蕾切爾·金文 孟潔冰譯

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.

隨著數(shù)以百萬計的美國人在家辦公，避免與直系親屬和親密好友以外的人交往，已經(jīng)有大量報道討論化妝品和服裝零售等行業(yè)的銷售額暴跌，這些行業(yè)都要依靠人們出門才能生意興隆。

整形手術(shù)就沒有這方面的問題。人們有更多的時間待在家里，反而帶動了整容服務(wù)業(yè)務(wù)的繁榮，這些服務(wù)提供肉毒桿菌注射和皮膚填充等頗受歡迎而價格不菲的皮膚護理。

甚至早在2020年夏天美國一些地區(qū)解除封鎖措施前，人們尚在隔離期間便對整形手術(shù)興趣盎然。2020年6月，美國整形外科醫(yī)生協(xié)會對1000多名消費者進行的一項調(diào)查發(fā)現(xiàn)，49%沒有做過整形手術(shù)的受訪者表示，他們愿意在不久的將來接受整容或整形治療。該協(xié)會在同月公布的另一項研究報告發(fā)現(xiàn)，新冠疫情開始前以來，64%的美國整形外科醫(yī)生的遠程醫(yī)療咨詢量已經(jīng)有所增加。

根據(jù)與美國兩岸皮膚科醫(yī)生的交流，這種需求急劇增長的誘因不止一個，而是這次疫情最普通卻也最普遍的幾個特點在共同起作用：人們有大量時間待在家里，日程安排出現(xiàn)空白，社交活動減少，強制要求戴口罩，還有Zoom視頻會議。

紐約市上東區(qū)第五大道美學(xué)中心的創(chuàng)始人、皮膚科醫(yī)生瑪麗·哈亞格博士強調(diào)了她所說的“Zoom會議效應(yīng)”，她解釋說，她聽到很多新老病人抱怨，他們在視頻會議期間注意到自己有雙下巴、皺紋和眼袋。

哈亞格說，有更多的時間本身可能不是計劃做手術(shù)的唯一重要因素;由于困在家里不能外出，人們也在尋找各種方法來利用和打發(fā)時間。

“越來越多的患者在家辦公，可以接受需要他們‘宅幾天的手術(shù)?！惫喐裾f，“停工休養(yǎng)期間，沒有什么社交活動讓人顧忌。手術(shù)讓他們有事情可做，他們也期待手術(shù)，這讓他們可以暫時擺脫Zoom會議和家里的孩子。”

新冠疫情開始前，安排整容手術(shù)的一個主要限制是沒有停工休養(yǎng)時間，有創(chuàng)手術(shù)和無創(chuàng)手術(shù)都必須有休養(yǎng)時間，因為這些手術(shù)往往導(dǎo)致病人在愈合過程中有非常明顯的淤青和皮膚變色。

“現(xiàn)在大多數(shù)人都在家辦公，這個限制已經(jīng)不復(fù)存在，所以更高強度的激光手術(shù)不像以前那么令人生畏?！边_瓦爾·G.巴努薩利博士說道，他是皮膚科和激光外科醫(yī)生，在曼哈頓開了自己的哈德孫皮膚病和激光外科私人診所，“我認為是眾多的Zoom會議迫使我們所有人以批判的眼光審視自己，遠超過我們或許應(yīng)該審視的程度?！?/p>

巴努薩利說，他的診所也更頻繁地拒絕了某些病人的要求?！白鳛獒t(yī)生，負責(zé)任地為患者提供服務(wù)也是我們的職責(zé)，如果他們對自己過于苛刻或有不切實際的要求，我們需要加以正確的引導(dǎo)，溫和地告訴他們?！彼忉屨f，“考慮到目前的環(huán)境，這種情況確實經(jīng)常發(fā)生，所以我們有時候不得不予以干預(yù)。”

莉薩·古德曼創(chuàng)辦的美麗肌膚診所在疫情開始前生意興隆，現(xiàn)在依然如此。而他們也不得不拒絕病人的要求。該公司在洛杉磯的新診所于2020年3月開業(yè)，但在加利福尼亞州居家令生效后很快關(guān)閉，紐約的診所也關(guān)門歇業(yè)。古德曼說，在春末重新開業(yè)后，幾家診所都收到了大量客戶請求，咨詢他們希望在家里接受的治療，但她說，為了保護自己團隊的健康和安全，各診所堅決沒有受理這些請求。

