Pop culture and social media helped to influence a new generation of people being proud and transparent

about cosmetic enhancements.

But in 2020, things took a dip.

Hospitals and centers closed, staff members were laid off and elective surgeries came to a halt.

However, the plastic surgery industry bounced back strong.

What we found after the moratorium on elective surgeries ended was that there was a pent up

demand for cosmetic procedures, which people did fulfill.

The government put money into the economy so that it remained strong, people had disposable income, and

they still used it for cosmetic procedures.

Americans working from home spent hours and hours watching themselves on

camera, endlessly scrolling on social media and experiencing inevitable downtime from work

and social events.

This all but benefited the plastic surgery industry, which saw a record number of patients as pandemic

restrictions were lifted.

I think most plastic surgeons thought, "Oh my God, it's really over because people are going to have a

very difficult time really worrying about plastic surgery when they have this epidemic, pandemic

happening, but it ended up being the complete opposite.

So just how long will the plastic surgery boom last?

And with a new normal taking shape, what does the future look like for the industry?

Born in Virginia in 1787, Dr.

John Peter Mettauer is widely recognized as America's first plastic surgeon.

But it was World War I that catapulted the plastic surgery industry into new realms.

Extensive face and head injuries from war required physicians to innovate, while advances in blood

transfusions, anesthesia and antiseptics allowed doctors to experiment with new techniques.

By the 1960s, plastic surgery for purely cosmetic purposes was becoming more common.

Procedures that were originally designed as medical treatments saw an uptick in patients getting them to

enhance their appearance.

For example, Botox was first approved by the FDA as a treatment for crossed eyes, but doctors

soon realized those injection areas didn't have wrinkles.

Not only are we reconstructing function of the face and body, but now we're also helping to

bolster confidence by doing cosmetic procedures, which means sometimes restoring things the way they

were. A youthful appearance is associated more with being energetic and virile and

capable, and for many of us, that's very important in our day to day affairs.

As Baby Boomers began to age, they wanted to appear younger and cosmetic procedures outpaced

reconstructive ones.

The 90s was also an era where doctors fought hard to dismantle the stigma that was associated with plastic

surgery. There was a growing public perception amid some sensationalized stories that these

surgeries were high risk.

And in 1992, the FDA issued a moratorium on silicone breast implants following

growing fears that the implants were unsafe.

I am asking that physicians cease using silicone gel implants.

But things soon took a turn, including health care reform.

After extensive lobbying in 1998, President Bill Clinton signed a bill into law,

allowing reconstructive surgery to be covered by health insurance.

And by 2005, cosmetic procedures almost doubled over reconstructive ones.

In 2020 over 24 million cosmetic procedures were performed worldwide.

But it was the U.S.

that had the highest number of both surgical and non-surgical treatments, leading the way with over

4,600,000 procedures.

Brazil comes in second, often serving as a destination for hopeful plastic surgery candidates

around the globe. They are three different categories when it comes to cosmetic plastic surgery.

There are surgical procedures, noninvasive type procedures, and then there are injectables and

fillers. The most common plastic surgery performed in the U.S.

is breast augmentation, followed by liposuction and eyelid surgery.

Botox was the number one non-surgical procedure worldwide.

Although plastic surgery, like any surgery, carries risks.

The vast majority of patients in the U.S.

are satisfied with their results.

In 2019 98 percent of those who got breast augmentation and 97 percent of those who got a tummy

tuck said they'd do it again.

I am ecstatic with my results.

I'm still projected to see the final result a few more months from now, but my surgeon and the

team had said that I'm healing great.

I'm happy with it. I haven't had any issues.

Plastic surgery is a hefty investment.

The average cost of breast augmentation is $4,789.

And Americans pay on average $7,944 for a facelift.

You get what you pay for.

It is an investment.

You don't want to go to the lowest common denominator.

You really want to go to someone who's talented in what they do and how they do it.

Cost barriers do motivate many to travel to other parts of the country or even the world in order to

save money on their dream procedure.

But that isn't always the best route.

Plastic surgeries can go horribly wrong, as seen on the reality TV show 'Botched.' A

2018 study found that .78 percent of plastic surgeries have complications, including

infection, pulmonary embolism and organ damage.

Definitely, medical tourism in plastic surgery was, not as much post-COVID,

before COVID, was a big industry.

And unfortunately, just like everything else, there are great surgeons abroad and there are bad

surgeons abroad. As there are great surgeons in Los Angeles and there's some

surgeons that aren't so great.

But the problem is if complications arise.

Going under the knife has always carried some sort of stigma.

