COVID-19 Testing and Cosmetic Procedures

As a board-certified dermatologist, I have noticed the wide spectrum on COVID-19 testing requirements for cosmetic procedures. Ranging from medical spas to plastic surgeons who perform long procedures under general anesthesia, there seem to be many approaches to COVID-19 testing, quarantining, and mask wearing.

Variability is also heavily influenced by the length of time it takes for a COVID-19 test to return. In some cases, a more rapid COVID-19 test can be performed; however, in other cases it takes much longer for results to arrive and can take up to two weeks. Another important item to consider is how much the test will cost and what kind of exam is ordered.

For a cosmetic procedure I had performed in the middle of the summer, I was required to get COVID tested at an expensive center, pay approximately $250, and quarantine for two weeks after the test as the result took two weeks to be processed.

As the COVID-19 vaccine becomes available over the next few weeks to months, what will happen to these mandates and requirements prior to having cosmetic procedures?

COVID-19 has required dermatologists, cosmetic surgeons, and plastic surgeons to continuously adapt during the pandemic and to stay up-to-date with local news, mandates, cases, and trends. Many of us have used the ASPS’s COVID-19 resource available on their website, which summarizes guidelines in terms of awareness, patient flow, enhanced cleaning measures, greater awareness of needs on PPE requirements and use, pre-operative testing and scheduling, new consent forms, and communication between staff, patients, and members of the community.

Variability comes in with what is going on in your area both in terms of local and state guidelines and policies that may affect your practice including hospital numbers and the prevalence of COVID locally and regionally. Staying current with FDA and CDC as well as state/local government updates is essential, particularly in terms of when staff and other persons should return to work after COVID exposure. Enhanced cleaning measures are important to follow and to make your patients aware of, as there is still much we do not know about the virus and precautions are necessary. Implementing enhanced cleaning protocols for the facility and office particularly in areas of high contact such as restrooms, waiting rooms, and patient rooms has been key. We have been able to minimize unnecessary exposures by doing telemedicine for refills, restricting visitors, online completion of documents, and limiting the waiting room use.

While the pandemic was seen to abruptly close many practices as it banned elective and non-essential visits and procedures, others have reported a boom in plastic surgery and aesthetic procedures. As patients no longer can spend as much on vacations, hotels, and restaurants, the spending has shifted into other areas, including elective aesthetic procedures. The presence of video chatting and zoom meetings also makes some feel more self-conscious about their appearance than they usually would, as they are seeing themselves on a screen for longer periods of time speaking to others. An area of popularity that has become a fixture for some patients who are having a lot of zoom meetings includes chin procedures, as sometimes virtual meetings can make a double chin look more noticeable.

Fortunately, an end to the pandemic seems near as vaccines have been developed and are currently in early stages of seeking approval and implementation. It appears that there is a light at the end of the tunnel of these guidelines. As our nation and regions begin to prepare for the arrival of the first FDA-approved vaccines for COVID-19, it is important to keep patients informed of events as they happen. Several companies are completing large clinical trials for these vaccines and they have gained approval in some nations such as the United Kingdom regarding the Pfizer vaccine, making it a possibility that they will become available by the end of the year. As initial supplies will likely be limited, it is important to start thinking about allocating resources for storage and distribution if administering the vaccine, or prioritizing obtaining the vaccine for you and your staff as healthcare workers. Plans should be in accordance with guidelines from the FDA, CDC, and state agencies.

It is very likely that the vaccine will be free and covered like a regular flu vaccine. Due to initial limits on supplies, the CDC and the FDA are prioritizing healthcare workers and members at the frontline until more supplies are available, followed by vulnerable patients at risk such as those in nursing homes and with comorbidities. Afterwards, it is expected that the general public will follow with vaccination as supplies permit, and distribution and production is expected to increase the following year. Hopefully this will change current measures for preparation for cosmetic and elective procedures in the future, as guidelines evolve.

References:

1. Considerations for the Resumption of Elective Surgery and Visits: ASPS Statement https://www.plasticsurgery.org/for-medical-professionals/covid19-member-resources/resumption-of-elective-surgery

2. Ozturk CN, Kuruoglu D, Ozturk C, Rampazzo A, Gurunian Gurunluoglu R. Plastic Surgery and the COVID-19 Pandemic: A Review of Clinical Guidelines. Ann Plast Surg. 2020;85(2S Suppl 2):S155-S160.

3. Diaz A, Sarac BA, Schoenbrunner AR, Janis JE, Pawlik TM. Elective surgery in the time of COVID-19. Am J Surg. 2020 Jun;219(6):900-902.

4. Wu M, Wang J, Panayi AC. Plastic Surgery During the COVID-19 Pandemic: The Space, Equipment, Expertise Approach. Aesthet Surg J. 2020 Aug 14;40(9):NP574-NP577.

5. Dorfman R, Saadat S, Gupta N, Roostaeian J, Da Lio A. The COVID-19 Pandemic and Plastic Surgery: Literature Review, Ethical Analysis, and Proposed Guidelines. Plast Reconstr Surg. 2020 Oct;146(4):482e-493e.

6. Mayer HF, Persichetti P. Plastic surgery during the COVID-19 pandemic times. Eur J Plast Surg. 2020 May 7:1-2.