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Blow-up (1997)Photography Donna Trope

Why is lockdown making more people get cosmetic surgery?

Clinics reported double the amount of appointments after the first lockdown – including many first-time triers – and are expecting even more in time for Christmas, we investigate why

As we crawl out of another lockdown, many of us can count the times we’ve left the house on a solitary hand, but despite a lack of occasion or audience, it seems we are looking at ourselves more than ever. It appears that since lockdown many of us are surveying our faces with new scrutiny, with cosmetic surgeons across the UK reporting an explosion in appointments following the first lockdown and have predicted another spike in time for Christmas.

The Cadogan Clinic in London experienced a 100 per cent increase in appointments in August and September 2020, and during the second lockdown, the Harley Academy received double the amount of bookings in time for December. But in the absence of the usual festive party circuit, and the likelihood of a Christmas spent surrounded by immediate family, why are we so desperate to look better?

Much has been written about the ‘Zoom Boom’ effect in the aftermath of the first lockdown, with many patients blaming hours staring at their on-screen reflections for accentuating existing hang ups and propelling many into the clinician’s chair for the first time. Author and ‘tweakment’ expert Alice Hart-Davis found that many women seeking ‘anti-Zoom’ treatments were between the ages of 35-55 with busy careers and families who weren’t used to looking at themselves for long periods of time from unflattering camera angles. As a result, she discovered that many new patients were seeking “fat-freezing for double chins, skin tightening for saggy jowls, or filler to redefine facial features including the jawline.” 

It’s not just bad camera angles though that have led many people to take stock of their appearance; the stress of the first lockdown led some of us to seek solace in food, while others furiously planked their way to an almost discernable two pack. Either way, fluctuating weight has taken a serious toll on our complexions according to Dr Emily MacGregor, an aesthetician at STORY. “We’re seeing a 50/50 split of either significant weight gain or weight loss,” she explains. “Weight loss creates sunken temples and cheeks and weight gain can cause the cheeks to sag which contributes to jowls and down turned mouth corners, creating a ‘sad mouth’ effect.” 

A popular solution to combat new saggy skin has been injecting filler into the cheek and temple area to ‘lift and plump’ in the case of weight loss and ‘lift and slim’ patients with a little extra paunch. “During my first few clinics after lockdown about 75 per cent of my patients had a filler cheek lift which is significantly higher than usual,” Dr MacGregor remembers. “It was even more popular than Botox which you would expect to be highly requested after a long period of clinic closure.”

“I’m not someone who has always wanted surgery, but this was quite minor so I wasn’t that worried about it and after lockdown I just thought fuck it” – Joy, 25 

After saving some money, Joy, 25, decided to book an appointment for a fat freezing treatment as soon as clinics reopened – her first procedure. “I’m not someone who has always wanted surgery, but this was quite minor so I wasn’t that worried about it and after lockdown I just thought fuck it,” she says. Joy eschewed filler and opted for a CoolSculpting procedure, where flesh is placed between two panels that cool the skin to a freezing temperature, killing fat cells that are then eliminated naturally over several months. “It was really painful actually; it was so cold my head went numb, but I’ve seen really good results. Although, I think I’ll always have a bit of a chin unfortunately,” says Joy. When I ask if she would consider any other treatments, she pauses. “All my friends are really natural and anti-surgery so I don’t think I’d get anything else done, unless it’s laser hair removal that looks quite useful.”

The recent upswing in tweakments and minor surgeries has led some mental health practitioners to express concern about the effect of the pandemic on those with Body Dysmorphic Disorder. Dr Chi-Chi Obuaya, a consultant psychiatrist at the Nightingale Hospital is seeing an increasing number of patients requesting phone sessions, after finding video calls have reinforced negative body image beliefs. “My view is if we don’t need to see each other, then we should be flexible with that possibility,” says Dr Obuaya. “There is a cohort of patients we know who will seek cosmetic procedures more readily and when they have these procedures they are often unsatisfied. There’s something that they pick up on which tends to be a minor asymmetry and then there’s another body part they’re not happy with. So the (insecurity) escalates and perpetuates.” 

