Social Media Selfies Stimulate Demand for Aesthetic Surgery

Snapchat, for example, features upward of 20 filters that help users add freckles, enlarge eyes, lengthen eyelashes, contour cheekbones, straighten or reduce their nose and remove skin blemishes, among other augmentations.

“We live in an era of edited selfies and ever-evolving standards of beauty. The advent and popularity of image-based social media have put Photoshop and filters in everyone’s arsenal. A little adjusting on Facetune can smoothen out skin and make teeth look whiter and eyes and lips bigger,” said senior author Neelam Vashi, MD. “A quick share on Instagram, and the likes and comments start rolling in. These filters and edits have become the norm, altering people’s perception of beauty worldwide.”

As the filtered images become standard on social media, the perception of what is attractive worldwide also changes, which can adversely affect self-esteem and trigger body dysmorphic disorder (BDD), an excessive preoccupation with flaws in appearance, often characterized by people going to great lengths to hide their supposed imperfections. BDD, a mental illness on the obsessive-compulsive disorder (OCD) spectrum, is surprisingly common, affecting one in every 50 people and growing, as millennials are influenced by what they see online.

"We now see photos of ourselves daily via the social platforms we use, which arguably makes us more critical of ourselves. Patients using pictures of celebrities or Snapchat-filtered versions of themselves as reference points is okay,” said cosmetic surgeon Tijion Esho, MD, founder of the ESHO Clinic (Newcastle, United Kingdom), who coined the term Snapchat dysmorphia. “The danger is when this is not just a reference point, but it becomes how the patient sees themselves, or the patient wants to look exactly like that image.”

“Filtered selfies can make people lose touch with reality, creating the expectation that we are supposed to look perfectly primped all the time. This can be especially harmful for teens,” said Dr. Vashi. “Rather than going under the knife, people suffering from BDD should seek psychological interventions such as cognitive behavioral therapy, as surgery can worsen underlying BDD. It is important for providers to understand the implications of social media on body image to better treat and counsel our patients.”

The International OCD Foundation (Boston, MA, USA) estimates that BDD affects 1.7-2.4% of the U.S. population, between five and 7.5 million people. People with BDD tend to use social media as a means of validating their attractiveness, and studies have shown that adolescent girls who share more selfies on social media overevaluate shape and weight, suffer more from body dissatisfaction, practice dietary restraint, and internalize the thin ideal.

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Boston University School of Medicine