key: cord-0772641-8zhmtxxt
authors: Ugradar, Shoaib; Massry, Guy G
title: Commentary on: The Zoom Boom: How Video Calling Impacts Attitudes Towards Aesthetic Surgery in the COVID-19 Era
date: 2021-07-07
journal: Aesthet Surg J
DOI: 10.1093/asj/sjab275
sha: ac71477aba24fc2abf7f232ddc4e383a58ec4397
doc_id: 772641
cord_uid: 8zhmtxxt

nan

A c c e p t e d M a n u s c r i p t This is an excellent and well-designed study showing a positive correlation between video teleconferencing and acceptance of aesthetic surgical enhancements (assessed via the validated Acceptance of Cosmetic Surgery Scale (ACSS)) during the COVID-19 pandemic. 1 It is referenced appropriately and clearly presented. I find this to be an interesting phenomenon of modern technology and culture, which I believe is here to stay and will surely evolve further, and, like all trends, can be used or misused to guide the future of our field. We must always assess the benefits and downfalls of how we practice and what we do. For this reason, I think it is important to evaluate what this study suggests and how we, as aesthetic surgeons, can learn from the results and can correctly apply the data gathered to maintain the highest standards of patient care.

I started in practice 25 years ago. At that time, as an eager young surgeon, I would ask mentors and colleagues how to ethically generate patient flow through the office. Almost universally I was told to do good work, be available, affable, and attentive to the needs of both patients and my referral sources. This has served me well, is how I built my practice, and continue to do so today. However, technology, primarily social media has changed this.

We have learned how websites and posting applications such as Facebook (Facebook, Inc., Menlo Park, CA, USA) and Instagram (Facebook, Inc., Menlo Park, CA, USA) can drastically modify the face one one's practice. I will not go into the pros and cons of these applications, as this is a discussion of its own for a different day. What I can say, is that this report is also about technology, and as such must be applied with the same caution as social media marketing, education, and application.

To start, I agree with the assumption the data suggests, that increased use of, and time on, teleconferencing modalities correlates with increased acceptance, and I would suggest anecdotally, proceeding with aesthetic interventions. In my personal experience the volume of consults and surgical interventions during the evolution of the COVID-19 pandemic has increased at least 30-40% (quick evaluation of my practice pattern), much of this starting with a video consult, which has previously been shown to have great utility in an aesthetic practice. 2 The authors reference various potential reasons for this which are valid and understandable. 1,3,4 One potential association not reviewed which I feel plays a significant role in this trend, is whether the respondents to the survey are active on social media sites. It is reasonable to assume that social media savvy individuals have increased awareness of plastic surgery procedures and outcomes, as these are posted daily, and seen by millions on the many social media posting applications (both photos and videos). This is a powerful tool A c c e p t e d M a n u s c r i p t to instruct, educate and potentially subliminally influence individuals on aesthetic interventions. If the study cohort surveyed was subdivided in not those who engage in social media sites, and those who do not, we may have seen a dichotomous trend. This is important as it may have rooted out an important confounding variable. This does not take away from the study findings but is just "food for thought." Also, the results of the study suggest and may validate what I have referred to as the "ah ha moment theory." When I train fellows, I find that surgery and its steps are frequently memorized at first. This can be an arduous and frustrating task for a newbie surgeon. Then, often in an instant, an "ah ha moment" occurs where clarity prevails, and the procedure is engrained. This is the joy of teaching. Fast forward to this report and I think the same concept, but in a different setting applies. As people go about their daily lives, they are often to busy to pay attention to what seems mundane. They are buried in the background noise of their world, as perspective is often lost when life takes over. When the stay-at-home orders began during the pandemic, life stood still, or at least slowed down, and having time became an asset, and the lack of it no longer a liability, a life altering combination. People could now pay attention to things they had forgotten about or ignored for years. Hence the information presented from the report, seeing one's face for what it is (flaws and all), hiding defects with lights, filters, and angles, and having to come to grips with these deficits was the population at large "ah ha moment." Sometimes willful ignorance, for lack of a better word, is bliss, and paying attention painful. In the 16 th century Ponce De Leon supposedly found waters that could rejuvenate appearance (the fountain of youth). 5 What video teleconferencing modalities have done, and this report suggests, is to provide access for those who have gained awareness of their appearance and desire that fountain -an "ah ha moment" indeed.

Finally, from an ethical perspective, it is important to maintain medical judgment, by not increasing surgical interventions and volume based on a stimulator which we have yet to truly understand (teleconferencing, "aha moment") without appropriate in person evaluations.

Temptation runs deep when patient flow increaseswise word shared with me long ago. I would love to see an evidence-based study comparing what percent of teleconferencing driven inquiries and consults converted to surgery during the pandemic vs a proper control group. Further, evaluating outcomes, complications, and patient satisfaction in both groups would be telling. I want to thank the authors for their great work and for stimulating me to think deeply about the topic presented.

The Zoom Boom: How Video Calling Impacts Attitudes Towards Aesthetic Surgery in the COVID-19 Era

The Aesthetic Oculoplastic Surgery Video Teleconference Consult

Data-Driven Insights on the Effects of COVID-19 on Public Interest in Medical Aesthetics: Part II (Active Analysis)

Don't Like What You See on Zoom? Get a Face-Lift and Join the Crowd

The New York Times website

Fountain of Youth Archaeological Park. Wikipedia website

A c c e p t e d M a n u s c r i p t