Doc, I want to look like my app-enhanced selfie

SINGAPORE — With a swipe and a pinch, selfies taken with mobile applications that enhance or beautify one’s facial and body features are redefining the perception of beauty and fuelling visits to aesthetic and plastic surgery clinics here.

Some doctors told TODAY that more people, including men, are seeking cosmetic procedures to look like app-edited versions of themselves — a trend that started about five years ago.

Users of social media and beauty apps, such as Snapchat and Meitu, typically use facial filter features and editing options to erase perceived imperfections and enhance other facial features such as the lips, nose and eyes.

Every month, about three to five patients show up at consultant plastic surgeon Tan Ying Chien’s clinic with phone-edited selfies. About one in 10 are men, the majority in their 20s.

A father-of-two in his 30s was one of them.

Dr Tan of SW1 Plastic Surgery said: “He had prominent ears, which he hated, and came in with an altered image of himself with his ears pinned back. I’m not very sure which app he used but I think it was (the Chinese beauty app) Meitu… I managed to give him what he wanted through surgery, and he was very pleased.”

At The Clifford Clinic, its managing director Gerard Ee has been seeing five to 10 of such patients each month in the last five years.

About one in five are men. Their ages range from early 20s to mid-30s.

Similar to female patients, most of Dr Ee’s male patients ask for treatments to get rid of acne scars and enhance the profiles of their nose. They also tend to be well-informed about the latest aesthetic treatments in the market, Dr Ee said.

He said that easy access to social media and selfie-enhancing apps have enabled both men and women to see how they look like with cosmetic enhancements, such as larger eyes, smoother skin, sharper nose and a slimmer face.

“This encourages them to seek treatment because they like what they see (on their phones),” Dr Ee said.

‘MINOR EDITS’

This trend that plastic surgeons here are seeing was first highlighted by their counterparts in the West.

In a 2017 survey by the American Academy of Facial Plastic and Reconstructive Surgery, more than half of plastic surgeons (55 per cent) saw patients requesting surgeries to improve their appearance in selfies — in comparison to the 13 per cent the academy reported in 2013.

While app-edited selfies can range from mild to grossly filtered ones — think razor-sharp cheekbones and disproportionately large eyes — the doctors here said that Singapore patients seeking cosmetic enhancements are still generally conservative.

“Most patients come in using filtered selfies with minor edits such as smoother complexion or sharper-looking features,” Dr Ee said.

“Their requests are mostly realistic because they already have pre-existing concerns that they want to address. These apps and filters allow them to see how they would look like, to some extent, if they have these concerns treated,” he added.

Dr Tan said that his patients tend to ask for “natural results” and he hardly has to turn patients away for unrealistic requests.

DIGITAL IMAGING TOOLS

The desire to look like an upgraded version of oneself is not a new concept in the plastic surgery scene.

Some surgeons are using high-tech 3D imaging software to help patients visualise how they would look like after surgery.

For instance, Dr Tan uses an imaging machine to simulate the desired outcome after breast augmentation, which until a few years ago, involved placing implant sizers (implant samples of various sizes) under T-shirts.

He now uses the imaging software about two to three times a week.

Dr Mohamed Zulfikar Rasheed, consultant plastic surgeon at Azataca Plastic Surgery, uses a simulation software that churns out 3D images of the patient.

The images, which can be rotated and viewed from multiple angles, and manipulated, is especially useful for rhinoplasty (nose) and breast surgeries, he said.

While there are some limitations, the simulated images provide a good gauge for plastic surgeons to see what the patients want, Dr Zulfikar added.

Dr Tan said: “What we are discussing today (the use of apps) is something similar, except the patients are now doing the job for me.

“Requests from patients who take filtered images of themselves can give surgeons an idea of their preferred change and meet their expectations as long as they are realistic.”

That said, there is no need for patients considering cosmetic procedures to start with a selfie — just consult a good plastic surgeon, Dr Tan added.

He also advised patients to have realistic expectations and be prepared to accept some deviation from their desired results.

BODY IMAGE ISSUES

In the digital age of filtered selfies, the blurred lines between reality and fantasy could spell trouble for mental health.

It can be particularly dangerous for those who are already struggling with body image issues.

Dr Adrian Wang, a consultant psychiatrist at Gleneagles Medical Centre, said: “Social media has definitely shaped people’s sense of beauty, attractiveness and self-image. It has a definite effect on people with body dysmorphia disorder because they tend to compare their perceived imperfections with what might be trending on the Internet.”

Body dysmorphia disorder, which is estimated to affect 1 to 2 per cent of the general population, is characterised by an excessive preoccupation with a perceived bodily flaw and a heightened sense of body shame and belief that others are judging their looks or appearance, Dr Wang said.

Dr Wang gets around three to four referrals yearly from plastic surgeons and aesthetic doctors, who suspect their patients might have the mental disorder.

He reckons that there are likely more undetected cases as Asians and Singaporeans are generally reluctant to seek help from mental health professionals.

Male patients make up about half of the total number of patients with this mental disorder he sees.

While Dr Wang does not think that social media filters and beauty apps directly contribute to the development of body dysmorphia disorder, they can trigger “strong emotional reaction” in people who are preoccupied with their looks, including those with low self-esteem and body dysmorphia disorder patients.

For those with body dysmorphia disorder, it may worsen the sense of shame and self-consciousness, he said.

Dr Ee, who has encountered about 20 patients suspected to have body dysmorphia disorder, is adamant that at-risk patients who are overly fixated on perceived flaws in their looks should not be going for cosmetic procedures.

“I have to decline their requests because aesthetic treatments will not treat their underlying body dysmorphia disorder and dissatisfaction with how they look.

“Undergoing aesthetic treatments will be detrimental for this group because they may go down a slippery slope of repeatedly seeking enhancements without ever being satisfied,” he said.

“While you can have fun using social media and beauty apps to enhance your photos, be careful not to be too obsessed with heavily altered images of yourself as a reference point (for aesthetic enhancements),” he added.