Think of it as a sort of physical photoshop: In response to the current obsession with social media selfie photos, more people are resorting to plastic surgery to fix imperfections like prominent noses, unacceptable wrinkles or curves, or hands that don't look perfect in Instagram wedding ring announcement photos.
First impressions have always been important, but today those impressions are likely to be made on social media, and the proliferation of selfies has called attention to personal appearance to a degree that was unheard of in the past. Plastic surgeons have responded by offering specialized procedures to correct imperfections that in some cases people didn't even know they had, including hand makeovers, the injection of fillers into feet to make them easier to squeeze into sky-high heels and surgery to trim "cankles," as unusually stout ankles are called.
Bigger boobs, flatter stomachs and straighter noses are still in demand, but the selfies that dominate Facebook, Twitter and Instagram profiles have created demand for new procedures and are specific to the needs of younger clients.
“Call it ‘hyper-vanity’ -- the tremendous focus on image that results from social media's reliance on pictures to make an impression,” said Dr. Christopher Khorsandi, a plastic surgeon based in Las Vegas. “Post witty commentary and get 10 likes, post a sexy shot of your cleavage and pouty lips, get 300 likes -- the math is simple. If you want to grow your following, improve your status, and get ‘likes,’ then looks are it.”
Dr. Philip Miller, who practices facial plastic surgery in New York, said he cautions his clients not to overreact to what they look like in a selfie.
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“I do caution patients that selfies are shot at arm’s length using a wide-angle lens. That will make anyone look horrible,” Miller said. “While selfies bring patients into the office, I’ll take more standardized photographs in better lighting and say, ‘Now let’s take a look at what you really look like. Maybe what you have to do to make yourself look better is to twist, turn or contort your head [in selfies] rather than undergoing any plastic surgery.’”
Dr. Anthony Youn, a plastic surgeon in Detroit, said his patients "are getting younger and younger. At times it can be disturbing, as I get calls for plastic surgery as graduation gifts." He turns down anyone under 18, he said. The data indicates Youn's experience is not unique: A new study by the American Academy of Facial Plastic and Reconstructive Surgery reports that more than half of facial plastic surgeons surveyed found an increase in cosmetic surgery or injectables in people under age 30.
But based on anecdotal evidence, it’s not just millennials who want to look better online.
“I now hear my baby boomers complain about how they look on Skype, or how they dislike their photos,” Khorsandi said. “One baby boomer patient of mine recently took a job teaching online. She has already had her rhinoplasty and is looking to have her facelift in the fall. Her motivation: She didn't like how her videos were looking.”
Procedures to correct selfie imperfections vary. Besides the ever-popular nose job, chin implants, facelifts and eyelid lifts are popular surgical solutions. Then there are non-surgical fillers such as Botox and Juvederm, which can be injected into the skin to soften deep folds like wrinkles and laugh lines. Depending upon the type of injection, a patient must repeat the procedure every six months to a year to keep the same results, but shorter recovery periods, cheaper prices and the lack of need for general anesthesia has helped the business grow to 9.5 million procedures performed last year.
“We live in a youth and beauty obsessed culture,” said Vivian Diller, a psychologist who consults for skincare companies including Estee Lauder Cos. Inc. (NYSE:EL), the Proctor & Gamble Co. (NYSE:PG) and Clairol. The strong demand has resulted in the average consumer having more options for procedures that can change nearly every part of one's body. In addition to breast augmentation or reduction, there is laser liposuction, Brazilian butt lifts and grin lifts.
“The people who take advantage of this are no longer in the domain of the rich, famous and on-screen actors. Now, we have normalized the availability of these procedures,” Diller said.
Regardless of whether a patient opts to go under the knife or be on the receiving end of a syringe, the desire is to look “like me, just better,” said Karen Grant, a beauty industry analyst and vice president of market research company NPD Group. Most do not want the results to scream that they had work done.
“If someone is going for surgery, minimal is bigger,” Grant said. “People want to look naturally flawless.” Many have wised up to the touched-up images on magazine spreads and understand that perfection is unattainable. This has led to patients opting for less intrusive surgeries that offer more subtle results.
