When wearing a mask that hides the lower half of your face, it's only natural that you become more aware of what's going on with the upper half. To enhance the visible features you might apply an extra coat of mascara and pull your hair into a tight topknot to feel confident with what's left on display — or you might consider a longer-lasting solution for achieving bright eyes and high-arched brows and book an appointment with a plastic surgeon.
As Manhattan-based plastic surgeon Melissa Doft, MD, explains, the advent of COVID-19 and face-mask mandates, coupled with the fact that many New Yorkers are still working remotely, has caused a remarkable surge in demand for elective procedures, specifically those around the eyes.
"I have honestly never been busier in my entire career," Dr. Doft tells us. "So many people think late summer is the 'golden hour' to finally schedule the cosmetic procedures they've been considering in quarantine, which might be just Botox, or a slightly more invasive procedure like an eyelid lift. Before COVID, time was always a big factor; people would ask, 'Well, how much time do I have to take off work?' Now, with everyone working from home, the downtime that accompanies something like an eyelid lift is a total nonissue."
Across the country in Arizona, Sarah Quinn, the medical director at Arcadia Wellness Center, which specializes in cosmetic injections, has seen a similar trend in patients making requests for eye-adjacent Botox procedures. "We've seen almost a 30% increase in people asking for mid- and upper-face injections," Quinn tells us. "Whether it's Botox around the eyes or a Botox brow lift, the requests for injections stem from the fact that we're all wearing masks, but still want to feel confident in the way we look."
Botox Around The Eyes
In light of the demand for eye-area Botox, Quinn has added a new service to her menu of injectables. "We're calling this new procedure 'the bright-eyed look,' and it essentially involves putting more units of Botox than standard around the eyes," she explains. "The Botox injections relax the facial muscles and soften the crow's feet, the lines and wrinkles on the sides of the eyes. In conjunction with that, we might also do standard Botox on the forehead to smooth any wrinkles on the 'elevens' or frown lines, but that's always been a pretty standard request."
So how exactly does Botox make your eyes look wider without surgically altering the shape? Dr. Doft explains that the neurotoxin affects the anatomical muscular structure around the eye. "Around each eye, you have four key muscles: one that pulls up, then three that pull down," she says. "The goal of Botox injected around the eye is to weaken the muscles that pull down, so you only have the lift. Your eyes will appear more rested and more awake simply by virtue of the fact that you won't have the wrinkles or fine lines sagging the skin downwards."
Of course, cost comes into question here — and Botox is not cheap. Quinn says her office typically charges around $400 for a standard Botox procedure focused around the eyes, while Dr. Doft says the Manhattan price point is closer to $600. The upside? Though some patients may initially be interested in under-eye filler in addition to a Botox injection, Quinn tells us there's often no need for filler post-Botox. "We usually start with the Botox injections and see how it looks, and typically once the muscles around the eyes are relaxed, we see a huge decrease in under-eye darkness and hollows, so we don't even need to add any filler."
Botox Brow Lift
Along with Botox injections placed around the eyes or forehead, Quinn tells us that Botox brow lifts are also becoming increasing popular. "A Botox brow lift is a form of Botox that's placed directly underneath the eyebrow, smoothing and tightening the skin that sits directly between your eyebrow and eyelid," she says. "This creates a nice, subtle lift in your brow arch, thereby making your eyes look bigger and brighter." Like any Botox injection, the arch lift is temporary — usually lasting between 3 to 6 months — and again, the cost will typically run anywhere between $400-$600.
One of the more invasive — and most permanent — approaches to changing the appearance of the eye is an eyelid lift, but Dr. Doft tells us it's not as scary as it sounds. "In New York, we're seeing lots of eyelid surgeries, even in conjunction with Botox around the eyes," she explains. "It can be done in the office, under local anesthesia, so you don't have to go into the hospital. The surgery is just a small incision on the upper eyelid, and we remove a small section of skin, which effectively removes weight from the eyelid and lifts and opens the eye."
As you may have guessed, this surgery costs more, both in dollars and downtime. "It takes about a week to recover, so you're black and blue or maybe a little swollen for about a week," Dr. Doft says, "and the cost is somewhere between $3,500 and $4,500."
Of course, we can't talk about the impact of the COVID-19 pandemic on the field of plastic surgery and cosmetic dermatology without touching on the safety of these elective procedures. At this time, most states have given to go-ahead for practitioners to resume in-office procedures — including Botox and eyelid lifts — but with increased safety measures.
"We're testing all of our patients for COVID within 72 hours of their elective procedure," Dr. Doft tells us of the safeguards in place in her New York office. "There are a bunch of different rapid COVID tests out there, but we're doing the PCR or nasal swab, which has been cited as the most accurate. The test is covered by insurance, but I have to counsel my patients on the importance of isolation after being tested: You can't go out, you can't see people, because if you contract the virus between your test and your procedure, it could very dangerous — as we're all still learning more about the potential secondary effects of COVID."
As our understanding of the virus continues to develop, it's clear that the cultural implications will extend far beyond the current health crisis, impacting the psychology of self-confidence and how we all choose to be seen for the foreseeable future.