Brazil: Plastic Surgery, Covid-19 and Self-Esteem

Brazil is the country where most aesthetic surgeries were performed in 2019, according to the International Society of Aesthetic Plastic Surgery (ISAPS). Brazil had almost 1.5 million surgeries and one million non- surgical procedures, the highest in the world. Liposuction (15.5%), breast augmentation (14.1%), abdominoplasty (10.4%), as well as eyelid surgery and buttocks augmentation, were the most popular. Most of the cosmetic surgeries were performed on people ages 18 to 35—which would seem to indicate that cosmetic surgery is not about the desire to look young, but beautiful.

At the pandemic’s start in 2020, the Brazilian government ordered that all elective procedures be put on hold as a way to free up beds for Covid-19 patients at hospitals. At the already overloaded national health system, Sistema Único de Saúde (SUS), all non-emergency surgeries were put on hold for months.

Personal trainer Suelen Cunha shows her recovery to her followers on Instagram. Photo by: Suelen Cunha

I was in Brazil in January 2020; back then we were talking about a virus killing people in China and Italy but the chances of a pandemic in Brazil seemed remote. However, in March 2020—after the Carnaval, which attracts tourists from around the world and as Brazilians returned from vacation abroad—we started to see a large number of hospitalizations. It was then that the Ministry of Health announced the first Covid-19 death and many mayors declared a lockdown in cities throughout the country.

Brazil has always had a large income disparity, exacerbated in times of pandemic. The wealthier were able to stay at home, work and attend school online, pay for home delivery and ride an Uber. The poor kept using crowded public transportation to go to work since the monthly $600 reais (about US$120) provided by the federal government in the early months of the pandemic was insufficient.

I went back to Rio in the middle of the pandemic in January 2021. After almost a year of restrictions, mask mandate, thousands of deaths and no vaccine, I saw that people were exhausted, depressed without money and jobs. The fact that President Jair Bolsonaro and his government downplayed the importance of the virus only encouraged the population in not complying with Covid restrictions.

January 2021, crowded Ipanema Beach despite bad weather and the pandemic. Photo by: Shirley Farber

One would think that with the imposed lockdown and the social distancing, people would not care about their appearance while they are isolated at home mostly in pajamas. While we watch a class, participate in a meeting or just chat with a friend we are looking at the screen that not only shows our interlocutor’s faces but our own and worse, in a non-flattering way.

Because of the isolation we must stare at ourselves and reflect. This introspection leads us to finding things in our appearance that we are not completely satisfied with and that may not even be real. Researchers call it Zoom Dysmorphia.

Dr. Marcelo Daher, president of the Brazilian Society of Plastic Surgery section Rio de Janeiro (SBCP-RJ) explains the Body Dysmorphic Disorder (BDD)  “as a disturbance of the self-image. This happens when people stay at home, with more time to look in the mirror or at themselves on the computer screen and start to observe a large number of changes in their appearance. This doesn’t happen as much when they are busy going out to work or to the gym.”

I was curious to see how his Interclinicas in Jardim Botânico, Rio de Janeiro, was handling the Covid-19 protocols. Dr. Daher recounted that “in the first months of the pandemic we only attended to patients in case of emergency. Later with the relaxation of the restrictions by WHO [the World Health Organization] we could assist patients in reconstructive surgery. It wasn’t until the end of the 2020 that we opened for cosmetic surgery.” He explained that in March 2021, the clinic experienced an increase because of the repressed demand, saying that some patient preferred a clinic because of fear of exposure to Covid-19 at hospitals.

We are conditioned to be image-conscious, even more if you work on social media. Personal trainer Suelen Cunha has been documenting her cosmetic rhinoplasty with septum deviation correction at a public hospital in Ribeirão Preto, São Paulo, to her more than 12,000 followers on Instagram. “SUS has a long waiting list for plastic surgery in general and due to Covid the list has increased. Thank God I was able to realize my dream [in September 2021].”

Journalist Maria Eduarda Volta, 21, said that “Since I was a teenager, I have had the desire to undergo rhinoplasty. During the pandemic I saw many influencers undergoing surgeries and I made the decision.” She has been documenting the procedure performed at a private hospital in Rio de Janeiro to her 30,000 followers on TikTok. She originally planned for January and canceled due to the fear of contamination. “But now in September, I already had the two doses of vaccine and the hospital informed me that patients with Covid would be on a different floor.”

Maria Eduarda Volta smiles for followers from the hospital bed after the surgery. Photo by Maria Eduarda Volta

Digital influencer Diélica Devitte, who owns an accounting office with her husband, had surgery in late September in her state of Rio Grande do Sul. “It was a good time for the abdominoplasty with flankplasty (lower body lift) because of the possibility of working from home.” While recovering, she shared her experience with her more than 11,000 Instagram followers.

According to the numbers, men and women care a lot about beauty and hygiene, as well as cosmetic surgery. Brazil is the number one consumer of deodorant, fragrances and sun protection in the world and second in consumption of baby care, men’s hygiene, hair, bath and depilatory products [Chameleon Pharma Consulting]. It is even more surprising if you take into consideration Brazil’s economy in comparison to the rest of the world.

Between the “I can do it all” adult generation and the social media-centered youngsters, it looks like no pandemic or lack of money is going to stop Brazilians from enjoying life and taking care of their image.  The pursuit of happiness for many Brazilians is linked to their appearance: once you look good, you feel even better. Just as our Brazilian poet and famous author of The Girl of Ipanema, Vinicius de Moraes, said: “as feias que me perdoem mas beleza é fundamental” [the ugly ones would forgive me but beauty is fundamental].