As shelter-at-home orders begin to lift and governors cautiously begin to allow businesses to reopen their doors, where do cosmetic dermatologists, plastic surgeons and cosmetic dentists fall on the spectrum? Here, the latest on where each state stands on resuming these aesthetic and elective procedures.
This is a developing story that will be updated as news is announced. Please contact your doctor or healthcare provider directly with any specific questions you may have regarding the current status of your local doctor’s office.
As of April 30, Alabama resumed elective surgeries statewide. As Birmingham, AL dermatologist Corey L. Hartman, MD puts it: “Alabama is open for business and the cosmetic patients are ready!” After returning to the office on May 1 for an “injectable clinic,” Dr. Hartman says the turnout was astounding. “Every spot was filled; the demand was incredible. Since then, it has been surprising to me that the injectable patients have been more eager and have come to the office more than the medical dermatology patients. It has been a pleasant, welcome surprise and it feels so good to have a syringe in my hand again after five weeks of being at home.”
Governor Mike Dunleavy’s health mandate, issued April 21, notes that non-urgent, elective surgeries and procedures would resume on May 4. The plan also notes that should a resurgence of COVID-19 occur, or if there is a PPE shortage, practices must reduce or halt procedures.
“We are optimistic and cautiously excited as we reopen in our state,” says Scottsdale, AZ plastic surgeon Bryan W. Gawley, MD. As of May 1, governor Doug Ducey greenlit Arizona hospitals to resume elective surgeries. All patients must test for COVID-19 prior to surgery and cases will be prioritized by necessity. “Additionally, medical and dental practices have been allowed to resume nonessential procedures with strict adherence to CDC guidelines, and we are phasing in our nonsurgical aesthetic procedures gradually, modifying our clinical schedules to accommodate CDC guidelines and social distancing appropriate for our aesthetic practices,” adds Dr. Gawley.
While bans have been lifted in the state, certain doctors, such as Scottsdale, AZ facial plastic surgeon Kelly Bomer, MD, are still giving it some time before reopening their practices, noting that her practice will not open its doors in May. “While some patients and staff in cosmetic offices may disagree with this approach, I do not feel comfortable at this [time] to significantly increase the risk of a person having a newly acquired infection of COVID-19 due to treatment services at [my practice],” notes Dr. Bomer.
Elective surgeries resumed in Arkansas beginning April 24. Patients must demonstrate a negative COVID-19 test result prior to any procedure.
Governor Gavin Newsom ordered a stay-at-home order on March 19 with no set end date. Meanwhile, Concord, CA plastic surgeon Eric Mariotti, MD says the state continues to “slowly and cautiously open back up.” As of April 22, elective procedures, with the exception of purely cosmetic treatments, were allowed to resume. On April 29, the Beverly Hills City Council voted four to one to resume elective and cosmetic surgeries, allowing the city’s doctors to reopen. Newport Beach, CA plastic surgeon Sanjay Grover, MD says his practice continues to hold virtual consults. “We are coordinating to resume elective surgery in an appropriate manner with appropriate preoperative COVID testing.”
While the state’s “safer at home” order is in effect until May 27, Colorado’s official stay-at-home order was lifted on April 27, allowing elective, voluntary and dental procedures to resume. Facilities must follow approved protocols with a plan to halt procedures if the number of COVID-19 infections rise.
Governor Ned Lamont extended a mandatory statewide shutdown until May 20. On April 30, Lamont outlined the industries that officials in the state are looking at for reopening on May 20. The list did not include elective or cosmetic procedures.
District of Colombia
“Washington, D.C. remains in lockdown and will likely remain so for at least one or two more months,” explains Washington, D.C. dermatologist Tina Alster, MD. “We currently have the fourth highest COVID infection rate in the U.S. and haven’t yet reached our peak, so the chances are slim that we will be able to resume nonessential practices anytime soon.”
On March 17, The Department of Health issued a statement recommending the postponement of all elective medical procedures, non-urgent hospital and outpatient visits and non-urgent dental procedures.
Update: As part of the district’s phase one reopening, effective May 27, healthcare providers may resume offering services, including outpatient or other surgical procedures, that will not unduly burden hospital capacity or resources necessary to address COVID-19. Patients must be assessed for symptoms of COVID-19 prior to treatment.
