Self-image and plastic surgery in the digital age

We live in an increasingly digital world with many amazing tools in the palms of our hands. With smartphones, tablets or desktops we have our day-to-day lives to manage, as well as our digital lives.

Recent studies indicate average users spend up to three or more hours on social media daily. Unsurprisingly, the line between our real and digital lives is blurring.

Our perceptions of beauty have dramatically changed due to the trends and standards set by celebrities and digital influencers. Enhanced or filtered images flood our social media platforms projecting unattainable perfection, leading users to experience dissatisfaction with their self-image, low mood and/or depression.

Dr Linda Monshizadeh, Plastic Reconstructive and Craniofacial Surgeon, West Perth
Dr Linda Monshizadeh, Plastic Reconstructive and Craniofacial Surgeon, West Perth

Filters on Snapchat, Instagram and apps such as Facetune, which allows users to alter their complexion or dimensions of any part of their face and/or body, have led to ‘selfie dysmorphia’ with patients seeking cosmetic surgery to resemble their filtered images. Not only are we comparing ourselves to others, but now also to our enhanced filtered images!

Body dysmorphic disorder (BDD) is also on the rise and has been attributed to social media. It is estimated to affect 2.3% of the Australian population and up to 15% of patients seeking plastic surgery. This condition is characterised by preoccupation with a perceived defect that is not observable or significant to others. Patients struggle daily with thoughts of their defects and display repetitive behaviour(s) or mental acts in response to those concerns.

Patients suspected with body dysmorphic disorder should have formal psychiatric assessment and treatment. This is paramount as surgery does not relieve any symptoms. Even patients who do not have BDD report no significant change in their background anxiety or depression after cosmetic surgery although they may be highly satisfied with outcomes of their surgery.

It is important that surgeons relay this to patients as they may have unrealistic expectations of becoming happier after their physical alterations.

Our obsession with physical perfection has raised significant concerns about the psychological impacts social media platforms are having on the younger population. Recently Instagram has stated they will ban all augmented reality filters that depict or promote cosmetic surgery amid concerns about mental health.

There are minimal rules and regulations about what can and should be advertised by the aesthetic industry. The majority of plastic surgeons in Australia have a high level of interest in developing best practice standards to ensure ethical use of social media platforms.

Further serious discussions and changes are required to fully address effects of filtered images on mental health and its relation to self-image and plastic surgery.

Key messages

  • We live in an increasingly digital world
  • ‘Selfie dysmorphia’ and body dysmorphic disorder (BDD) are on the rise and has been attributed to social media.
  • Further serious discussions and changes are required to fully address effects of filtered images on mental health and its relation to self-image and plastic surgery.

References available on request.

Questions? Contact the editor.

Author competing interests: the author works for a group providing imaging.

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