When stay-at-home orders forced millions of us to talk to each other online, many folks discovered that they weren't all that keen on what they looked like on Zoom. Heather Schwedel was one of them.

At one of her Zoom meetings, "a gargoyle" stared back at her from her laptop screen, said Schwedel, who works for the online magazine Slate. It was her face, which looked a "dull shade of greige (you know, gray-beige)." And, was one of her eyes "wonky?"

"I don't think it's especially vain of me or anyone else to worry about my on-camera grotesquery; video conferencing awakens the vanity in all of us," she said.

Seeing our faces in full Zoom, in fact, has been enough of a shock to send some of us to the plastic surgeon.

Members of the American Society of Plastic Surgeons report increased demand for cosmetic enhancements, especially Botox injections and fillers that erase lines, wrinkles, crow's feet and all those telltale signs of aging on the face. Patients also are inquiring about more invasive surgical procedures, including tummy tucks, breast augmentations and liposuction.

"It is a Zoom thing," said Dr. Michelle De Souza, a plastic surgeon for the University of Kansas Health System. "They are commenting on their appearance on the webcam or the computer, that they look tired, they look mean.

"I just think the camera sometimes is not flattering."

Wearing masks has people focusing more closely on their eyes and foreheads — the parts of their face not hidden.

"With a mask on it's harder to express your emotions," said De Souza. "So if all you're seeing is just your brow that may be furrowed or scowling, you probably don't look as happy as you feel."

She said patients have told her that "they're at home not doing anything. So with the downtime that's kind of built in from them working from home, or not traveling, they're like, 'Well, let's get this surgery done ... this seemed like the right time.' "

Schwedel recalled seeing a meme suggesting that Zoom's slogan should be "It's you, but ugly."

"That kind of says it all to me: Everyone feels this way," she said. "When there's a thumbnail version of you on screen, it's really hard not to look at it and start critiquing your face."

De Souza doesn't think people are contemplating surgery just because of Zoom "but for anyone who was already contemplating, it's not like the loneliness and anxiety of this crisis was going to improve anyone's self-esteem."

It's all about the face

Interest in facial treatments was growing at a modest rate before COVID-19, up 2% from 2018 to 16.3 million performed last year.

The five most popular minimally invasive procedures: Botulinum toxin type A (Botox is one brand name), soft tissue fillers, chemical peels, laser hair removal and intense pulsed light treatment, a skin treatment that works similarly to laser therapy.

"It's been an increasing trend for years now," said Dr. Lynn Jeffers, a California plastic surgeon and president of the American Society of Plastic Surgeons.

"I think part of it is ... some people aren't quite ready to have a procedure like a face-lift, yet in the meantime they can use Botox and fillers and peels and lasers and all the things that are out there, minimally invasive procedures, as a bridge."

But the pandemic clearly has picked up the pace.

California plastic surgeon Dr. Scott Miller reported that people are bringing him screenshots from their Zoom calls, anxious about how their necks and jowls look on small screens.

"Working from home, being seen a lot (and seeing themselves) via company video conferences, and having mask-wearing bring increased focus to certain facial features, I think a lot of people have had a tremendous amount of time to be supercritical of themselves," Miller said. "They pick up on things they want to improve about their appearance."

But do we really look that bad on Zoom (or Webex, Google Hangouts or whatever online mode our meetings take)? The answer can be yes if we don't know what we're doing.

"Zoom has shown many of us that it does matter, for example, the quality of your camera, the lighting, the position of your camera, which angle it's looking at you from," said Jeffers. "Of course, many YouTubers could have told you that a long time ago, but most of us weren't recording ourselves or putting ourselves out there as much as we have during this entire crisis."

Presentation plays a big role in how we come across virtually.

"It does matter if the camera comes from above or below," he said. "If it comes from below, it really accentuates that double chin, right? And if you have your lighting not quite right then it accentuates every bag and every shadow and every jowl, so it looks worse than if you used different types of lighting.

"So I do think people, especially if you set up Zoom in gallery view, you can see yourself as well as everybody else and you think, my gosh I didn't know I looked like that!"

No insurance

Cosmetic procedures are not covered by insurance. The national average physician fee alone for one Botox injection is $408, and more than $2,000 for a nonsurgical skin-tightening procedure, according to the plastic surgeons' group.

Botox injections have been this year's most-requested treatment so far, followed by breast augmentations, soft tissue fillers, liposuction and abdominoplasty, or a tummy tuck.

"Anecdotally, I would say across the country there seemed to have been a pent-up demand, more than we expected," said Jeffers. One attraction, he thinks, is that people can spend post-surgery in privacy. They think, "This is a great time because now I can recover at home and still work and (no one has) to see me recovering."

No one is sure if demand will drop as the pandemic's restrictions drop.

"I think people are still expecting there to be a time when we can go into offices again," said Schwedel. "Isn't the beauty of getting Botox to look better on Zoom, that it will probably also improve how you look in real life?"