We’ve heard the catchphrases: Instagram face. Snapchat dysmorphia. We’ve scrolled the feed photos: Which Kardashian is that? The cult of celebrity sameness (made possible by apps like Facetune, AirBrush, and Selfie Editor) that is making it increasingly difficult to differentiate who’s who on social media is influencing our appearance IRL, too. Our choice of makeup techniques, preferred beauty and aesthetic treatments, and — as new research shows — our decision to undergo both surgical and non-surgical cosmetic procedures are all swayed by what we see on social media.
The fact that celebrities and influencers have a powerful say in our collective body image and self esteem is nothing new. Until recently, however, whether that translated into a trip to the cosmetic surgeon's office hadn't been quantified. A September 2019 study published in JAMA Facial Plastic Surgery showed a correlation between photo editing apps and perceptions of plastic surgery. “This study’s findings suggest that the use of certain social media and photo editing applications may be associated with increased acceptance of cosmetic surgery,” the authors conclude. More recent research takes these findings one step further.
“Patients started coming into the office bringing in photos of celebrities or photos of themselves that they’d Facetuned or Photoshopped,” says Jason Bloom, MD, a double board certified facial plastic and reconstructive surgeon in Bryn Mawr, PA. “I started wondering how the apps influence patients in choosing plastic surgery and if they had or hadn’t considered plastic surgery until they started fooling around with these apps.”
In a study published in the Aesthetic Surgery Journal in March 2020, Dr. Bloom and his colleagues surveyed 70 patients patients ranging in age from 22 to 77 to find out the following:
- Who is using photo editing apps?
- How are they using them?
- Are the apps fueling aesthetic surgery decisions?
The majority of those surveyed were returning clients looking for non-surgical treatments (think: Botox® and facial filler). About one-third (mostly females) admitted to using face-editing software. Not surprisingly, the median age of patients who used the apps (about 36 years old) was younger, than those who didn’t use them (about 54 years old).
The most common reason for utilizing face editing apps cited by patients was social media use, with Instagram making up the lion’s share at roughly 90 percent. Other reasons included sharing with family and friends, online dating apps, and just for fun. According to the study, the majority of patients who used the feature-altering apps reported that these apps played a role in their pursuit of cosmetic procedures.
“They were seeing themselves on social media and didn’t want to post anything until they’d tuned it,” Dr. Bloom says. “Fifty six percent said that — after they’d tuned their face to what they wanted — it influenced them in seeking out cosmetic procedures. They thought, That really does look good. I’m interested in seeing if that could be done permanently.”
Dr. Bloom says that when patients come to him with pictures of their Facetuned selves, he has to manage their expectations. “They show you a picture of their face that they’ve edited and go, ‘This is what I want,’” he says. “They think it’s like a robotic computer program, but it’s my hands, my skill. I’m a human.” Prospective patients will even come in with 3D vector imaging from other surgeons. “I tell them I don’t even want to see that, and I don’t give out imaging until patients book surgery with me because it’s my intellectual property,” he shares. “It’s something I’m creating with my years of expertise, something I know I can realistically achieve.”
Making sure a patient’s goals are realistic is part of a larger evaluation performed by plastic surgeons during a consultation. That process has been complicated by social media, face tuning, and selfie culture. A 2017 survey from the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) found 55 percent of surgeons report seeing patients who request surgery to improve their appearance in selfies, and these filtered images can affect self esteem to the point of body dysmorphia.
As patients become more media and cosmetic surgery savvy, surgeons are seeing patients with insecurities based on various photo and video formats. It’s widely known, for example, that selfie angles tend to amplify the appearance of the nose, which has led to more rhinoplasty requests. Photos taken by others, meanwhile, often reveal forehead wrinkles and shadowing and wrinkling in the eye area, which can be treated with fillers and neurotoxins, respectively.
Dr. Bloom says that the recent COVID-19 stay at home orders that led to a boom in teleconferencing has led many people to scrutinize often-overlooked areas like the neck. Plastic surgeons wouldn’t be surprised if that leads to an increased interest in surgical face and neck lifts. “That’s really going to influence what they want,” Dr. Bloom says of patient preferences. “There’s even a ‘touch up my appearance’ button on Zoom now — like built-in autotune for Zoom.”
As photo editing apps become more widespread and sophisticated, cosmetic cosmetic treatment and plastic surgery trends will no doubt continue to evolve, with people wanting the face they see in the mirror to match their Facetuned social media pics. “We found that 87 percent of the patients who had used these face tuning apps had no regrets about it,” Dr. Bloom says. For plastic surgeons, keeping patients happy through cosmetic changes under the influence of social media comes down to balancing a patient’s wants with what is reasonable and safe.
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