Many celebrities, including Kylie Jenner, Tyra Banks and Lady Gaga, notoriously spoke out against

plastic surgery and later came clean about getting some cosmetic work done.

I think that the taboo for plastic surgery has often been that it's seen as something that is

unnecessary or, say, cosmetic surgery seen as unnecessary.

We've also seen cosmetic surgery as showing signs of insecurity, so that if you are doing cosmetic

surgery to completely change your appearance, your appearance is part of your identity.

So I think part of the taboo has been a rejection of identity because you're pursuing cosmetic surgery.

But a few things have changed the negative perception of cosmetic treatments, namely pop culture and

social media. What was once seen as a denial of self, shifted into a popular and accepted trend for

everyday people.

People see themselves in a photograph on Instagram.

They can filter their appearances and they see what they like as a change.

So they could also image themselves to come up with a look that they think

reflects themselves.

And so they'll come and ask us if we can help them achieve that.

But I think with social media filters that come through social media, people, seeing their

friends and seeing people that they admire morphed and trying to

emulate that to some degree.

So that's how social media has changed.

It has become more acceptable.

Another thing helping to change the narrative around aesthetic procedures is the introduction of ethnic

plastic surgery.

The 90s and early 2000s was an era of extreme plastic surgery transformations, often leading

to a lot of criticism aimed at the patient.

Doctors now say the key to a successful procedure is subtle changes while maintaining the

patient's ethnic identity.

I do feel that cosmetic procedures because it's done for personal reasons, not necessarily

done for attention or fame, or to be an Instagram influencer, but done for

personal reasons that it should be somewhat discreet and that the results that we give should look

natural and look congruent with the ethnicity, to not be extremely dramatic unless

necessary, but usually subtle.

The plastic surgery boom has also coincided with society's new emphasis on wellness.

Today, more Americans are focusing on self-care and the needs of the individual.

I think women are understanding that, that their desire to have cosmetic

surgery doesn't mean they don't like who they are or feel more comfortable saying, "This is what I've done

to make myself feel better.

This is what I've done to make myself look better, more refreshed and more like my old self." And that's

certainly something to be proud of when you've taken ownership of your appearance.

The Covid-19 pandemic shook the industry.

The total number of cosmetic procedures decreased by 1.8 percent in 2020 compared to

2019, but that's mainly due to hospital and center closures, not demand.

Our schedule has never been this busy.

There's not enough time in the day to do all the surgeries and procedures that our patients are

requesting.

Experts point to a phenomenon called the 'Zoom effect' or the 'Zoom boom.' Covid limitations

shifted in-person meetings and social events to video calls, meaning more people became

hyper-critical of their facial features.

That dissatisfaction led to a much higher interest in plastic surgery above-the-shoulder.

When people were doing Zooms all the time, they really focus on their face because that's what they

see, the reflection of Zoom and Facetime and constantly looking

back at yourself, you start looking and finding flaws.

Or maybe there are issues that you were concerned with for forever and now it's coming out.

So facial, nasal and eyelid surgery has been tremendously

on the uptick.

According to a study by ASPS, 11 percent of women surveyed said they were more interested in

cosmetic procedures a year into the pandemic than they were prior to it.

That number goes up to 25 percent for women who've already had a procedure.

Some patients are motivated by the down time spent at home.

An increase in work-from-home policies across U.S.

employers allows patients to fully recover at home while saving PTO.

Others are motivated by the ability to recover in plain sight.

More and more people are getting procedures done on features that are covered by their mask.

However, the opposite is also having a moment.

Doctors say they're seeing more patients getting work done above-the-nose, since those features are

highlighted when wearing a mask.

Another big influence due to Covid?

Finances.

I was able to finance my procedure through the savings that I acquired working from home during the

pandemic and also did use a credit card to finance.

I think I would have needed to wait a little longer to get the procedure done if I had not saved as

much as I had up until that point working from home.

I was in a better position to pay any additional costs.

Doctors say the future of plastic surgery is plastic surgery.

And some of the changes the industry has seen are here to stay.

Some of the things that have changed about how we offer plastic surgery for us.

We certainly are offering more virtual consoles and those will remain.

And so access to the plastic surgery will probably remain to be more convenient.

We also created more office space procedures for convenience and also

for patient safety, and I think that also will remain and that the way we access plastic

surgery will be different and that the demand for plastic surgery in the setting of people who are

still working, even if they're working virtual, that the recovery times need to be less dramatic and

shorter. I think that probably won't change.

And with cosmetic treatments becoming more advanced, more affordable and less taboo, the

Covid-19 boom is just the beginning.