Bone smashing is a hazardous DIY cosmetic trend that poses severe health risks such as facial disfigurement, infections, and nerve damage.
Beware of misleading trends on social media, which may negatively influence self-esteem and body image, contributing to dangerous actions
In the latest corner-cutting cosmetics trend: Bone smashing. It is, unfortunately, what it sounds like. People are intentionally breaking or fracturing their bones in an effort to achieve a certain look. On TikTok, the hashtag #bonesmashing has collected over 258 million views. One reel, in particular, shares how teenagers are using blunt tools, like hammers, on their chin and cheekbones to achieve a “chiseled and sharp look.”
Plastic surgery has long been popular in the US. Between 2020 and 2021 alone, the number of surgical procedures increased by 54%, and non-surgical procedures shot up by 44%, according to data from The Aesthetic Society. But plastic surgery isn’t cheap—or easily accessible. For many, the sky-high costs and lengthy wait times drive people to test out riskier alternatives.
In recent years, social media has become a leading resource for people looking to learn about plastic surgery options. However, research shows that most plastic surgery content posted online isn’t shared by board-certified plastic surgeons. The result: non-plastic surgeons are sharing and promoting risky cosmetic procedures that could lead to life-threatening complications.
The health risks associated with bone smashing can be severe and permanent. “With bone smashing, you also run the risk of having very asymmetric results from the left and right side being that there is no control over what bones are broken, where they are broken, and where their final resting place is,” Jeffrey Lind, MD, a double board-certified plastic surgeon and owner of The Lind Institute of Plastic Surgery, told MDLinx.
What is bone smashing, and what are the health risks?
Bone smashing is based on a misunderstanding of Wolff's law, a theory that suggests you can trigger bone growth by inflicting repeated trauma on a bone. But it’s not that simple. The face is made up of muscles, nerves, and blood vessels—inflicting trauma on the face could impair not only one’s bones but their soft tissues, nerves, and blood vessels as well, according to Rajnish Jaiswal, MD, Deputy Chief of Emergency Medicine at NYC H+H Metropolitan Hospital. “Our face is more than a series of bones fused together,” says Dr. Jaiswal.
In the short term, bone smashing could cause bleeding, bruising, and swelling, says Dr. Lind. The long-term risks could be catastrophic. People may develop facial disfigurement from misaligned bones that have been fractured, says Dr. Lind. Facial trauma can result in infections, internal bleeding, and nerve damage.
In some cases, facial fractures can impair basic functioning — people may develop difficulty breathing through their nose or mouth or have trouble eating, chewing, speaking, and swallowing. “Even the most subtle disturbances in these structures can cause severe and sometimes permanent problems with eye movement, breathing, functions of the sinuses, alignment of the teeth and movement of the jaw,” Dan Yamini, MD, FACS, a board-certified plastic surgeon at VISTHETIC Surgery Institute and Medspa in Beverly Hills, CA, said.
In severe cases, breaking one’s facial bones can trigger a cerebrospinal fluid (CSF) leak or a tear or hole in the membranes surrounding the brain. Left untreated, the leak could lead to meningitis or air entering open spaces around the brain (a condition called tension pneumocephalus). Under no circumstances could bone smashing lead to cosmetic or functional improvements, says Dr. Yamini.
The safest and most effective route: use a certified plastic surgeon
“When bones need to be broken in order to achieve an improvement in one’s facial structures, a high amount of precision needs to be used,” says Dr. Lind. That level of precision can only be achieved by working with a board-certified plastic surgeon who has the proper training, tools, and techniques to promote proper bone healing and remodeling.
“The key message here is that breaking bones to reshape any part of the face — or the body for that matter — is a very serious medical and surgical process that requires expert analysis, diagnosis, consultation and only then executed carefully with full consent of the patient,” says Dr. Yamini. Surgeries also require meticulous follow-up to ensure everything is healing safely and properly, he added.
Minimally-invasive procedures, like soft tissue filler, administered by a certified healthcare practitioner, can be used to subtly alter facial features. If you cannot afford surgery but want to change your appearance, you have two options, says Dr. Lind: “Save money until you have enough to pay for the surgery you want, or you can finance your surgery.” Many plastic surgery practices offer financing options for people who cannot pay the full price upfront.
How does mental health play a role in bone smashing?
Self-harm, which occurs when people injure their body on purpose, in any form, is a sign of emotional distress. In this case, bone smashing also may be a sign of low self-esteem and poor self-perceived body image. Some people who attempt bone smashing may be suffering from body dysmorphic disorder, a mental health condition that causes intense shame and anxiety over perceived body defects. “Your perceived flaw and the repetitive behaviors cause you significant distress and impact your ability to function in your daily life,” says Dr. Yamini.
Social media is known to exacerbate these issues, especially in younger people. “Such trends connect with people who are looking to improve their looks and feel insecure,” says Dr. Jaiswal.
One study found that viewing pictures of attractive celebrities and peers can have a negative effect on mood and body image. Very high use can damage one’s self esteem and increase a person’s risk of depression and anxiety, the report suggests.
Some people may try to change their appearance by dying their hair or changing how they apply their makeup, perhaps in extreme cases, bone smashing. “Social media trends tend to thrive on copycat behaviors as well, so even people without any self-esteem or mental health issues can get swept away in the movement,” Dr. Jaiswal said.
Healthcare providers who see patients hurting themselves by bone smashing or any other technique should intervene and refer them to a mental health professional.
The main takeaway: “Do not participate in bone smashing — or any other crazy TikTok trend that you may run across — to achieve your facial plastic surgery goals,” says Dr. Lind. Bone smashing could cause health complications that may be irreversible and life-altering. It takes years to become a plastic surgeon, and the techniques and tools used have taken decades to perfect. “Please don’t think that a hammer and chisel from Home Depot can be a suitable alternative,” Dr. Jaiswal said.