Like it or not, social media and the “selfie” era are here to stay.According to a recent survey released by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), social media’s impact on aesthetics has been enormous, especially in how people perceive and project themselves. The survey results showed that in 2017, 55% of facial plastic surgeons consulted patients that wanted to look better in selfies. This is a 13% increase from 2016.
This phenomenon has also thrust aesthetic practices into participating on social media platforms, such as Facebook, Instagram and Snapchat, to promote and market their services. To resist social media would be to ignore a foremost modern marketing tool.
For better or worse, social media is actually advancing the aesthetic cause, stated Jason Emer, M.D., F.A.A.D., a cosmetic and dermatologic surgeon in Beverly Hills, Calif.
“It’s not just filling a line anymore, it is full facial shaping,” he said. “When we talk about the stomach, it’s not regular liposuction anymore, it is body contouring and shaping because people see what these devices can do, and they talk about it online.”
Social media has also made people more comfortable and interested in visiting aesthetic clinics.
“Patients are more informed than they used to be and are doing more research before they step foot into a practice,” said Mara Shorr, B.S., CAC, vice president of marketing and business development for Shorr Solutions (Winter Park, Fla.).
“They’re learning not only about the procedures offered and what the different providers are doing, they are also getting a feel for the providers’ personalities,” she said.
There are some downsides associated with social media apps, such as so-called “SnapChat dysmorphia,” in which someone requests an outcome that matches their exquisitely Photoshopped, digitally enhanced smartphone-generated
“I have seen people bring in a filtered Snapchat photo and say they want their skin to look like that all the time, without makeup,” said Sheila Nazarian, M.D., a plastic surgeon in Beverly Hills, Calif.
Although using filtered photos can help patients communicate ideas of how they might look, “Some people ask for relatively extreme procedures to achieve unnatural results,” stated Leif Rogers, M.D., F.A.C.S., a plastic surgeon in Beverly Hills.
“The most common look today is the ‘JLo Jaw,’” Dr. Rogers continued. “Many female patients are asking for a highly defined, yet feminine jawline. Many people will use various apps to achieve a look that they will present to me as their desired after result, but what they don’t realize is that it could mean major surgery to achieve this look.”
As Ms. Shorr pointed out, one reason for SnapChat dysmorphia is that people are much more critical of themselves because they spend so much time looking at their selfies.
“Even a generation ago, people did not spend this kind of time looking at photos of themselves,” she said. “Selfies have changed social behavior. This may be good for the medical aesthetic business, but may not be good for society, overall.”
Furthermore, amateur photography often overstates the dysmorphia problem, Dr. Nazarian noted.
“Sometimes, in these photos, a person’s nose looks big because the camera is too close to the face, which is a known optical illusion,” she said.
Patients today tend to be hyper aware of their bodies – sometimes to the point of being falsely aware and unrealistically hopeful,” Dr. Nazarian remarked. “This can put both the physician and patient in a weird spot, because the patient has impossible expectations.”
“There are definitely people who have an altered perception of reality,” Dr. Emer concurred. “Many patients don’t realize they have unrealistic expectations. They look at Kylie Jenner and think, I want her lips. What they don’t realize is that she’s received 10 to 15 syringes of a dermal filler that cost $10,000 to $15,000. They think one syringe is going to work.”
Spotting Problem Patients
In Dr. Nazarian’s experience, people suffering from this syndrome are pretty easy to spot.
“I’ve turned some patients over to therapists,” she admitted. “You definitely want to do surgical procedures for people who are joyous and excited about doing it, not someone that is unsure and emotional.”
To help weed out those with dysmorphia issues, Dr. Nazarian includes specific questions on her intake forms, such as, ‘Are you doing this for anyone else? Is anyone pressuring you to do this? Are you depressed?’
“There comes a point when the physician has to take prudent medical care versus the exacerbation of beauty,” Ms. Shorr maintained. “Physicians should not allow the patient’s will and desires to control their surgical and / or artistic ability.”
Both body dysmorphia and social media addiction have become relatively common in the cosmetic surgery patient population, reported Dr. Rogers.
“It works as a contraindication to a surgical procedure, and the risk of a dissatisfied patient is significantly higher,” he said.
“Another important note is that an addiction to social media does not necessarily indicate unreasonable expectations for a cosmetic procedure,” Dr. Rogers added. “And social media addiction is a problem all of its own and affects all age ranges.”
Social Media Influencers
Increasingly, patients go online to discover the latest aesthetic treatments from social media influencers – YouTube stars, Facebook-based pundits, Instagram celebrities and other online personalities that have developed a strong presence across the most popular online platforms and command hundreds of thousands of followers.