莉薩·卡西萊思博士是整形外科醫(yī)生，也是位于貝弗利山的卡西萊思整形外科診所的創(chuàng)始人兼首席執(zhí)行官。她承認，曾以為業(yè)務(wù)量會隨著新冠疫情和隨后的經(jīng)濟危機的繼續(xù)而減少。卡西萊思說，疫情前生意很好，因為患者有更多的可支配收入，很樂意做抽脂、隆胸和腹壁整形等受歡迎的手術(shù)。

2020年3月封鎖措施實施以后，她的診所只能對乳腺癌患者開放，留下基干人員在現(xiàn)場對患者進行護理，其他人都在家里工作。專門做面部美容手術(shù)的醫(yī)生根本不用工作。雖然大多數(shù)患者都想取消手術(shù)，但卡西萊思說，有少部分人反而提前了手術(shù)時間，或者不顧一切地設(shè)法在診所停業(yè)前把手術(shù)排上日程。她說：“少數(shù)能夠進行手術(shù)的人現(xiàn)在感到非常自豪，因為事實證明，在全世界都分隔開來、心神不定的時候，正是術(shù)后恢復(fù)的好時機?！?/p>

卡西萊思解釋說：“由于人們待在家里更注重自我感受，業(yè)務(wù)增多了，患者類型也發(fā)生了變化?！爆F(xiàn)在患者要做的不是快速修復(fù)和出于沖動安排的手術(shù)，而是他們多年來一直考慮想做的手術(shù)。40多歲的人縮小胸部，十幾歲孩子的母親做腹壁整形術(shù)，去除乳房植入物，都是常見的咨詢話題。

但現(xiàn)在不是每個人都有空閑時間。卡西萊思說，從新學(xué)年開始以來，由于許多母親平添了照顧孩子遠程學(xué)習(xí)的責(zé)任，又出現(xiàn)了新一輪的取消預(yù)約和預(yù)約改期。因此他們把預(yù)約時間推遲到2021年年初，預(yù)計（或者說希望）到時候不會那么忙?！叭藗兊呐d趣是增加了，空余時間卻減少了?！?/p>

美在觀者的眼睛

在我們都戴著口罩出門的時候，許多患者會重視他們的眼周區(qū)域，這也許不足為奇。古德曼說，治療報價為每次1700美元的眼下填充術(shù)目前最受歡迎。

古德曼說：“我認為這表明了一個事實，即人們做這些治療是為了對自己的皮膚更有信心，而不是給別人留下深刻印象，我覺得這種態(tài)度真的很不錯?！?/p>

如果說戴口罩讓眼周和額頭現(xiàn)在成了臉上最顯眼的部位，那么也多虧了戴口罩，整容患者越來越熱衷于在鼻子或嘴周圍動手術(shù)，正是因為口罩可以在手術(shù)恢復(fù)期間遮掩淤青和皮膚變色。

“口罩可以遮蓋下半張臉暫時出現(xiàn)的淤青和痕跡?！惫喐裾f，“那些推遲了幾個月做維持治療的患者，看到治療給他們的外形帶來的變化后，迫切地想要開始新的美容治療?！?/p>

哈亞格認為，隨著疫情的持續(xù)，整形手術(shù)將繼續(xù)呈上升趨勢，其中有很多原因，包括，即便在新冠疫苗獲得批準后，保持社交距離和戴口罩的習(xí)慣可能也會持續(xù)下去。病人也已經(jīng)更習(xí)慣于遠程醫(yī)療和通過視頻會議軟件咨詢，許多人可能將繼續(xù)在家工作，即使不是每天如此，居家辦公至少也會更常見。

巴努薩利認為，我們會看到越來越多的整容手術(shù)，但整容趨勢將朝著更自然的外觀和審美方向發(fā)展。

（譯者為“《英語世界》杯”翻譯大賽獲獎?wù)撸?/p>