Governor John Carney has extended the state’s stay-at-home order until May 31. Carney also announced a framework for a phased reopening of the economy, with plans to begin June 1. An order regarding elective surgery has not been issued.
Medical providers in Florida received approval to reopen for elective surgery on May 4. Since then, “practices have been taking significant efforts to create safe environments and protocols to welcome both staff and patients back into the office,” says St. Petersburg, FL oculoplastic surgeon Jasmine Mohadjer, MD. “Many procedures such as neurotoxin injections are slowly resuming and patients are eager to get back to normal! Other procedures, such as facial fillers, which would require patients to remove masks, are coming back a little more slowly and providers are creating safe regimens for these procedures.”
Sarasota, FL cosmetic dentist Jenifer C. Back, DDS says she has pandemic protocols in place and she and her staff are proceeding safely, carefully and slowly. “We are seeing only one patient inside the office at a time. We are using ozone and UV air filtration methods, as well as sanitizing and disinfecting every surface.”
Governor Brian Kemp announced that offices performing elective procedures—along with spas, gyms and nail salons—were able to reopen starting April 24.
Governor David Ige has issued a stay-at-home order for all residents until May 31. Aside from the exceptions such as swimming, surfing or working in essential businesses, violators of the order face large fines or even jail time.
Update: Governor Ige’s Executive Order 20-25 ordered all healthcare facilities and providers to render assistance—including canceling or postponing elective surgeries and procedures as each facility determines appropriate under the circumstances—in support of the state’s response to the COVID-19 pandemic. The governor’s sixth supplementary proclamation restates the prior elective procedure executive order, which includes canceling or postponing elective surgeries.
Governor Brad Little’s statewide stay-at-home order did not include a ban on elective surgeries, but many medical professionals and hospitals have chosen to postpone them.
Beginning May 11, restrictions against elective surgery were lifted in Illinois. However, hospitals are required to practice extra caution, including ensuring patients test negative for COVID-19 72 hours before surgery. A mandatory quarantine from the day of the test to surgery day is also required.
Governor Eric Holcomb allowed elective surgeries to resume in hospitals beginning April 21, and in other offices—including dental, ambulatory surgical centers, plastic surgeons and dermatology offices, according to state general counsel Joe Heerens—on April 27.
As long as hospitals reserve 30-percent of ICU beds and have enough PPE for COVID-19 patients, governor Kim Reynolds lifted the ban on nonessential surgeries and procedure beginning April 27.
Governor Laura Kelly’s stay-at-home order ended on May 4. On May 6, Kelly allowed dental services to resume in compliance with special guidelines adopted by the Iowa Dental Board. Gyms and personal-service businesses where close contact cannot be avoided must remain closed at this time. Kansas does not yet appear to have issued an order regarding elective procedures.
Louisville, KY plastic surgeon M. Bradley Calobrace, MD tells NewBeauty that all Kentucky medical offices opened April 27, elective and aesthetic surgery resumed as of May 6, and spas are able to open May 25.
Louisiana’s stay-at-home order expired May 15 and the state resumed elective, nonessential procedures beginning April 27.
While Governor Janet Mills announced an extension to the state’s stay-at-home order through May 31, elective procedures, along with a number of other industries, were greenlit to open on May 1.
Maryland governor Larry Hogan eased restrictions on elective procedures on May 9, noting that patients may schedule nonessential procedures at the discretion of their doctor and should expect to undergo additional health screenings.
Chevy Chase, MD cosmetic dentist Claudia Cotca, DDS explains that her practice has long applied such screening protocols and appropriately coordinate timing and sequence of dental treatment on a case-by-case basis. “Additionally, standard universal precautions assume combatting full blown contamination, therefore our OSHA, CDC and expert adapted guidelines stand to protect and are enhanced by common sense principles of operation, patient flow and management in real time.”
Massachusetts governor Charlie Baker announced an extension to the timeline for the closure of nonessential businesses until May 18. The statewide stay-at-home order has also been extended until May 18.
The Massachusetts Department of Public Health issued an order where all hospitals and ambulatory surgical centers are required to postpone or cancel any nonessential, elective invasive procedures. The order is effective through the end of the state of emergency in Massachusetts, or until rescinded.
