and faces in a way they weren’t before. And now, they have the medical lingo to match.
“Patients used to simply compare themselves to social media stars who showed before and after photos on Instagram of their latest procedure or treatment. But now, this social media trend snowballed into patients “coming in using ‘influencer words,'” says Dr. Pittman.
“It’s not uncommon for a patient to come in and say, ‘I noticed that I have a little bit of facial asymmetry’ and actually use those words. You can almost tell when they’re being influenced by something that they saw,” says Dr. Pittman, who calls social media a blessing and a curse for cosmetic surgery. “The more we see that commoditization of cosmetic surgery on social media, the more patients can also see themselves getting it.”
The Economy Will Play a Factor in Cosmetic Surgery’s Future
“Much of COVID is reflected in the stock market, and is reflected in people’s lifestyle choices,” explains Dr. Pittman, suggesting that a cosmetic surgery practice usually thrives in a strong market economy, giving people that extra boost of financial confidence to spend their disposable income on a big-ticket procedure.
“So with cosmetic surgery being one of those kinds of cost-sensitive lifestyle choices, I don’t think we can make a solid prediction that it’s going to go back to the way it was before COVID,” he says, before rationalizing that we can’t say 2022 is going to be great, either, in our current cosmetic surgery boom bubble. “I think cosmetic surgery in 2022 is going to be unpredictable because COVID is unpredictable.”
Originally published on Allure.com