"We decided to continue caring for our patients but in a remote aspect as much as possible," says Beverly Hills surgeon Jaime Schwartz after the city took coronavirus precautions.
The day after L.A. Mayor Eric Garcetti announced the closure of all gyms, movie theaters and dine-in restaurant services, the city of Beverly Hills took some precautions of its own to prevent the spread of the coronavirus. On Monday, March 16, the city council prohibited all elective medical and surgical procedures. Since then, Beverly Hills plastic surgeons have been getting creative on how to service the continuing demand for cosmetic help or alternately shut down altogether.
Dr. Gabriel Chiu of Beverly Hills Plastic Surgery sent a letter to patients on Tuesday to inform them that the clinic was temporarily closed. Patients can contact Chiu on his cell or home phones for emergencies or concerns, and he is also prepared to Skype for follow-ups of recent surgery patients.
“We value patient safety and are committed to your wellbeing. We are also committed to being responsible members of our community and want to do our part in controlling the situation we are all experiencing,” read his letter to patients, obtained by The Hollywood Reporter.
His office also told THR on Tuesday that several patients “are adamant” about receiving non-surgical treatments such as injectables, fillers and immunity booster shots. “On a carefully evaluated case-by-case basis, we do deploy a mobile service to such patients who require it,” a rep says. “We have an aesthetic nurse who will be making house calls." Payments can be made via PayPal or Venmo for the time being.
Beverly Hills plastic surgeon Dr. Kevin Brenner notes that Beverly Hills’ decision comes after a call from the American College of Surgeons to curtail elective procedures in order to save personal protective items, hygiene supplies and ventilators for more necessary operations. Cedars-Sinai Medical Center and Cedars-Sinai Marina del Rey Hospital postponed all elective surgeries and procedures as of Tuesday.
“While this is certainly disappointing to patients and physicians alike, it is an understandable and reasonable action at this time,” Brenner says. “These are extraordinary times; and they call for extraordinary measures by us all.”
Still, he says there are many medically necessary surgical procedures that he performs as a plastic surgeon. Likewise, Los Angeles surgeon Dr. Farhad Ardesh and Beverly Hills surgeon Dr. Jaime Schwartz were conducting procedures at a facility on La Cienega Blvd. through Wednesday, since patients had flown in from around the U.S. to undergo surgery for the fat disorder lipedema and swelling caused by lymphedema.
While the office used by the two surgeons notes that elective surgeries are prohibited, Schwartz and Ardesh will still treat people whose cases are "emergent, life threatening or medically necessary." Life threatening cases may include complications such as a hematoma or blood clot following a previous surgery: “That is considered necessary,” says Schwartz. Other instances include removal of cancers that could spread, whereas elective surgeries such as rhinoplasty or breast augmentation will be postponed.
“COVID-19 has affected everyone’s lives substantially. From a healthcare standpoint we need to balance risk versus benefit when dealing with people's well-being and care,” says Schwartz. “If we continue to bring patients into our office we are risking contamination, cross-contamination and exposure that might’ve been unnecessary. We decided to continue caring for our patients but in a remote aspect as much as possible.”
The two are spreading out in-person visits and limiting the amount of people that can gather at any one time. And they encourage phone or virtual meetings when possible.
“Surgery is where things get more tricky,” Schwartz says. “My concern was if someone has been exposed and due to the fact that it can take up to two weeks to show symptoms, I would be worried about putting them under anesthesia. Anesthesia collapses and compromises the lungs in the short term. Adding this to a virus that attacks the respiratory system could then make things a lot worse. The risk is not worth the benefit unless the procedure is truly medically necessary.”
Dr. Rady Rahban of Beverly Hills says that moving forward for the “indefinite future,” he is only seeing patients in the recovery stage of recent surgeries and has canceled his surgery schedule “until we are given the all clears and this quarantine is lifted.” Dr. Paul Nassif of Botched closed on Tuesday, too, and says he is doing consultations via Skype as "plastic surgery has come to a complete stop."
Dr. Alexander Rivkin, the founder of Westside Aesthetics, who specializes in non-surgical procedures, has decided to close his office until further notice and do consultations via Skype or FaceTime. “We are not making house calls because that really goes against the whole point of social distancing and shelter in place,” he says, noting that a house call potentially exposes the provider or the patient to the virus.
“The U.S. still has extremely limited testing for COVID-19 and we have yet to see the kind of organized, effective government measures that are curtailing the epidemic in China,” he says. “The federal response to this threat has been abysmal. As the leading global superpower, we should have implemented universal testing weeks ago and we should currently be running coronavirus isolation field hospitals.”
Rivkin believes the U.S. should have ramped up ventilator production two weeks ago, along with implementing a shelter-in-place policy. “Instead, we are on the same infection curve as Italy and headed for an overwhelmed medical system. Social distancing is our only hope right now to buy time as we race to develop a treatment and a vaccine."
Elsewhere, New York Mayor Bill de Blasio has committed to banning elective surgeries to free up resources for those impacted by the coronavirus, which has affected more than 10,000 people in the U.S. as of Thursday. Vice President Mike Pence has also called on hospitals to delay unnecessary procedures.
