Slowly and hopefully surely, many aesthetic practices are re-opening their doors and starting to see cosmetic patients again. Multiple organizations and experts have released guidance on how to best accomplish this, but the truth is that there is no roadmap. It’s a trial by fire in many ways. The first practices to open—and their patients—will be guinea pigs when it comes to the efficacy of new safety and sanitation protocols. Many practices will be implementing virtual consults, temperature checks, and possibly antibody testing when and if such testing is proven reliable. Shorter procedures as well as those that take place off the face and are not “aerosol generating” will likely be first to come back. There will be a surge in demand for fillers and neuromodulators, given the amount of time most of our patients have been spending looking at themselves on Zoom or other video conferencing services. That said, this demand may be offset by the economic fallout from COVID-19. Unemployment rates are high, and disposable income will likely be limited in the immediate aftermath of the pandemic. Instead of competing on price, board-certified aesthetic doctors should instead reinforce their credentials as expert injectors. We have all seen our fair share of complications from non-qualified injectors. The most important thing for us to keep in mind as we reopen our doors is a doctrine as old as medicine itself: First, Do No Harm.


In the pre-COVID-19 days, packed waiting rooms at aesthetic practices, like rising hemlines, were considered a sign of prosperity. Those days are over. Unless and until there is a vaccine for the novel coronavirus, packed waiting rooms will be a thing of the past. Instead doctors will have to implement staggered schedules, teleconsults and other new policies to prevent the spread of COVID-19 in waiting rooms. To that end, the Project AesCert Guidance, which appears in Facial Plastic Surgery & Aesthetic Medicine, suggests reorganizing waiting rooms by either removing chairs, spacing the remaining chairs at least six feet apart, or by designating certain chairs to be used and others not to be occupied. Other considerations include limiting the size of the waiting room or common areas to prevent individuals from congregating in one place and removing magazines, promotional or other reading materials from the waiting room. In addition, patient reception coffee, beverage and snack bar service should be discontinued, the guidance states. Other office updates should include touchless everything, sanitizer stations, and air filters in every room. All of these efforts will go a long way toward assuring patient and staff safety. We are all in this together.