People Still Really, Really Want Their Botox Under Quarantine

"Although I used to do three rhinoplasties per operation day, I’m now doing five with just 20-minute breaks."

Despite the COVID-19 pandemic, many people are still reaching out to plastic surgeons for procedures...
Getty Images/Margaret Flatley

By the time New York City banned elective surgeries in late March to help contain COVID-19, Dr. Dara Liotta, M.D., had already closed her Park Avenue practice on Manhattan’s Upper East Side, turning away the 25 patients she typically saw each day for Botox and fillers, and postponing the 10 elective surgeries — mostly rhinoplasties — she’d otherwise perform each week. From March 13 until her office reopened on June 8, Liotta heard from tons of patients willing to risk their health to see her: “Their requests range from slightly overstepping to wildly ridiculous,” she says. Now that Liotta is venturing out of her home in Larchmont, New York, which she shares with her husband and two children, to see patients six days a week, Bustle caught up with the double board-certified facial plastic and reconstructive surgeon for a glance at her timesheet before and after quarantine. “I’ll never complain about working again,” she says.

A Day In The Life During Quarantine

6:30 a.m.: Before quarantine, I used to wake up at 5 a.m. for an Orangetheory class, then come home and shower before going to work. Now, I sleep a little later and join a group of women in the beauty industry who ride Peloton together every morning. Afterward, my husband wakes up and we do interval weight training together.

8:15 a.m.: I wake up the kids, make them a quick breakfast, and hop in the shower. At first, I was like, forget it, I’m not going to do my makeup, but I feel like I have my sh*t together more if I have some semblance of a normal skin care routine.

9 a.m.: School starts! Our first-grader and third-grader do work on their iPads and a shared laptop. They’ve gotten used to their new routines, but I still set them up, check in, and help out as often as I can. I’m the teacher since my work schedule isn’t as hectic as it would be if I were in the city.

Although my office is closed, I’ve gotten as many as 10 Instagram messages, five emails, and three texts from patients in a day checking to see if they can come to me for Botox, which is an elective cosmetic procedure and therefore illegal. When I turn people away, they’ll sometimes push back by offering to come to my house (no) and undergo treatment outside while wearing a mask (still no).

I think interest in cosmetic enhancements, particularly my signature Litlift treatment, has been high because everyone is working remotely and using video conferencing and FaceTime nonstop. Patients will literally say, “I’ve been staring at myself all day on Zoom and I need more Botox!” or, “I’m dreaming of Botox and hugs from people I’m not related to.”

Patients will literally say, "I’ve been staring at myself all day on Zoom and I need more Botox!"

While most of my patients are millennials and Gen Zers who get low-volume filler about every two months and are due for their normal injections, camera lenses instigate insecurity. They display your image the way others see you — something you’re not used to since mirrors show a flipped reflection. The change accentuates natural asymmetries that make people think they look worse.

I’m guessing this is why four or five times a week, people offer to pay me extra to come to them for Botox or filler. I haven’t gotten into any kind of numbers since it’s illegal at the moment.

12:30 p.m.: As soon as we wrap up schoolwork, I become the lunch lady. I cook roasted chicken and vegetables and make stock for my husband and me.

1:30 p.m.: After lunch, I schedule virtual playdates via Nintendo Switch or Zoom for the kids to get some interaction. I also schedule calls that require my full attention and can’t be interrupted, like new patient consultations, which I’ve offered virtually before the pandemic since I have an office in Dubai for patients who want to fly to New York for surgery.

I ask patients to email me photographs of the nose or other facial features from different angles before the consultation so via Zoom, we can screen-share morphed images to give them a sense of the results they can expect.

The only thing I can’t do from afar is look directly up the nose with a camera, which is important for certain functional corrections. At this point, though, my advice is usually the same — I’m confident that good surgical candidates will be happy with their results. Typically, I book about 75 percent of the people I see for virtual consultations, but lately, conversion rates are even higher: Every single patient I’ve seen virtually since lockdown has put down a deposit and booked a surgical date.

5 p.m.: As soon as I wrap up work, I’ll go for a run or bike ride with the kids, and barbecue and eat dinner as a family before the kids go to sleep. Then it’s TV and wine time for me and my husband. So far we’ve tuned in to Ozark, The Plot Against America, and The Man in the High Castle.

10:30 p.m.: As soon as I get to bed, I’m woken up by an “urgent” text about a forehead wrinkle: “The crack across my forehead has gotten twice as deep in five weeks.” Because everyone is home all day, there’s no more respect for evenings or weekends. I should change my number!

A Day In The Life After Quarantine

5:30 a.m.: I shower, do my skin care routine, and put on black commute scrubs. I no longer see my kids in the morning; their nanny, who I haven’t seen since she came back to work for us, will arrive at 8 to get them up. I’m in the car on my way to the Upper East Side by ten to 6; I drive in and park in a garage a block from my office to avoid public transportation.

6:45 a.m.: At the office, just one of my receptionists is in and the waiting room is empty. We stagger our employees’ schedules, don’t let patients or their companions sit in the waiting room, and have made everything paperless so even medical history forms and payments are submitted digitally to avoid unnecessary interactions. I’m really not worried about getting COVID-19 at work: I wear an N95 and surgical mask nonstop all day except when I break for lunch, and I test my staff and myself twice a week. I also test surgery patients myself — to make sure it’s done correctly — two days before their procedures since COVID-19 is associated with an increased risk of anesthesia complications like blood clots and respiratory issues. I swap my black commute scrubs for blue surgical ones, and go into my first surgery.

9 a.m.: One down! Although I used to do three rhinoplasties per operation day, I’m now doing five with just 20-minute breaks, during which the rooms are thoroughly cleaned. I’m also operating on Saturdays since we’ve got such a big backlog. It’s why the last month of income has been equivalent to two. I see fewer patients on non-surgery days because we no longer double book and it takes us more time to clean rooms between visits. Plus I linger with patients — many really want to talk since this is the first time they’ve left their house, and I’m the first person they’ve seen. I’ve also been starved for contact in the past few months, so chatting is nice for me, too. When patients side-text me for an appointment, I’ll usually agree to see them outside my regular office hours since my schedule is booked until July 20. No one has had to offer me a Hamptons house or cash on the side, but I’m sure it’s coming.

No one has had to offer me a Hamptons house or cash on the side, but I’m sure it’s coming.

11:20 a.m.: On surgery days, I don’t always have time to eat lunch, but my office coordinator orders food for the entire staff so no one has to leave the building.

6 p.m.: I finish my last case. Although working 10-plus hour days leave me tired, I’m not stressed. Operating is like a hobby for me.

7:45 p.m.: It takes me 45 minutes to get home now that parts of the city are reopened and more cars are on the roads. When I get home, I leave my commute shoes in the garage and go straight into the basement bathroom where I put my black commuting scrubs into a plastic bag that gets dumped into the washing machine. I shower and put on fresh clothes before I see my family. I feel pretty confident that my system won’t put them at risk, particularly because I test myself so regularly.

8 p.m.: I eat the dinner my husband has cooked. He’s already fed the kids, who get to stay up late to hang out with me for an hour.

9 p.m.: My husband takes the kids up to bed so I can work out before bed. It’s late, but when I don’t have that time to mentally check out, I’m unhappy. I miss the camaraderie of morning rides with my beauty crew so I try to repeat the ride they did while I was working, but I get lazy when no one is watching. For me, quarantine was physically restorative, while going back to work has been mentally restorative. Now I’m trying to put the two together.