“I personally had my eyes done right as soon as we were able,” Rick Beil says. “I’ve seen myself on all those meetings, too!”

Beil, one of the board-certified plastic surgeons at the Center for Plastic & Reconstructive Surgery, is sixty years old. But what got his attention was the same thing that’s sending more patients their way during the pandemic: people suddenly self-conscious about how they look–thanks to online meetings.

“I would say 15, 20 percent say they are there because of Zoom,” says Beil. “But the other thing is, even if they’re not saying it’s because of Zoom, they’re saying, ‘Look, I have an opportunity to have something done while I’m wearing a mask. And this is the perfect time to get something done.'”

That was the case for “Donna,” a patient of Beil’s who asked that her name not be used. “With the Covid thing going on, it made sense to do it now,” she says, putting me on speaker while getting a pedicure.

“I got a neck lift, and then I got a procedure called ‘fat transfer.’ It’s really cool … he actually took fat out of my hip area, and then they do some sort of technique where they spin it (“a centrifuge,” her pedicurist chimed in), and then … they transfer it with a little bit wider needle into wherever you want to get full again. So he transferred it into lines in my face.” Together the procedures cost “under $10,000,” she says. Since insurance doesn’t cover surgery that’s purely cosmetic, she paid out of pocket.

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“It’s a really interesting concept,” says Paul Cederna, chief of plastic surgery at Michigan Medicine. “With the advent of Skype and FaceTime, we saw a lot of people coming in for operations–for instance, on their neck.” Because people are “holding their device low … [they] see extra tissue underneath their chin on their neck that is bothersome to them. And now having to watch themselves in video meetings “has certainly led people to seek more aesthetic surgery.”

Surgery isn’t the only solution. Just becoming more sophisticated with video technology can make a big difference. “People have gone with brighter lights to hide wrinkles,” Cederna says. “People have gone with higher cameras to hide extra tissue under the chin.”

But when that’s not enough, “people are pursuing more skin resurfacing techniques, more fillers to fill in small wrinkles, more Botox to address more wrinkles, and certainly more involved operative procedures like neck lifts and facelifts to address any of the elements of an aging face,” he says. “We’ve been very busy–double the amount we did last year at this time. I suspect it’s going to get busier in the coming months.”

Beil says it’s happening at his practice, too. In September, he was already booked for the year and making appointments in January.

But because people are still anxious about coming into a hospital or medical building–or any building for that matter–many are choosing to do pre-op and post-op appointments online. Cederna says he’s been “completely shocked at how good the video encounters have been … I can ask them to do all the things I would ask them to do if I was seeing them in person. The only thing I can’t do is, obviously, touch their face and pull their skin, but I can ask them to raise their eyebrows. I can ask them to crinkle their brow. I can ask them to close their eyelids. I can ask them to smile, to pucker their lips, to frown.”

And since “the average patient that comes to the University of Michigan takes about a ninety-mile round trip,” it’s a huge time saver. “Think of someone who comes for a typical visit,” Cederna says. “They’re getting ready to go, they’re getting dressed, they’re getting in their cars, they’re driving, parking, and waiting to be seen. They’re being seen. They’re getting back in their cars, they’re driving home. That’s a huge time commitment.” For a virtual appointment, “they get on their computer at 10 o’clock, we see them, and by 10:15 we’re done.”

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How do people pick a surgeon for elective plastic surgery? Googling “plastic surgeons, Ann Arbor” won’t separate the good from the bad. “There’s no question that there are good surgeons and bad, even in this area,” says Cederna. He strongly recommends “selecting a surgeon for cosmetic surgery who is board-certified by the American Board of Plastic Surgery.” Beyond that, the key is “having confidence in the person that they’ve met; that that person who is going to care for them is going to do the best job they possibly can to get them the outcome they’re looking for.”

Cederna recently did multiple procedures on a patient in her mid-fifties. Even before surgery, she “looked quite a bit younger than her age–she looked great,” he says. “But she had been on a lot of virtual meetings, like many of us are, and she had seen herself over and over, and she did not like the way her neck looked and the way her nasolabial folds looked–the fold between the base of the nose and the corner of the mouth.

“She thought they looked deep, and she thought she had extra skin on her neck. I had a chance to meet her virtually during the time when we were not having any clinic visits. And I could see what she was talking about, for sure. The kinds of change we could make with her is the kind of change that would really freshen her up and make her look incredibly well-rested–and not make her look like she was a different person.

“She had the time, because she had been traveling a lot, and she was no longer traveling. And she was really interested in doing it.”

Cederna did a facelift, a neck lift, and a “fat graft”–what Donna called a “fat transfer.” Adding “subtle amounts of fatty tissue to the face,” he explains, “really rejuvenates the face nicely … We can smooth out the contour between the lower lids and the cheek. We can add a little volume under the cheek to give a little more fullness to the cheek, add a little in the nasolabial folds to flatten them out a little bit. All of us lose a little bit of volume in our lips with age. Just adding a small amount to the lips can make them look just a little bit fuller but not have them look really big. Those procedures in combination with the facelift can make a dramatic difference for people.

“And so we did that operation for her as soon as we were allowed to do elective operations again,” in July. “Since then she looks incredible, and she’s so happy with the outcome.” (She declined to be interviewed, even anonymously.)

The only problem? “She’s so proud of the way her face looks, and she’s disappointed that she has to wear a mask in public because she wants to show off her face.”

But a day will come when we don’t need a mask to go out in public safely. When that day comes, Cederna says, “everyone is going to look a little bit older than the time they started wearing a mask. And she’s going to look a little bit younger.”