The problem is, when you alter a photo and the result is a you-but-better-version staring back, you may start to get it in your head that that's what you should look like. Cosmetic doctors are noticing an uptick in people who are bringing Facetuned, filtered and otherwise altered photos into their offices, or pulling up unaltered selfies to point out what they want fixed. They're calling it "Snapchat dysmorphia," and although the term has been around for a while
, a recent article in the JAMA Facial Plastic Surgery
brings the topic into focus.
"Overall, social media apps, such as Snapchat and Facetune, are providing a new reality of beauty for today's society," the article reads. "These apps allow one to alter his or her appearance in an instant and conform to an unrealistic and often unattainable standard of beauty."
The article claims that the phenomenon can mess with our heads, fostering some unhealthy ideas about what we really see in the mirror -- and on our phones.
Dr. Patrick Byrne, director of the Facial Plastic and Reconstructive Department at the Johns Hopkins University School of Medicine, says the root of the problem is fairly simple: In the selfie age, people just see their faces (and bodies) more.
"The experience of younger humans in particular in this regard, how they relate to their own appearance, is so profoundly different than at any other point in time," he said. "We used to have photographs, of course, but we gazed upon them and thought about them infrequently. Now, we're in this world where people are exposed to their own facial image thousands of times per year."
Not to mention, it's not just you who sees your face every day. Social media platforms, online forums and even dating apps mean that often, the first -- and sometimes only -- version of ourselves other people meet is a digital image. In a recent set of statistics from the American Academy of Facial Plastic and Reconstructive Surgery
, 55% of facial plastic surgeons reported seeing patients who wanted to improve how they looked in selfies in 2017, a 13% increase over the previous year.
In the report, academy President Dr. William H. Truswell partly attributes this rise to the importance of our digital image to our social opportunities. "Consumers are only a swipe away from finding love and a new look, and this movement is only going to get stronger," he said.
When you see your face dozens of times a day, there are plenty of opportunities to obsess over little imperfections that other people may not even notice, and that can lead to feelings of dissatisfaction and even dysmorphia.
Byrne says he sees the disconnect between reality, mirror images and photos frequently in his practice.
"I've always handed patients a mirror, and they've picked it up and pointed, and we've discussed what they wanted," he said. "Now, what happens is at least once a week, I'll hand someone a mirror, and they'll look at it for a moment, get frustrated and say, 'You can't really see it here' and show me a picture. And that's amazing, because we're looking at the same face through different media. They're bothered by their pictures but not by their reflections."
Another sign that selfies and photos are affecting how people see their faces is the type of procedures requested.
"Prior to the popularity of selfies, the most common complaint from those seeking rhinoplasty was the hump of the dorsum on the nose," the JAMA article says. "Today, nasal and facial asymmetry is the more common presenting concern."
Byrne called a pronounced hump on the nose (dorsum) one of the most understandable reasons to seek cosmetic rhinoplasty, as it is often a noticeable facial difference that may affect someone's confidence or social interactions.
"You can find imperfections on any face," he says. "The question is how pronounced they are and how much they actually matter to your overall appearance."
This perception gap, combined with the natural tendency to intimately critique one's own oft-viewed face, can cause serious psychological problems that can't be addressed in a plastic surgeon's office, the article says.
The JAMA article describes body dysmorphic disorder as "an excessive preoccupation with a perceived flaw in appearance, classified on the obsessive-compulsive spectrum."
"The disorder is more than an insecurity or a lack of confidence," it says. "Those with BDD often go to great lengths to hide their imperfections ... and may visit dermatologists or plastic surgeons frequently, hoping to change their appearance."
Byrne says it's hard for practitioners to identify when a patient has actual dysmorphic thoughts, rather than just an unrealistic expectation of what can or should be done for them. A 2017 Johns Hopkins study
of three separate clinics found that plastic surgeons were able to correctly identify only about 5% of patients who were screened positively for body dysmorphic disorder.
What these patients need isn't a new nose or some injectables, Byrne says. They need psychological help.
"Anything you do with BDD, they will not be happy with," he said. People with the disorder "have a habitual repetitive brain pattern. Even if you make someone look better, you're not helping them. You may be hurting them by deepening their obsession and reinforcing its source."
Body dysmorphic disorder is linked to eating disorders and depression
. A 2015 study from the International Journal of Eating Disorders
investigated the link between social media usage and body-related behaviors among girls. It found that girls who shared photos of themselves online reported higher levels of both body dissatisfaction and an overvaluation of "the thin ideal."
Here's where it gets interesting: It wasn't just sharing and consuming such photos that contributed to such unhealthy patterns. How much girls actually edited their photos mattered too, along with how much they cared about or believed in the result.
"In addition, among girls who shared photos of themselves on social media, higher engagement of and investment in these photos, but not higher media exposure, were associated with greater body-related and eating concerns," the study says.
Want your mind blown? Allow this observation from Byrne to send you into orbit.
"The only face in the world that you can never see is your own," he said.
Think about it. You've only ever seen reflections of yourself, or pictures, or possibly the sides of your nose if you close one eye. Even you don't know exactly what you look like. So when you alter photographs of yourself, you're just creating one unreliable image on top of another and correcting imperfections that the average observer may not notice anyway.
It's clear that "selfie dysmorphia," as described by dermatologists and plastic surgeons, is more than just wanting to look like an idealized version of yourself, so easily accessible with filters and retouching apps. It's also about what you see in the first place that you think needs correcting, and how you compare it to other people's photos -- often as retouched as your own but presented as reality.
"I think that's the key, more than just the morphing technology itself," Byrne said.
So in a way, the face we see in the selfie is an accurate representation of ourselves, just not our physical selves. It's a reflection of our ideals and aspirations and insecurities -- and that can be as distorting as any photo filter.