Hidden costs of “Instagram face”

By Alpana Mohta, MD, DNB, FEADV, FIADVL, IFAAD | Fact-checked by Barbara Bekiesz
Published May 31, 2024

Key Takeaways

  • “Instagram face" refers to a uniform look achieved through injectables and plastic surgery, characterized by poreless skin, high cheekbones, catlike eyes, long lashes, a small nose, and full lips—as influenced by social media users and celebrities.

  • Constant exposure to enhanced images on social media skews perceptions of reality for non-enhanced individuals and can worsen body dysmorphic symptoms. 

  • Clinicians working with young people should always inquire about their social media usage patterns and motivations to better understand and address body dysmorphic symptoms.

"Instagram face," coined by Jia Tolentino in The New Yorker, describes a "single, cyborgian look," popular among young women—achieved through minimally invasive procedures like injectables and plastic surgery.[]

This aesthetic features poreless skin, high cheekbones, catlike eyes, long lashes, a small symmetrical nose, and full lips, influenced by social media users and celebrities.[]

The American Society of Plastic Surgeons (ASPS) reports a nearly doubling of the cosmetic surgery business since the onset of the pandemic, with women aged 31 to 45 driving this increase. Popular procedures include Botox, fillers, non-invasive fat reduction, and nonsurgical skin tightening.[]

"Instagram face" and distorted reality

A study by British researchers examined 24 women who willingly underwent “overtreatment” with lip fillers, which resulted in “strikingly distorted lip anatomy.”[]

When interviewed about their motivations, most participants said social media influenced their views on beauty. The report concluded that constant exposure to enhanced images on social media changes what people think is natural.

Today's beauty standards lean toward exaggerated looks rather than natural ones, with social media playing a big role in this shift. The ASPS 2022 annual report states, “Platforms like Instagram and TikTok play a big role in shaping beauty trends. Many influencers shared their experiences with lip fillers, making the procedure less intimidating.”[] Healthcare providers and aestheticians are gaining popularity on Instagram, TikTok, and YouTube by sharing videos of procedures and before-and-after images.

However, not everything online is real. Many posts show highly edited and filtered images or videos with hashtags like #wokeuplikethis, #nofilter, and #nomakeup—setting unrealistic user expectations. 

Affordable beauty

Two decades ago, plastic surgery was costly, invasive, permanent, and risky. However, in 2002, the FDA approved Botulinum toxin (Botox) for dynamic facial wrinkles and later approved hyaluronic acid (HA) dermal fillers, both of which paved the way for cosmetic procedures that are more affordable for the general population.[] 

In 2022, over 8.7 million neurotoxin and 5.7 million filler injections were administered.[] Initially used for anti-aging, these minimally invasive procedures can now also reshape jawlines, noses, and cheeks.

They are cheap, with minimal downtime, and claim to produce reversible, temporary results that last 6 to 12 months.[]

The risk of body dysmorphia

Image-based social media can create a cycle that reinforces body dysmorphic symptoms.[] Users who compare themselves to others—whom they perceive as better—are more prone to these symptoms due to unrealistic ideals of appearance. High body dysmorphic symptoms and self-oriented perfectionism—which involves setting excessively high standards for oneself—lead to more harmful appearance-related social media behaviors.

The evidence is irrefutable; consider the following:

  • A systematic review in the Psychology of Popular Media by the American Psychological Association found that increased use of social networking sites, especially passive and appearance-focused use, is linked to body image dissatisfaction and is a risk factor for body dysmorphic disorder. Appearance-based comparisons were strong mediators.[]

  • A study of teens aged 16 to 18 in England found a strong link between frequent use of image-based social media and body dysmorphic symptoms. Appearance-based motivation for social media use was the primary factor, with self-oriented perfectionism worsening this relationship.[]

  • A recent study reported a 24.4% prevalence of body dysmorphia in Saudi adults aged 18 and older. Those spending 4 to 7 hours daily on Snapchat and Instagram had a higher prevalence of body dysmorphia and were more likely to seek cosmetic surgery.[]

The need for counseling

As a clinician, before any minimally invasive cosmetic procedure is done in young patients, conduct a thorough psychological evaluation to rule out body dysmorphia by involving a psychiatrist or psychologist.

The UK-based researchers writing in Frontiers in Psychology recommend that “when working clinically with young people with body dysmorphic symptoms, conversations should go beyond asking about the frequency of SMU [social media use], and additionally explore the type of platforms young people are using most as well as their motivations for SMU.”[]

The report further states, “Such exploration may highlight when excessive appearance-related SMU may be interacting negatively with a young person’s body dysmorphic symptoms and protective measures can be identified, such as limiting time spent on image-based platforms or finding value in alternative reasons for using social media that are not appearance-focused.”

Educate patients on the unrealistic beauty standards on social media. Counseling on the fake façade of social media and self-worth should be provided in schools, colleges, and cosmetic clinics.

What this means for you

When treating young patients with body dysmorphic symptoms, explore the frequency and type of social media platforms they use and their motivations. If you identify excessive appearance-focused social media usage, suggest protective measures, such as professional counseling, limiting time on image-based platforms, and encouraging alternative, non-appearance-focused uses of social media.

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