Update: As of May 18, the Reopening Massachusetts plan allowed hospitals and community health centers, upon attestation, to provide high-priority preventative care, pediatric care and treatment for high-risk patients and conditions. During phase two, this plan calls for expanded ambulatory in-person routine care to resume.
Michigan governor Gretchen Whitmer issued Executive Order 2020-17, effective between March 21 and until the state of emergency is in effect, requiring all hospitals, freestanding surgical outpatient facilities, and dental facilities to implement a plan to postpone all non-essential procedures.
As opening day approaches, Grand Rapids, MI plastic surgeon Bradley Bengtson, MD is confident in his practice’s ability to bounce back. “We believe we can both open safely and save our practice financially by establishing very high standards set forth by our plastic surgery societies, OSHA, the CDC and other regulatory bodies, as well as requiring testing of our staff and surgical patients.”
“We are planning to test all of our staff three days prior to returning to work and all surgical patients in this same time frame as well as encouraging isolation/quarantine prior and following surgery for up to two weeks depending upon the procedure. We are currently planning to resume surgery at the end of the month and our nonsurgical patient treatments in early June, with higher screening standards and testing than any of the hospitals in West Michigan,” adds Dr. Bengtson.
Update: Governor Whitmer issued an executive order, effective May 29, rescinding the state’s prior order prohibiting elective procedures, allowing for the resumption of elective procedures on that date.
Beginning on May 11, Minnesota governor Tim Walz lifted the state’s elective procedure ban. Surgery centers, clinics and hospitals may resume performing nonessential procedures as long as social distancing and heightened health screening are adhered to.
Mississippi’s statewide “safer-at-home” order is scheduled to end on May 25, while the state’s stay-at-home order was lifted on April 27. A number of hospitals and private practices have resumed elective procedures.
Update: On July 7, State Health Officer Dr. Thomas Dobbs announced that the Mississippi State Department of Health will restrict procedures that require hospitalization in several counties.
With enhanced health screenings and strict guidelines in place, elective procedures resumed in Missouri on May 4.
Montana governor Steve Bullock’s state reopening plan allowed elective surgeries to resume beginning April 27.
Omaha, NE dermatologist Joel Schlessinger, MD tells NewBeauty that elective procedures in Nebraska have resumed as of May 4, now with heightened screenings and protocols in place. “Due to concerns about COVID-19, we are generally pre-screening patients via telemedicine for rashes and general issues. Many of our visits are conducted over telemedicine in order to limit the amount of people in the office at one time, but we are seeing cosmetic patients and other procedures if patients are in a low-risk category. We take temperatures on everyone who comes to the building, as well as the staff. So far, we are doing well and have been pleased to see that opening is being seen in a positive light by our patients.”
Elective surgeries and procedures resumed in Nevada on May 18, following the state’s stay-at-home order expiration on May 9, instead of the expected May 15. “I’m able to move up this announcement because, as a state, we have met our gateway benchmarks for starting reopening,” said Nevada governor Steve Sisolak in an official release.
New Hampshire governor Chris Sununu issued a modified stay-at-home order, now in effect until May 31. However, time-sensitive elective surgeries were able to resume on May 4.
“As of May 12, the state of New Jersey is only performing emergency surgeries,” says Wayne, NJ facial plastic surgeon Jeffrey B. Wise, MD. “Elective surgeries are being performed by hospitals and surgery centers on a case-by-case basis, determined by medical necessity. We anticipate the resumption of elective surgeries in the near future,” he notes.
“We have been hit hard by COVID in our area,” adds Englewood, NJ plastic surgeon Shwetambara Parakh, MD. “Our caseload is trending down, but at this time we still have not met the criteria for phase one reopening and elective procedures and surgeries remain suspended. We are following our governor’s press conference daily and are hoping this will change soon, hopefully as early as next week.”
Update: On May 19, the New Jersey Department of Health issued guidance for ambulatory surgery centers to resume elective surgery and invasive procedures and a separate guidance for hospitals to resume elective surgeries.
