Post-procedure patient downtime is less of a concern because the pandemic allows patients to heal privately at home. Some prescription cosmetic neurotoxin makers report record-high demand.

By Tonya Johnson

The aesthetics market is resilient, says Alisa Lask, vice president and general manager, aesthetic business unit at skin health company Galderma, and aesthetic treatments have become more normalized since the last recession. “Aesthetics has become part of people’s routines, like getting your hair done or working out,” she adds. Recent data from the company’s ASPIRE loyalty program shows that even during these unprecedented times, people’s desire to maintain their aesthetic routine has not diminished. The opposite is true in many cases: Virtual meetings are the new norm, and people are scrutinizing their facial appearance more than ever.


Konstantin Vasyukevich, MD (aka “Dr. K”), says the process of facial features being marked by age varies from person to person. Some lucky people notice the first signs of aging during their 40s, but others detect changes in their late 20s. Dr. K clients range in age from 20 to 94 at his New York City-based plastic surgery practice. His two main patient groups are 30 to 40-year-olds, pursuing the mini-facelift procedure and clients ages 50 to 60, who typically request deep plane facelift techniques.

He told Plastic Surgery Practice that cosmetic surgery procedures are accepted as much more mainstream than in the past, and many of his millennial clientele proudly display their results through cell phone selfies.

“Social media has increased the collective interest in plastic surgery, as more people now have access to celebrities and influencers with desirable features, and apps that allow you to change your appearance entirely. This has played an enormous role in de-stigmatizing plastic surgery, since more people are sharing their experience online,” he says.

“Ninety-three percent of millennials own cellphones and spend an average of 5.7 hours a day on them with 13% spending over 12 hours per day, so it’s not surprising that social media has such a huge influence upon them,” says AAFPRS president Mary Lynn Moran, MD, of Franklin, Tenn.

She reports that the upward trend toward “prejuvenation” among millennials has been steady over the last several years. Prejuvenation refers to an emphasis on early and preventive care.

Moran, a facial surgeon and assistant clinical professor in the Department of Otolaryngology at Vanderbilt University School of Medicine, also notes, “Millennials are extremely knowledgeable and sophisticated when it comes to the latest advances, and our AAFPRS stats are showing that they are very aware of the damage that sun and cigarettes do to the skin. They also view taking care of their skin and their appearance as an essential reflection of their health and beauty. Visible signs of aging may not be obvious until the 30s, but 20-somethings know that the more they do to reverse and prevent visible signs of aging, the better off they will be down the road, and this is where facial plastic surgeons are seeing this ‘prejuvenation’ trend.”

However, before taking drastic measures to preserve the fountain of youth, Dr. K advises his younger patients to start with a minimally invasive procedure and to only proceed with surgery if other treatments are ineffective.


Amid COVID-19, Dr. K’s practice has pivoted to medical consultations via Zoom but will schedule follow-up visits for those who require a subsequent in-person consultation (with masks required and using recommended sterilization and cleaning protocols). “If I don’t believe the patient would benefit from the treatment, I offer them a better alternative,” he explains. “Most people are quite open to suggestions made by an expert injector and appreciate the candidness and transparency in being told that the treatment they are seeking doesn’t work for them. Honesty is always the best policy and creates a stronger and lasting physician-patient relationship.”

As the doors reopened earlier this summer, June and July were some of the busiest months for the practice, and his office continues to receive a significant influx of patients requesting cosmetic injections. People have been trying to catch up on the cosmetic procedures they’ve missed while offices were closed, he points out. They also view quarantining as an ideal time to receive treatment. Downtime from work is less of a concern because most patients are working remotely, as well as they can cover certain treatments during recovery with a mask while in public.

Jasson Gilmore, vice president of the global digital and consumer marketing department at Allergan Aesthetics, marketers of Botox, says the brand’s loyalty program reflected the highest number of treatments of Botox Cosmetic ever performed in one week, coinciding with practices reopening in early June. This showed that patients were eager to return to treatment after sheltering-in-place, he says. (Since then, the company is seeing demand resume to more typical levels on a weekly basis.)

Galderma’s Phase 4 study shows that patients treated with its Dysport prescription injection achieved high levels of satisfaction and natural looking results with two treatments per year. Lask says these findings help give providers peace of mind knowing they can provide optimal patient outcomes, while seeing patients twice a year. What’s more, the company’s Stay Connected Survey found 90% of patients plan to return for their aesthetic treatment within 2 months, with 55% eager to treat frown lines between the eyebrows. 

Results from Galderma’s “Stay Connected Survey”

Since aesthetic practice providers are focused on ensuring the safety of their patients and staff, Lasks admits that some physicians are more comfortable administering neurotoxins than conducting other services because patients can wear their mask for the entire appointment.

“Understandably, the aesthetics business is continuing to ebb and flow as customers and patients navigate reopenings and new restrictions, due to COVID-19,” says Bob Rhatigan, global chief executive officer at Merz Aesthetics. “However, we have seen an eagerness to get back to a sense of normalcy, and for many that means a self-care routine that includes [prescription injection] Xeomin. We are committed to supporting our customers in safely reopening, and have developed resources to help meet their needs.”


To attract young adult clients, Dr. K recommends creating clear messaging on social media platforms that highlights popular cosmetic procedures among younger patients and anti-aging/prejuvenation” strategies.

In the future, he foresees that the anti-aging trends will continue to offer a more multi-faceted approach to treatment. “We’re moving away from attempting to solve all of a patient’s problems with one, expansive (and most likely invasive) surgery and are beginning to adopt an ideology that promotes anti-aging treatment as a consistent, sustained effort.”

Tonya Johnson is associate editor of Plastic Surgery Practice.