- A recent opinion piece published in JAMA Facial Plastic Surgery suggests that a growing number of patients are seeking cosmetic procedures to look like their filtered selfies.
- The piece names apps with augmented reality filters like Snapchat and photo-editing tools like Facetune as two examples of "accessible" technologies that people are using to "alter their own appearance."
- The JAMA authors argue that filtered selfies may "act as a trigger and lead to body dysmorphic disorder."
- Doctors are calling the phenomenon behind this trend "Snapchat dysmorphia."
- Early research suggests selfies may be associated with a higher level of body-related concerns.
A recent opinion piece published in JAMA Facial Plastic Surgery suggests that a growing number of patients are seeking cosmetic procedures to look like their filtered selfies. According to clinicians, these photos typically feature "fuller lips, bigger eyes, or a thinner nose" than the patients have in real life.
Written by a team of doctors and researchers in the dermatology department at Boston University's School of Medicine, the piece names apps with augmented reality filters like Snapchat and photo-editing tools like Facetune as two examples of "accessible" technologies that people are using to "alter their own appearance."
Apps like Snapchat and Facetune, the authors write, allow users to "alter" their appearance instantly, in a way that they believe "[conforms] to an unrealistic and often unattainable standard of beauty." The authors go on to argue that this trend is "alarming" because filtered selfies — and the "pervasiveness" of these digitally altered images — blur the line between reality and fantasy, which may "act as a trigger" or even "lead to body dysmorphic disorder."
According to the Mayo Clinic, people who suffer from body dysmorphic disorder, or BDD, fixate over one or more perceived "flaws" in their appearance — "flaws" that are either minor or unobservable to others. Individuals with BDD, which is classified on the obsessive-compulsive spectrum by the DSM-5 (the fifth edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders"), may repeatedly check their appearance in the mirror, ask for reassurance from peers, and seek out plastic surgery to "fix" their perceived flaws.
Doctors are calling the phenomenon behind this trend 'Snapchat dysmorphia'
According to British cosmetic doctor Tijion Esho, who coined the term "Snapchat dysmorphia" earlier this year, patients previously brought him photos of celebrities or models whose appearance they wanted to emulate. But, as "social platforms and filters" became more readily available "over the last five years," he said his patients' attention shifted to filtered photos of themselves.
Speaking to the Independent in February, Dr. Esho said he believes that social media has made people "more visually aware than ever before," and therefore "more critical" of themselves.
"Today's generation can't escape the 'Truman effect,'" Dr. Esho argued. "[F]rom birth they are born into an age of social platforms where their feelings of self-worth can be based purely on the number of likes and followers that they have, which is linked to how good they look or how great these images are."
In an email to INSIDER, Dr. Neelam Vashi, the corresponding author of the JAMA opinion piece, said she believes patients have an easier time wanting to look like "enhanced versions" of themselves than like strangers they do not know, such as models or celebrities. "It is much harder to convince others — or yourself — that they cannot look like an edited, more beautiful version of themselves," explained Dr. Vashi, the director of the Ethnic Skin Center at Boston Medical Center.
According to Dr. Vashi, there has been very little research on filtered selfies and the accessibility of photo-editing tools to date. "This is a new phenomenon and trend that both dermatologists and plastic surgeons are becoming aware of," she said.
Early research suggests selfies may be associated with a higher level of body-related concerns
While some patients are seeking plastic surgery to look like their filtered selfies, others are doing it to look better in selfies themselves, according to the JAMA authors.
In a 2017 survey conducted by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), which represents more than 2,500 facial plastic and reconstructive surgeons around the world, 55% of surgeons reported seeing patients who requested procedures to "improve their appearance in selfies," compared to 42% in 2015.
According to the AAFPRS, this trend, dubbed "selfie-awareness," was first identified by the academy's members more than three years ago, and "continues to gain steam and transform the plastic surgery industry."
The JAMA authors also pointed to a 2015 survey of adolescent girls, published in the International Journal of Eating Disorders, which asked 101 girls in seventh grade to answer questions about their social media use, bodies, and eating concerns.
The survey found that those who regularly shared selfies on social media, compared to those who did not, reported "significantly higher" levels of body dissatisfaction, dietary restraint, and internalization of the thin ideal. And among those who shared photos of themselves online, girls who were more engaged in editing their selfies reported more "body-related and eating concerns."
When reached for comment, a representative for Snap Inc. said that the company strives to ensure its users feel comfortable expressing themselves. The representative told INSIDER that Snapchat's augmented reality lenses, which include a wide range of options from playful filters to makeup looks, were designed to help people have fun and tell stories in front of a camera.
A representative for Lightricks — the company behind Facetune, and the original app's successor, Facetune 2 — told INSIDER in a statement that the two apps are "actually breaking the illusion of 'perfect body' ideals."
"Everyone — from famous supermodels to your aunt — uses it, and everyone knows everyone is using it," the Lightricks representative continued. "It levels the playing field for everyone. Society no longer believes 'unrealistic' body standards are actually real or attainable."
Experts say cosmetic doctors who notice signs of body dysmorphia should decline to treat patients
According to the International OCD Foundation, research suggests that cosmetic treatments rarely eliminate appearance concerns in individuals with BDD. Often, patients' distress over their perceived "flaws" remain unchanged or may even get worse. They may also develop new areas of concern.
During informal assessments, Dr. Vashi told INSIDER, physicians should look out for the following signs of BDD: excessively checking one's appearance in mirrors; doctor shopping without satisfaction; seeking reassurance; using makeup and clothing to cover up perceived "defects;" making statements indicating impaired work, school, or social lives; and spending substantial amounts of time thinking about or trying to camouflage the perceived "defects."
"Management of the disorder should include an empathetic and nonjudgmental approach by the clinician," the JAMA authors emphasized. According to the International OCD Foundation, treatment options for BDD typically include cognitive behavioral therapy (CBT) or selective serotonin reuptake inhibitors (SSRIs).
Read the full statement from Lightricks below:
"Facetune and Facetune 2 are actually breaking the illusion of 'perfect body' ideals. Everyone — from famous supermodels to your aunt — uses it, and everyone knows everyone is using it. Arguing otherwise is naive. It levels the playing field for everyone — society no longer believes 'unrealistic' body standards are actually real or attainable. For most, social media is a highlight reel of your life, putting yourself out there the way you want to be seen. Facetune gives you the power to do that on your own. It's putting on a sequined party dress because you woke up feeling fabulous. Is it you? It's who you choose to be when you walk out the door."
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