Along with New Mexico governor Michelle Lujan Grisham’s stay-at-home order, requiring 100-percent of non-essential workers to work from home, an additional order, issued by the New Mexico Department of Health, has prohibited “all hospitals and other health care facilities, ambulatory surgical facilities, dental, orthodontic and endodontic offices…from providing non-essential health care services, procedures, and surgeries.” This order is to stay in effect until the state of emergency in New Mexico is over.
Update: The New Mexico Medical Advisory Team issued reopening guidelines noting that office procedures that are cosmetic and procedures that can be delayed for 90 days in patients without pain, disability or increased challenge to treat should continue to be avoided. The guidelines do not apply to dentists, chiropractors, alternative medicine or veterinary medicine.
On April 21, governor Andrew Cuomo announced that elective outpatient treatments could resume on April 28 in counties and hospitals without significant risk of COVID-19 surge in the near term. Patients must test negative for COVID-19 prior to any elective outpatient treatment, and restrictions on elective surgery remain in place in a number of counties as the state continues to monitor the rate of infections.
On May 13, Governor Cuomo announced 12 more counties, now totaling 47, are now eligible to resume elective surgeries. Ambulatory surgical centers within these counties may also resume elective surgeries. The counties are: Albany, Allegany, Broome, Cattaraugus, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Columbia, Cortland, Delaware, Dutchess, Essex, Franklin, Fulton, Genesee, Herkimer, Jefferson, Lewis, Livingston, Madison, Monroe, Montgomery, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Otsego, Putnam, Rensselear, Saratoga, Schenectady, Schoharie, Schuyler, St. Lawrence, Steuben, Sullivan, Tompkins, Ulster, Warren, Wayne, Wyoming, and Yates. Restrictions on elective surgeries will remain in place for the following counties: Bronx, Queens, Rockland, Nassau, Westchester, Richmond, Kings, Suffolk, New York, Sullivan and Erie.
“We’re lucky to have a proactive governor in New York that shares data which can then be used to make informed decisions on when and how we can safely reopen. And because New York is following guidelines, when we do get back to work, we’re going to be doing it in a safer fashion than most other states,” says New York facial plastic surgeon Andrew Jacono, MD.
“Even though we’re going to be testing staff regularly and patients ahead of surgery, we’re going to have to operate under the assumption that everyone is infected and exercise universal precautions—we can never let our guard down. What we have to realize is that we’re not going to be able to go back to ‘business as usual’ anytime soon,” says Dr. Jacono.
“North Carolina medical and dental practices reopened for normal operation on May 11,” says Charlotte, NC cosmetic dentist Patrick J. Broome, DMD. “Aesthetic procedures were in high demand prior to the COVID-19 outbreak and through the use of virtual consults, we were able to stay in touch with our existing patients and meet the demand from new patients seeking information or looking to schedule their aesthetic procedure. Since returning to full operation, the surge has continued and many are expressing a sense of relief in being able to move forward with elective care they didn’t know if they would be able to get just a few weeks earlier.”
Elective procedures resumed beginning April 22.
Ohio governor Mike DeWine announced that all healthcare procedures and surgeries that do not require an overnight stay in a hospital could resume as of May 1. On May 13, Dr. Amy Acton, director of health for the Ohio Department of Health, announced an order directing healthcare providers in hospitals and outpatient surgery centers to reassess procedures and surgeries that had been postponed.
“We are gradually opening back up in what we believe is the safest way possible,” says Dover, OH facial plastic surgeon David Hartman, MD. “We are mirroring the guidelines that are regularly presented by our local Cleveland Clinic Hospital.”
On April 24, Oklahoma governor Kevin Sitt announced he would allow any procedure for conditions that are not life threatening—and which would have the potential for increasing disease or death if not provided—to be performed.
Elective surgeries resumed in Oregon as of May 1, as hospitals abide by a stringent set of guidelines, including decreasing elective procedure volume by at least half of pre-COVID-19 levels and a plan to halt procedures should a resurgence surface.
“On April 27, the Pennsylvania Department of Health allowed all elective surgeries and procedures, including aesthetic surgery, to resume following guidelines outlined in the joint statement issued by the American College of Surgeons, American Society of Anesthesiologists, Association of Perioperative Registered Nurses, and American Hospital Association,” says Pittsburgh plastic surgeon Leo McCafferty, MD.
