A few years ago, it was not uncommon for patients seeking plastic surgery to show up to the doctor with a celebrity photo they wanted to look like. But in a JAMA Facial Plastic Surgery opinion piece a group of plastic surgeon's say there's a new wave of patients who are bringing in edited selfies that are not always attainable—and may have real psychological consequences.
Selfies become the new beauty standard
The surgeons from Boston University School of Medicine explain patients are coming to plastic surgeons asking to look like photos of themselves that have been edited by a smartphone application such as Instagram or Snapchat. Snapchat, for instance, offers users around 20 filters to apply. While some filters offer silly enhancements—such as dog ears—others give users longer eyelashes or clearer skin.
According to the American Academy of Facial Plastic and Reconstructive Surgery, 55% of surgeons in 2017 said they'd had patients ask for enhancements to make them look better in selfies. That's up 13% from 2016.
But in the JAMA article, the surgeons argue the beauty standards the apps cultivate are "unattainable." They write, "It can be argued that these apps are making us lose touch with reality because we expect to look perfectly primped and filtered in real life as well."
Neelam Vashi, an assistant professor of dermatology at Boston University and one of the authors of the article, said she's seen patients who say, "'I want every single spot gone, and I want it gone by this week or I want it gone tomorrow,' because that's what this filtered photograph gave them." Vashi said that isn't realistic. "I can't do that. I can make people a lot better, but it will take me a lot more time than a week, and it won't be 100%."
In addition, Noëlle Sherber, who runs a dermatology and plastic surgery practice in Washington, D.C., said many of the changes her patients want "are not achievable. We can't do that in real life. And if they really can't be made to match that, they will be inherently disappointed."
'Snapchat dysmorphia' and possible treatments
The phenomenon has been termed "Snapchat dysmorphia." In the new JAMA piece, the surgeons raise concerns that its negative effect could lead to body dysmorphic disorder (BDD), a diagnosable mental illness wherein individuals obsess over body image and physical appearance. It can be treated with therapy and medication, though about one-quarter of patients with BDD have attempted suicide, according to a 2007 study.
"The pervasiveness of these filtered images can take a toll one one's self-esteem, make one feel inadequate for not looking a certain way in the real world, and may even act as a trigger and lead to [BDD]," the authors write.
The authors warned that surgical intervention "will not improve or may even worse underlying BDD if present." They conclude, "It is important for clinicians to understand the implications of social media on body image and self-esteem to better treat and counsel their patients" (Anapol, The Hill, 8/6; Belluz, Vox, 8/10; Chiu, Washington Post, 8/6; Vashi et al., JAMA Facial Plastic Surgery, 8/2).
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