Social media influencers and celebrities that get caught up in the world of aesthetics have enthusiastically tried out new procedures on livestreaming TV, and share their experiences online with information-hungry fans.
“It is really funny how patients want to relate,” Dr. Emer added. “They want more than just a before-and-after or an expert. They want someone that is real and reveals all of the treatments they’ve had on social media.”
“Social media influencers are the true celebrities today,” opined Dr. Nazarian. “I would much rather advertise with a social media influencer or reality TV star than a traditional TV celebrity or actress. These influencers talk about the procedures they are getting done, so they bring awareness to plastic surgery. Yes, they crave attention, but they are the ones influencing the digitally inclined, which is a majority of the population right now,” she continued.
A controversial reality TV star is more likely to livestream her labiaplasty than a mainstream personality or actress, Dr. Nazarian pointed out.
“For example, I recently streamed a labiaplasty on Farrah Abraham, from MTV’s reality show, Teen Mom. While she may not be the person I want my kids to watch, I knew her presence was more likely to bring awareness to a practice or physician. I got 44 inquiries about labiaplasty after I did that event with her. She made it okay to talk about, and that is a public service,” she said.
Then there are the rock star practitioners that end up being social media influencers themselves, as a result of creating recognized digital brands and flooding social media sites with treatment images and videos.
For instance, “Dr. Miami,” a.k.a., Michael Salzhauer, M.D., has over 285,000 fans on social media and around 1.2 million SnapChat views daily. In 2017, he outdid himself with a reality TV series and a Billboard charting dance single.
Control the Conversation
With so many social media voices in play, it is important that the practitioner control the messaging to draw in new patients and keep existing ones happy.
“The online conversation is controlled by the patients, regardless of the age group, and there are positives and negatives,” Ms. Shorr stated.
For example, consider the surgeon who brands himself as specializing in the Brazilian butt lift. A potential patient looking around on social media for a surgeon may see this type of promotion and assume the doctor only specializes in butt enhancements, Ms. Shorr elaborated.
“If I’m interested in a rhinoplasty or facelift, then I am going to rule out that physician because I am unaware that they offer more than just butt lifts,” she said. “So sometimes this type of branding could negatively impact part of your practice.”
Taking control over the online dialogue is important, Ms. Shorr reiterated.
“There are times when you’re not able to control the dialogue in social media. This can be a very good thing when people are going on about how amazing your practice is and how much they love your results,” she said. “But, it can be harmful to your reputation if you lose control and someone suddenly becomes negative. The social media crowd can be swayed easily.”
To better understand how the online world perceives physicians, Dr. Emer shared this insight: “People want to go to someone that they see as an artist, but also one that they can identify with. They watch videos on YouTube to find the leading experts, see what procedures differentiate them from other practitioners, and also to see a personal side of the physician.”
Patients not only watch for the newest treatment modality, they also look for the physician using that modality in a novel manner.
“It could be the physician who is doing cutting edge combination treatments,” Dr. Emer remarked. “People get really excited and attracted to that, and it brings them in.”
Getting into the Stream
Practitioners that post or stream procedure videos are educating viewers, as well as doing external marketing in the process.
“You don’t even need advertising and marketing as much in the traditional sense if you’re constantly posting on social media,” Dr. Emer reported. “Social media posts catch people’s attention and are easily accessible.”
Ms. Shorr concurred, “Social media is going to continue to be the wave of the future and will get even bigger. The old, archaic advertising methods do not work as well on the demographics of millennials and generations to come. These people are all digital all the time.”
It is commonly believed that 20- and 30-somethings are easiest to reach via social media platforms. But according to Dr. Emer, if you look at the statistics you will see it is a mixture.
“The growing populations of patients are the 25- to 35-year-olds and those aged 65 and up. Everyone is using social media. If you focus on the millennial only then you’re short-changing yourself,” he said.
In Dr. Rogers experience, “One does get the younger demographic to some degree, but we have also seen an increase in patients aged 40 and older, as well as a rise in the return rate of established patients.”
The younger patient is not as highly influenced as one might think, simply because cosmetic surgery isn’t on their radar,” he added. “And they are not the typical patient that follows a cosmetic medical practice.”
So, how should one assess the modern, digital and social media savvy aesthetic patient?
“Social media tends to create a very self-conscious patient that is overly preoccupied by what others think,” Dr. Rogers commented.
“That being said, I believe there are good things to come from social media,” he stated. “For those that have learned to use social media to create a business or brand, I solute you for being innovative and thinking out of the box, just don’t let it – and the patient attitudes that it has spawned – rule your life.”