Governor Gina Rainmondo’s reopening plan reflected elective procedures resuming under enhanced safety protocols beginning May 11.
Under strict safety protocols and health screenings, South Carolina healthcare providers are resuming elective, non-urgent surgeries. “We are taking every precaution to ensure patient safety while performing any procedure, including aesthetic surgeries and procedures,” says Mt. Pleasant, SC plastic surgeon Thomas Hahm, MD. “This has always been of utmost importance to me, and now we have additional screening measures along with enhanced sanitation practices and safety protocols. Aesthetic patients should feel confident they will be given excellent care. I compare it to a pilot’s pre-flight checklist: We aren’t going anywhere until all pre-flight safety tasks have been performed and we have deemed everything safe for takeoff.”
On May 31, South Dakota healthcare providers will resume performing nonessential surgeries, which have been postponed to preserve personal protective equipment.
Tennessee hospitals resumed elective procedures beginning May 1 and are required to adhere to heightened health screenings and guidelines for both patients and staff.
After a month-long ban, elective procedures in Texas resumed on April 22. Hospitals are required to reserve at least 25-percent of their capacity for COVID-19 patients and elective surgeries are only permitted when they do not deplete the hospital’s PPE supplies.
Update: On June 25, governor Greg Abbott paused any further reopening in the state, and put a stop to elective surgeries to preserve bed space in hospitals in counties currently seeing a surge of COVID-19 cases. These counties include Bexar, Dallas, Harris and Travis.
Update: On July 9, governor Abbott expanded his ban on elective medical procedures Thursday to cover more than 100 counties across much of the state.
On April 21, Utah resumed elective procedures, with revised guidelines in place, including color-coding hospitals to designate virus risk, and only allowing outpatient procedures should there be sufficient statewide COVID-19 testing and PPE available.
Beginning May 4, Vermont governor Phil Scott lifted the state’s ban on nonessential or elective procedures. Hospitals can now resume “nonessential outpatient clinic visits, diagnostic imaging and outpatient surgeries and procedures,” according to a statement from Scott’s office.
The state’s ban on elective surgeries was set to expire April 24, but has been extended until June 10, but elective surgery and dental procedures were able to resume May 1.
“We are in Phase 1 of reopening in Virginia,” says Harrisonburg, VA plastic surgeon Saied Asfa, MD. After being closed since mid-March, practices in the area were able to re-open for in-person consultations on May 8. Elective surgeries may be resumed at local hospitals on May 29. While patients are thrilled that doors are back open—Dr. Asfa says he now has cosmetic surgeries booked into the fall—visits will be far from “normal.”
“We are not scheduling as many patients and spa clients per day, so we can maintain the recommended social distancing protocols. Appointments are spread out so people don’t ‘cross paths,’ numerous screening measures and increased safety and sanitizing protocols are in place for patients and staff, and we have had to reconfigure work stations and common areas within our facility,” says Dr. Asfa. “We will continue to offer virtual consultations for those who prefer to stay at home, as well as skin-care sales with curb-side pick-up or shipping. For now, it is a new way of doing business, but we are grateful that we were able to reopen.”
On March 19, Washington governor Jay Inslee ordered that in an effort to preserve personal protective equipment, all nonessential procedures requiring medical professionals to wear protective equipment must be postponed. On April 29, Inslee lifted the ban on “emergent” or “urgent” cases.
According to a statement from Inslee’s office, “Given the evolving and fluid nature of pandemics in general, and COVID-19 in particular, clinical judgments regarding non-urgent or ‘elective’ procedures need to be viewed through the lens of relative harm to patients of treatment versus deferment, in terms of potential patient and provider contraction of COVID-19.”
Adhering to the state’s six-week reopening plan, West Virginia lifted their ban on elective procedures beginning April 30. Hospitals are required to prove they have sufficient PPE and a response plan in place should they face a COVID-19 resurgence.
A suspension of elective procedures was never ordered in Wisconsin, but many hospitals and clinics are beginning to resume scheduling procedures following their voluntary hiatus.
Following state and regional orders, along with the Department of Health directives, Wyoming resumed elective and non-essential procedures beginning May 1.