What’s Behind the Plastic Surgery Surge?

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A look at why cosmetic procedures are booming and what it takes to cash in.


To say that Jeremy Warner, MD, FACS, has seen an uptick in demand for cosmetic surgery in recent years is a bit of an understatement. “Throughout the pandemic, I’ve easily seen a 50% increase,” says Dr. Warner, a double board-certified plastic surgeon and owner of the Warner Institute in Winnetka, Ill. He’s not alone. Plastic surgeons everywhere are enjoying a healthy boost in business. While there’s no doubt the pandemic and remote-work-driven demand have played major roles in the industry’s growth, it’s a dangerous oversimplification to solely credit COVID-19 for the increase in cosmetic-based procedures. Understanding the intricacies of the current plastic surgery landscape — as well as the multilayered reasons for growth — is paramount to capitalizing on this surging service line.

Fueling the boom

The sudden and significant increase in the number of Americans who transitioned to working remotely during the pandemic has contributed greatly to the increased demand for cosmetic procedures. Remote workers, fixated on their faces during an endless string of virtual meetings, gave birth to plastic surgery’s “Zoom Boom” by scheduling procedures to correct perceived flaws.

“Everyone is looking at themselves during calls and thinking, ‘Oh my, I look so bad. I need to do something about it,’” says Hisham Seify, MD, PhD, FACS, a board-certified plastic surgeon and associate clinical professor of plastic surgery at UCLA.

COVID-19 caused prospective patients to consider plastic surgery for the first time and played a significant role in how they’ve been able to afford lifts, tucks and injections. During the worst months of the pandemic, people didn’t have a lot of options to spend their disposable income and during the brief elective surgery shutdown they couldn’t get work done on themselves. As a result, when the shutdown ended, patients began scheduling procedures in droves. “When we opened back up, there was a boom in demand,” says Dr. Seify. “Patients had a lot of money in their pocket because they didn’t travel or spend it on the other things they usually did.”

While these factors might explain the sudden increase in cosmetic cases, the procedures had been trending upward long before COVID-19. “We’re at an inflection point,” says Dr. Warner. “More patients want to have cosmetic procedures done to improve their lives and feel good about themselves during an era when those procedures are less taboo and in a field where advancements in medicine and technology are making the procedures less invasive, less risky and not as big of a deal as they used to be.”

Who’s getting what done

KEEPING IT REAL Patients need to know exactly — with clear and specific details — what the surgery can and can’t do for them.  |  Amy Castelli

Cosmetic cases — such as skin tightening, eyelid lifts and nose reshaping procedures — are elective in the truest sense of the word. A knee replacement surgery, while labeled elective, isn’t really a choice when you’re dealing with bone-on-bone pain that’s compromising your quality of life. You can’t say the same for the tightening up of some loose skin on the neck.

Plastic surgery patients can be segmented into two main groups: face and body. Individuals who want facial procedures typically range in age from 20 to 75 years and have been largely responsible for fueling the increased demand for cosmetic surgery, according to Dr. Seify. “I’m seeing a lot of professionals coming in to get work done on their eyes and neck,” he says. “They want to look good when they meet with clients.”

Dr. Seify has noticed a recent uptick in the number of men who are getting work done, some of whom are referred directly by an interesting source. “I see husbands brought in by their wives,” he says. “She will get a procedure done and say, ‘You know, my husband has those heavy eyes, maybe it’s time to do something about that.’”

Dr. Warner is also treating more patients who undergo facial procedures, skin tightening and eyelid lifts. He notes that some newer technologies, such as a radiofrequency device that passes a probe through a tiny poke in the skin to tighten loose areas, have been extremely popular with patients because of their minimally invasive nature.

These types of relatively minor procedures can be performed in an office setting under local anesthesia, but even cases that were traditionally viewed as major surgeries are now done in clinics thanks to advancements in surgical techniques. “Some of the nose reshaping and recontouring that had historically required significant OR time and big recoveries are being done in a much less invasive way,” says Dr. Warner.

Image is everything

Surgical leaders and facilities with big ideas about jumping on the plastic surgery bandwagon and enjoying great success should pump the brakes and temper their expectations. A successful plastics practice takes at least a decade to build, according to Dr. Seify, who works at a surgery center that does mainly reconstructive plastic surgeries and a private practice that focuses on cosmetic procedures. While traditional marketing is certainly a crucial component of the plastics industry, it’s the word-of-mouth buzz that you’re after — and that type of cachet takes time to build.

We’re at an inflection point. More patients want to have cosmetic procedures done to improve their lives and feel good about themselves.
— Jeremy Warner, MD, FACS

When case volume fluctuates, which it almost certainly will, a bloated marketing budget can be disastrous. Dr. Seify, who gets 85% of his business from referrals of satisfied patients, offers a cautionary tale of a practice that specialized in facelifts to illustrate this point. “They were spending around $1 million a month on marketing alone, and when things got slow, they literally shut down overnight,” he says. “Employees showed up for work in the morning, and the place was closed.”

To prevent a similar fate, Dr. Seify offers one simple but critical piece of advice: Set realistic expectations with your patients from the start. “I tell my patients exactly how they’ll look after surgery,” he says. “If that’s going to make them happier, I tell them to proceed. If it won’t, I tell them I’m not the one to fix their problem.”

He also relies on a thorough, multitiered patient selection process that starts with a nurse actively looking for red flags of discontent — blatantly mean or aggressive patients, unrealistic expectations — during the initial pre-op visit because unsatisfied patients can cripple a plastic surgery facility’s reputation. “Some patients expect to walk away from surgery without scars, swelling or bruising,” he says. “That’s impossible.”

Regardless of the patient selection process, surgeons must perform successful procedures. That’s ultimately what will make or break their business, according to Dr. Warner. “You have to be able to provide good, consistent, long-term outcomes,” he says. “You’re not going to have too many patients showing up to get work done if your poor results are walking around in the community.” OSM

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