蕾切尔·金文 孟洁冰译

With millions of Americans working from home and avoiding socializing outside of their immediate family and close friends， much has been written about plummeting sales for industries that thrive on people going out， like makeup， and clothing retailers.

That is not the case for plastic surgery. On the contrary， extra time holing up at home has provided a boom in cosmetic services practices that offer popular—and pricey—skin care treatments like Botox and dermal fillers.

Even before some lockdowns were lifted around the country this summer， interest in plastic surgery was already bubbling over as people were isolating. In June， a survey conducted by the American Society of Plastic Surgeons （ASPS） of more than 1，000 consumers found that 49% of those who havent had plastic surgery indicated they are open to cosmetic or reconstructive treatment in the near future. Another ASPS study published the same month found that 64% of U.S. plastic surgeons had seen an increase in their telemedicine consultations since before COVID-19 began.

Based on conversations with dermatologists on both coasts， there isnt just one motivation for this surge， but rather a convergence of some of the pandemics most mundane but ubiquitous traits： plenty of time spent at home， empty calendars， less socializing， face mask mandates， and Zoom.

Dr. Marie Hayag， a dermatologist and founder of Fifth Avenue Aesthetics in New York Citys Upper East Side neighborhood， underscores what she calls “the Zoom effect，” explaining she has heard a lot of complaints from new and returning patients about double chins， wrinkles， and eye bags they noticed while videoconferencing.

Hayag suggests having the extra time itself might not be the only big scheduling factor; after being stuck at home， people are looking for various ways to fill and pass the time， too.

“More patients are working from home and can receive procedures that require them to ‘hide at home for a few days，” says Hayag. “There are no social events to worry about in terms of downtime. And it gives them something to do， and they look forward to it. It gives them a break from Zoom meetings and their kids at home.”

In the Before Times1， one of the primary barriers to scheduling cosmetic surgery was that inability to have downtime， a necessity for both invasive and noninvasive procedures that often result in very visible bruising and discoloration while healing.

“Now that most people are working from home， that barrier has been lifted， and so more aggressive lasering isnt as daunting as it once was，” says Dr. Dhaval G. Bhanusali， a dermatologist and laser surgeon at Hudson Dermatology and Laser Surgery， his private practice in Manhattan. “I think the countless Zoom meetings have forced us all to critically analyze ourselves， way more than we probably should.”

Bhanusali notes his practice has also turned down certain patient requests more frequently. “As physicians， it is our duty to also serve our patients responsibly， and if they are being overly critical of themselves or unrealistic， we need to do the right thing and gently let them know，” he explains. “Given the current environment， that does happen quite a bit， so we have to sometimes step in and intervene.”

Business at GoodSkin Clinics， founded by Lisa Goodman， was thriving before the pandemic started and still is. And they too have had to turn down patient requests. The companys new Los Angeles clinic opened in March， but then closed as soon as California stay-at-home orders took hold， as did its New York office. After reopening in late spring， Goodman says the clinics received an influx of requests from clients inquiring about treatments they wanted performed at home， but she says they were adamant in not entertaining these to protect the health and safety of her team.

Dr. Lisa Cassileth， a plastic and reconstructive surgeon as well as founder and CEO of Cassileth Plastic Surgery in Beverly Hills， admits she expected business to drop as the pandemic and subsequent economic crisis continued. Pre-pandemic， Cassileth says business was good as patients had more disposable income， and were excited to do popular procedures like liposuction， breast implants， and tummy tucks.

After shutdown measures went into place in March， her facility was able to stay open only for breast cancer patients， with a skeleton crew on-site for patient care while everyone else worked from home. Doctors specializing in facial aesthetic surgery did not work at all. Although most patients wanted to cancel their procedures， Cassileth says a small percentage instead moved their procedures up or frantically tried to put them on the schedule right before the shutdown. “The few that were able to undergo their procedures are very proud of themselves today， as it turned out it was a great time to recover as the world was so separated and distracted，” she says.

“As people became more in touch with themselves at home， business increased and the patient type shifted，” Cassileth explains. Instead of quick fixes and impulse procedures， patients are asking for procedures they have thought about and wanted for years. Breast reductions for 40-plus-year-olds， abdominoplasty on mothers with teenagers， and breast implant removals are common consultation topics.

But not everyone has extra time these days. Since the school year started， Cassileth says there has been another round of cancellations and rebookings as many moms have increased responsibilities with kids doing remote learning. So theyre putting off their appointments until early next year when they expect （or hope） to be less busy. “The interest is up， but the free time is down.”

In the eye of the beholder

Perhaps not surprisingly， many patients have homed in on the area around their eyes as were all out and about wearing face masks. Goodman says under-eye fillers， quoted at $1，700 per treatment， are a top draw right now.

“I think that speaks to the fact that people are doing these treatments to feel more confident in their own skin versus impressing others， which is really great to see in my opinion，” Goodman says.

But if the most visible part of the face is now around the eyes and forehead because of face masks， its also thanks to face masks that cosmetic surgery patients are increasingly eager to get work done around their nose or lips—precisely because theyll remain hidden while bruised and discolored during recovery.

“Masks can cover any temporary bruises and marks on the lower part of the face，” Hayag says. “Patients that delayed their maintenance treatments for months were desperate to begin anew their beauty regimen after seeing what a difference it made to their appearance.”

As the pandemic continues， Hayag posits that the upward trend for cosmetic procedures will continue for a multitude of reasons， including that the practices of social distancing and wearing face masks will likely continue even after a vaccine for COVID-19 has been approved. Patients have also become more comfortable with telemedicine and consults via videoconferencing software， and many people will probably continue to work from home， at least more frequently if not daily.

Bhanusali thinks we are going to see more and more cosmetic procedures， but the trend will be toward a more natural look and aesthetic.

隨着数以百万计的美国人在家办公，避免与直系亲属和亲密好友以外的人交往，已经有大量报道讨论化妆品和服装零售等行业的销售额暴跌，这些行业都要依靠人们出门才能生意兴隆。

整形手术就没有这方面的问题。人们有更多的时间待在家里，反而带动了整容服务业务的繁荣，这些服务提供肉毒杆菌注射和皮肤填充等颇受欢迎而价格不菲的皮肤护理。

甚至早在2020年夏天美国一些地区解除封锁措施前，人们尚在隔离期间便对整形手术兴趣盎然。2020年6月，美国整形外科医生协会对1000多名消费者进行的一项调查发现，49%没有做过整形手术的受访者表示，他们愿意在不久的将来接受整容或整形治疗。该协会在同月公布的另一项研究报告发现，新冠疫情开始前以来，64%的美国整形外科医生的远程医疗咨询量已经有所增加。

根据与美国两岸皮肤科医生的交流，这种需求急剧增长的诱因不止一个，而是这次疫情最普通却也最普遍的几个特点在共同起作用：人们有大量时间待在家里，日程安排出现空白，社交活动减少，强制要求戴口罩，还有Zoom视频会议。

纽约市上东区第五大道美学中心的创始人、皮肤科医生玛丽·哈亚格博士强调了她所说的“Zoom会议效应”，她解释说，她听到很多新老病人抱怨，他们在视频会议期间注意到自己有双下巴、皱纹和眼袋。

哈亚格说，有更多的时间本身可能不是计划做手术的唯一重要因素;由于困在家里不能外出，人们也在寻找各种方法来利用和打发时间。……