Selfie Reflection

Neelam Vashi, MD

Figure 1. Neelam A. Vashi, MD, discusses body dysmorphia and aesthetic surgery. 

It is no surprise that smartphones, and the ability to take self-portraits with them, has been one of the biggest influences on trends in aesthetics in recent years. In 2017, 55% of facial plastic surgeons reported patients requesting procedures for the primary purpose of wanting to look better in selfies, a 13% increase from the previous year.1 

One unfortunate side effect of this technology and the use of social media to share such images has been a negative impact on individuals’ body image, self-esteem, and mental health. The prevalence of high-quality cameras and software that allow users to edit, filter, and alter their image have made unattainable beauty standards even more ubiquitous, and despite efforts to counteract those messages, such as the #nomakeup and #nofilter campaigns, heavily edited images remain pervasive.

The Dermatologist spoke with Neelam A. Vashi, MD, who, with Susruthi Rajanala and Mayra B. C. Maymone, MD, DSc, at the department of dermatology at Boston University School of Medicine, coauthored a commentary in JAMA Facial Plastic Surgery that highlighted concerning trends in patients seeking cosmetic surgery to look more like their filtered selves.2 In particular, she discussed the importance of recognizing patients with body dysmorphic disorder (BDD) in cosmetic clinics. 

Selfies in Aesthetics

“The mass appeal of selfies comes from how fast and easy they are to create and subsequently share on social media networks,” said Dr Vashi. “People now want to look more flattering in these photographs that they share among their followers, which can range from mere acquaintances to family, old friends, and work colleagues.”

Dr Vashi has noticed an increasing scrutiny of selfies by those who take them. Many physicians are now seeing patients seeking cosmetic procedures to not only improve their appearance in traditionally taken photographs, but also “to look more like filtered and altered versions of themselves, with unblemished skin, bigger eyes, smaller noses, and fuller lips.”

Identifying BDD Patients 

While not every patient seeking to look better in a selfie has a mental health condition, it is important for physicians to consider the possibility that a patient may need more than fillers or rhinoplasty to address their problems with their appearance. BDD is estimated to affect 0.7% to 2.4% of the general population.3 Identifying patients with BDD is important because surgery rarely addresses, and could even worsen, the underlying condition. 

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