Doc, I want to look like my selfie

A 14-year-old girl recently approached cosmetic surgeon Dr Debraj Shome with her selfie and a request: “a pout” like in her photo, something she generated using a lip-enhancing photo filter on Instagram.

Dr Shome denied the request as patients below the age of 18 need parental consent and recommended therapy instead. “She was annoyed,” says Dr Shome. “Her boyfriend also wanted the look, she said, and told me she had 30,000 rupees for the procedure.” She later went on to write a caustic review of the doctor online. There was a time when patients approached cosmetic surgeons with requests to look like celebrities. But now, many come with their own selfies with filters applied – where the skin is smooth, jawlines unnaturally sharp, and facial proportions altered beyond biological feasibility, the latest being the “upturned upper lip,” says Chennai-based regenerative medicine specialist Dr Chandan A.

“A third of my clients are men,” he says.

Such is the power of filters that Dr Shome recently did a study on their effect on youngsters. “We realised there was a growing psychological disconnect between real and virtual self-perception, and very little data in the Indian context,” says Dr Shome, founder of The Esthetics Clinic. The study found that posting edited selfies on social media, especially with AI filters, worsened people’s self-image, driving them to approach cosmetic surgeons with requests for the filtered look in real life.

Women and Gen Z reported higher impact on confidence and interest in surgery, says the study, which was published in the Journal of Cosmetic Dermatology in December 2019. It also showed filtered selfies created unattainable beauty standards that deeply affected mood, self-esteem, and real-world identity. “It echoed what we see in the clinic every week, which is young people tying self-worth to their digital selves,” says Dr Shome.

He adds that selfies with filters may lead to a “perception drift”, wherein someone gets so used to the edited version that their sense of self gradually drifts from the original. “For example, someone with a wheatish complexion always uses a fairness filter when posing selfies, and over time, their brain gets rewired. They expect the face to look fairer in the mirror, but the skin colour has not really changed. This causes a false sense of self, which may lead to body dysmorphia.

” Such people end up in cosmetic surgeons’ clinics. But then, achieving the look isn’t easy. “Social media has filters that blur the pores and blemishes with a single click, which is not possible in real life,” says Dr Sasikumar Muthu, plastic and cosmetic surgeon and founder of PearlHealth Clinic in Chennai. “Once the idea gets into their head, they just want to somehow achieve the look. I’ve been in this field for more than 15 years, and the cases have considerably increased after phone camera filters became popular.

Children as young as 13 come in with these requests, and the parents indulge them. I send them away at the consultation stage itself. As cosmetic surgeons, generally, we believe that the more we say no, the better for the patient. We don’t operate unless the patient is fit for a procedure mentally and medically, and usually only if there is natural deformity or one caused by injury or illness.” Women ask for sculpted bodies with a slim waistline, smooth skin, and plumper lips.

Men generally look for sharp jawlines and hair transplants. Some want entire facial features altered according to filters, says Dr Sasi. But the bone cage is what gives the shape to body parts, which is augmented by soft tissue, and altering it will lead to more complications, he says. While some among Gen Z, such as 21-year-old Ahaana R, a copywriter from Chennai, feel that looking up to one’s own refined image rather than that of a celebrity is a positive shift, there could be larger consequences on self-esteem due to the perception drift, says Dr Shome.

“The person starts worrying that people may not like the real person vs the one on Instagram. At the ages of 12 and 13, the neural connections of the brain have not completely formed yet.

They live in a world where likes = worth, and where AI filters have blurred the line between aspiration and reality. The brain is a neuroplastic organ, which means it can be moulded. By constantly scrolling and seeing themselves and others look unrealistic all the time, we might be creating long-term changes in the way the neural circuitry behaves. Cosmetic surgery is a medical decision, not an emotional or trend-based one.” Filters are adding to body dysmorphia, and more young adults have developed self-doubt over the shape and size of their face and try for correction surgeries, says S Vandhana, clinical psychologist. “Patients are rarely satisfied with just one, and will keep going back for more. Self-esteem forms in childhood, and issues develop following comments about features, which can lead to depression and anxiety.

It’s time we created awareness about body dysmorphia.” **Tell, don’t show, says France** To address the potential negative psychological effects of manipulated images on viewers, particularly young people, France is considering a law that would require social media influencers to disclose when they use filters or retouch photos. This proposed law also aims to prohibit influencers from promoting cosmetic surgery. **In demand** - Rhinoplasty, driven largely by how noses appear in selfies, which distort angles - Lip fillers and jawline contouring, especially among young women - Under-eye rejuvenation, to remove “tiredness” filters often erase - Skin polishing and laser facials inspired by smooth-skin filters