Speaking to psychologists, surgeons, and a sufferer about whether people are really demanding surgery to look more their Snap filters
Most of us have pretty much never lived our adult lives without the internet. It’s affected us in innumerable ways – some good, some very bad – and despite not really knowing what a world without it looks like, it still continues to surprise us. In our Extremely Online series, we explore the apps, trends, subcultures, and all the other weird stuff the internet continues to offer.
Nicola* is 24 years old and works in the beauty industry. “It’s a competitive environment where you can’t just turn up looking a bit scruffy, and social media followers and likes really count,” she says. “I downloaded all these editing apps and I loved the way they made me look. I’ve always been conscious of my face shape and eye bags, but they slimmed me down and made my skin bright and my eyes much bigger.”
Social media users will be familiar with the effects Nicola describes. Apps such as Instagram and Snapchat apply filters using artificial intelligence to instantly smooth and brighten skin, contour the face, widen eyes and slim noses. We’re all prone to a filter now and again, but what happens when an airbrushed image of yourself is the only one you can stand?
Nicola is one of a reportedly growing number of young people turning to cosmetic surgery to achieve the same filtered look in real life. Earlier this month, as she began the consultation process that will see her undergo significant and expensive facial surgery, researchers at the Boston Medical Centre published a journal article in which they name this trend ‘Snapchat dysmorphia’. They argue that filters are triggering Body Dysmorphic Disorder (BDD) – defined by the NHS as a mental health condition where a person becomes obsessed by flaws in their appearance which are usually not noticeable to others – and causing self-esteem amongst young people to plummet.
Professor Marcos Sforza of My Aesthetics, an aesthetic surgeon and leading researcher into BDD, agrees with this analysis, pointing to figures from the American Academy of Facial Plastic and Reconstructive Surgeons which show that 55 per cent of facial plastic surgeons in 2017 saw patients who wanted surgery to help them look better in selfies, compared to just 13 per cent in 2013.
“I really do believe that social media is propagating and accentuating these unrealistic expectations of beauty” – Professor Marcos Sforza, aesthetic surgeon
“I really do believe that social media is propagating and accentuating these unrealistic expectations of beauty” he says. "Obsessing over the way one looks is a red flag for plastic surgeons and psychiatrists alike. The greatest danger of Snapchat dysmorphia, and focusing too much on edited images of yourself, is that it can trigger BDD.”
Other experts, though, caution against drawing a causal link where there is little evidence for one. Dr Jenny Cole, a senior Lecturer in Psychology at Manchester Metropolitan University, specialises in body image. She points out: “All image-based social media sites feed into the development of an appearance culture where we constantly compare ourselves to other people, and Snapchat is no exception. If people are indeed being inspired to have cosmetic surgery to try to match the filtered images they see, this is worrying. However, as with much research on the effects of social media on the mental health and behaviours of young people, there is little evidence that this is a widespread concern.”
While Nicola wouldn’t describe herself as having BDD, she does say she spends “an unhealthy amount of time” fixated on her appearance. For her, this was part of the impetus to go ahead with surgery. She says: “I just wanted it sorted. I didn’t want to wake up every day worrying that my clients would be disappointed by what I looked like in real life.”
Fuelled by discussion in the media and a sense of responsibility, she tells me that she went through a phase around a year ago of posting more natural images of herself. “They were getting half the amount of likes the filtered ones were getting. It made me feel like my unfiltered face wasn’t good enough, and I don’t want to feel like that anymore.”
Nicola’s experience at a top private London clinic has so far has been positive: she praises her surgeon for the time and patience he’s shown over multiple discussions and planning sessions, and says they have discussed her motivations and mental wellbeing at length.
This, says plastic surgeon and BAAPS member Dr Naveen Cavale, is vital. “I think labelling people with a term like Snapchat dysmorphia implies there’s something wrong with them, an abnormal condition.” Rather, he says, communication is key – and sometimes the discussion of filtered or airbrushed photos can provide clarity about the underlying issues patients are experiencing.
“I think labelling people with a term like Snapchat dysmorphia implies there’s something wrong with them, an abnormal condition” – Dr Naveen Cavale
“You have to sit down and talk to people to dig down into what they’re trying to tell you. Filtered photos can communicate something it’s been difficult to articulate in the past,” he says, explaining that discussing these images can help surgeons to pinpoint exactly what issues the client is trying to address and offer them tailored options and advice. “I'll listen to you talk to me using any form of communication you like – notes, selfies, filtered photos. The more you tell me – no matter what form it’s in – the better”.
Dangers arise, says Dr Cavale, when this process isn’t embarked upon with the correct moral and ethical standards. “Any good surgeon will probably be turning away more work than they’re taking on because sometimes the safest thing is not to do any surgery” he says. “The problem is there will always be somebody willing to do it if you look hard enough, because the industry is hugely unregulated, even in the UK”.
For both Dr Cavale and Professor Sforza, the correct response to the apparent Snapchat dysmorphia phenomenon isn’t to ban filtered photos or to ignore the discussion and do whatever a client asks, but rather is about taking a personalised approach, and being equipped to deal with these situations as they arise. Professor Sforza advocates training in BDD and psychological education for cosmetic surgeons, as well as stronger screening processes for clients.
“We should be asking more questions of the cosmetic surgeons that perform surgery on clients motivated by filtered images on Snapchat” – Dr Jenny Cole
Dr Jenny Cole agrees that the responsibility lies firmly in the hands of professionals. “‘Snapchat dysmorphia’ makes for a catchy headline, but there is no scientific evidence to suggest any direct links between Snapchat use and rates of cosmetic surgery or attitudes towards such procedures,” she points out. Rather, she says, “we should be asking more questions of the cosmetic surgeons that perform surgery on clients motivated by filtered images on Snapchat than of the ‘evils’ of Snapchat itself.”
For Nicola, the availability of these procedures is ultimately bittersweet. “I’m really excited and I know it’s the right thing to do for me. It feels like a weight off my mind,” she explains.
But, she concedes, “it would have been better if it had never gotten to this point. I think it’s a bit like a switch – once you start taking notice of this stuff, you can never turn it back off again”.
*not her real name