“We’re no longer going to strive for that perfect image, but instead we want to look the best we can for our age,” Diller said.
The idea has permeated all facets of cosmetic surgery, from more subtle breast augmentations to nose jobs that leave some faults in place.
“In the 1970s and 1980s, a scooped nose was favorable," Miller said. "More in the 1990s and 2000s, everyone wanted a straight bridge. ‘Don’t give me a scoop’ is what everyone said. Now the exact opposite is trending. We’re seeing younger individuals between the ages of 18 to 21 saying, ‘Do me a favor, put a little scoop in it. I don’t want it completely straight.”
Dr. Michael Apa, a cosmetic dentist with practices in New York City and Dubai, said this trend applies to peoples’ smiles as well.
“The trend in the States is to look like nothing has been done, to do less, to be more conservative and to have a much more natural appearance. In the late 1990s, early 2000s it was the exact opposite. Teeth were big and white. Plastic surgery was high and tight,” Apa said. In his trade, Apa offers his patients a less-invasive procedure that gives an understated look with porcelain veneers rather than ones that are thick, big and overcut the gums.
Opting for a more natural look may stem from two major shifts: Plastic surgery techniques are getting better and patients are becoming younger. The two combined allow plastic surgeons and dermatologists to practice their trades on fresher canvases.
“If somebody came in with no hair and wanted hair transplants, it wouldn’t look as good as somebody who came in with a receding hairline and wanted hair transplants,” Apa pointed out.
What is considered natural looking varies from place to place. "Here in the Midwest, people still want to look natural, just a better and younger version of natural," Youn said. "In California and Miami, there is more of a trend to looking 'done,' with plumped up lips and cheeks. That type of look may work in Beverly Hills, but has no place in Detroit."
Khorsandi, who practices in Las Vegas, said some of his patients have a distorted view of what natural is, thanks to plastic surgery trends over the years.
“The bar has been moved, and what is considered natural by today's standards may have been the augmented look of 20 years ago,” Khorsandi said. “When a patient comes into the office, nearly every single one of them tells me that they want to look natural, then they show me a photo of someone who obviously has breast implants. When I comment that the picture they are showing me is of an implanted breast, or a larger than average lip, the patient's usually reply -- well that’s the look I'm going for.”
The trend is not confined to the U.S. In South Korea, one in five women have received cosmetic surgery, according to according to the International Society of Aesthetic Plastic Surgeons. Many are looking for faces that emulate the doll-like features of the K-pop girls in the "Gangnam Style" video and bands like Girls Generation. Then there is the rise of “smile surgeries” taking place in Seoul where young men and women are asking for a procedure that lifts the corners of their mouths to give their faces added expression. Eyelid surgeries, which give eyes a more rounded look, are another procedure in widespread demand.
In Brazil and other South American countries, including Colombia, it’s all about the butt. Breast augmentations, facelifts, nose jobs and liposuction remain popular, but so-called bubble butts are the thing, and their popularity has spread worldwide. In the U.S., there was a 58 percent increase in the total number of butt augmentation surgeries between 2012 and 2013, according to the American Academy of Facial Plastic and Reconstructive Surgery.
The popular procedure highlights one of the fastest growing techniques in the trade: Fat grafting, which involves removing fat from a person’s abdomen or thighs, growing the tissue with stem cells, then reimplanting it into other areas that needs plumping -- most often, the derriere. Gluteal implants can also give someone a Kim Kardashian booty, but fat grafts give patients a more natural look and feel, Dr. Carlos Uebel, a plastic surgeon in Porto Alegre, Brazil, told IBTimes. He performs fat grafts on patients two to three times each week.
Khorsandi sees the same trend in tissue transplants as the new dominating force in the field, used to sculpt the body and provide filler elsewhere.
“Fat is the future of plastic surgery. Harnessing it and using it to reshape the body will continue to be the trend for many years to come,” Khorsandi said.