Hart-Davis has noticed a trend in multiple-treatment appointments, a phenomenon that has been dubbed ‘tweakment stacking’. With appointment availability scarce and the possibility of another lockdown probable, many people have decided to tackle several ‘problem areas’ at once. “They could start with a deep cleansing mechanised facial or a skin peel, and move on to a skin-tightening procedure, or some injectable filler, and perhaps have a fat-freezing treatment on their body while they’re there,” she says. 

Emma, 28, did just this, after feeling insecure about her forehead wrinkles she decided to try Botox for the first time in September, but when she arrived at her appointment she thought she may as well get an eyebrow lift at the same time to tackle a lifelong case of ‘resting bitch face’. “It’s improved my relationships, it’s improved my work and I find if I’m hungover or tired my skin still looks amazing,” she extolls. “I’ve actually booked myself in again already for December.” Since her appointment she’s noticed more and more of her friends’ and co-workers’ faces have seemed suspiciously pancake-smooth too. “It’s like a superpower once you’ve had it you look at people and can suddenly tell who’s had it,” she muses.

While it’s not yet known if the stress of our current confinement will have a lasting effect on our collective self-esteem, depression rates have been climbing steadily since March. An ONS study found that between March and June 2020, one in five adults in the UK experienced some form of depression, with almost a quarter of women reporting moderate to severe symptoms. According to Dr Olivier Amar, a London-based cosmetic surgeon, many of his patients have booked appointments as a form of self-care. “A lot of people are a bit depressed as a result of lockdown and want to treat themselves. We have heard a lot of patients tell us ‘I want to look good for me, I’ve never had the time to look after myself,’” he explains. 

But despite the flurry of new patients, Dr Amar has been surprised by what he describes as a more conscious approach to cosmetic procedures. While in the past, clients would pop in for a quick procedure during a lunch break, many have used the time to research and re-consider their usual treatments over lockdown. “Patients are far more concerned about the ingredients in their treatments as well as the long term effects than they were before,” Dr Amar says. His clients typically fall into two categories: the 25-35s and the 45-65s, with the older group increasingly eschewing semi-permanent solutions for surgeries like liposuction, pinch-lifts, and blepharoplasty (eyelid surgery). This could be in part due to the increasing amount of time at our disposal or, as Hart-Davis hints, the dawning realisation that facemasks double as a remarkably convenient bruise disguise. 

Younger patients continue to favour injectable treatments, but are moving away from traditional filler and towards their bodies’ own natural resources. A vampiric sounding practice called Uvence has soared in popularity and involves harvesting a patient’s own fat cells, purifying them and then injecting them back into their flesh in place of traditional fillers like hyaluronic acid. “A lot of young patients tell me they’re detoxing all the time right now, so why would they want to inject toxin in their face?” asks Dr Amar. 

All the cosmetic surgeons and beauty experts I speak with agree that the stress of lockdowns has a negative impact on our appearance. From heightened cortisol levels deepening fine lines or lack of vitamin D enveloping rosy cheeks in a green-grey pall, it’s likely most of us are feeling less than twinkly in the run-up to December. And if recent figures are anything to go by then we can be confident the demand for cosmetic treatments is unlikely to abate any time soon. “You see everything is relative to the skin”, explains Dr Amar, “if you have a mental conflict it can be expressed on the face.” 

But will new lockdown patients learn to embrace their ‘sad-mouths’ and forego cosmetic work in the future? Hart-Davis thinks not, “‘Perfectly imperfect’ is a standard aim in thoughtful cosmetic work – but no, I can’t see people who have experienced this sort of work opting to revert back to ‘natural’, even the celebs who claim they tried Botox once, then gave it up because it made them look bizarre…”