The Journal of the American Medical Association has : 鈥淪napchat dysmorphia.鈥� It describes people 鈥� usually young women 鈥� seeking plastic surgery to make themselves look the way they do through filters on social media apps like Snapchat and Instagram.
Here & Now鈥榮 Robin Young talks with plastic surgeon about what he鈥檚 seen in his practice.
Interview Highlights
On how body dysmorphia disorder is defined and how plastic surgeons look for it
鈥淏ody dysmorphia disorder is a recognized mental health condition, where people become obsessed about a perceived imperfection of their body. The key with BDD, or body dysmorphia disorder, is that that imperfection is usually only seen by the person, and it doesn鈥檛 really become obvious to other people, so we鈥檙e talking about someone who looks pretty good and is obsessed, because they think that there鈥檚 something wrong with them that other people can鈥檛 see.
鈥淎s a plastic surgeon, we are trained obviously in surgery, but we also have a lot of training in recognizing people with BDD. These are the exact patients we don鈥檛 want, because nothing that we can do surgically is going to make them feel better about that body part, because there鈥檚 really nothing wrong with the body part. So, we鈥檙e very in tune with BDD and try to pick up on signs that a person may have this disorder when we first meet them in consultation.鈥�
On social media鈥檚 effects on plastic surgery
鈥淥ne thing to keep in mind is social media is here. This is what everything鈥檚 about in 2018. The filters that are available on social media, such as Snapchat and Instagram, give people a really easy way to change the way they look, and we鈥檙e not talking about someone coming in with a silly rabbit filter, where they look like a rabbit and [say] make me look like a rabbit. We鈥檙e talking about people that are using these filters that make their skin look smoother or make their nose look a little smaller or make their eyes look wider.
鈥淭hat鈥檚 the thing that people are bringing into us to kind of show us what they want to look like, which on the surface, is really not unhealthy. Right? It鈥檚 just a way for someone to illustrate to the surgeon what their expectations are.
鈥淭o some extent, it鈥檚 actually a good thing, and we like it. It鈥檚 when people take it a little too far and they fail to recognize what they actually look like, because they think that the filtered appearance is their real appearance.鈥�
On the pros and cons of social media in relation to plastic surgery
鈥淚f someone comes in and they really want to look like a like a deer or a rabbit or a dog with their tongue hanging out, clearly that鈥檚 a problem. But, there are ways that we can we can kind of give the changes that they may like. Such as, a little bit of botox around the eyes can make the eyes look a little wider. If they bring a filter where their nose looks smaller, that may be a patient that is a good candidate for a rhinoplasty procedure. They are using that filter to show us what their ideal nose would look like.
鈥淚t鈥檚 kind of a slippery slope: It can be very dangerous, but there can be some positives if it鈥檚 used the right way.
鈥淥ne thing to keep in mind too is if you think back to years ago, in order for people to change their appearance in a picture, they had to be very skilled, they had to use things like Photoshop and some softwares that you really had to know what you鈥檙e doing. With Snapchat and Instagram, with one swipe, the average person can just morph their face into something different, so it鈥檚 so easy for people to change their picture.鈥�
On the suggestion that some people become so attached to their Snapchat-filtered appearance that they don鈥檛 want to be seen any other way
鈥淎s plastic surgeons, this is really kind of nothing new to us, because these are the things 鈥� like I was talking about at the beginning about body dysmorphia disorder 鈥� that we鈥檙e aware of and we look for signs of it. People that come in and exhibit unrealistic expectations or signs of a true dysmorphia, those are people that we clearly won鈥檛 operate on, and those are people that should be referred for psychiatric evaluation to help them, as opposed to having a surgical procedure done by us.
鈥淭hose are things that we should look out for, and in the plastic surgery community, this has been around for 40, 50 years, we鈥檝e known about. It鈥檚 just now that you kind of add the social media aspect to it and the Snapchat dysmorphia term, the public might becoming more aware of this.鈥�
On how Snapchat dysmorphia is being treated as a legitimate disorder, and how plastic surgeons respond to teenagers who want surgery
鈥淚t鈥檚 a recognized psychiatric disorder, but obviously, I just want to be clear that not everyone that wants to change things about themselves has dysmorphia, but clearly we need to define those people so that we can get them the help they need, and also, we don鈥檛 operate on them, because it鈥檚 not going to make them feel better about themselves.
鈥淎s a plastic surgeon, I don鈥檛 operate on young people. Now, there are people that do rhinoplasties, and nose jobs are commonly done on young people, but there is an age limit. Usually people wait till the child is about 16 years old, so their nose has grown into their face and we know that physically there鈥檚 no more changes. In that situation, the teenager would need to have parental permission, so there is kind of established guidelines for that.
鈥淏ut no, if someone comes in who鈥檚 17 years old, and she says, 鈥業 want my eyes to look wider, and I want my lips to be plumper,鈥� nobody鈥檚 going to do anything on that person, nor should they.鈥�
On whether plastic surgeons ever tell people they should seek psychiatric help
鈥淲e say it all the time. It鈥檚 really important to select our patients appropriately, based on the physical characteristics and also the psychological characteristics of each patient, so about 25 percent of the people that come to me for any type of surgery, I turn down, because either I don鈥檛 think psychologically they鈥檙e quite right for the procedure, or physically they鈥檙e not quite right. So, it鈥檚 very common to send people away and say that, 鈥榊ou need help, and it鈥檚 not help from a surgeon,鈥� and refer those people back to their primary doctor for psychiatric consultation.鈥�
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