Study finds selfie filters are driving young people to Botox

Young people who use Tinder and Snapchat – particularly with Snapchat filters – are more open to facial cosmetic surgery, according to a new study.

There has been a sharp uptick in Americans undergoing nips and tucks on their faces in the last few years.

Last year, Americans spent an eye-watering $2.95 billion on Botox, up from just over $1 billion in 2012. 

Much of that drive comes from young people, according to a recent report, which found a 28-percent increase in 20-somethings getting Botox between 2010 and 2017, and a 32-percent increase in the same group getting fillers.

Researchers at Johns Hopkins University School of Medicine show there is reason to be concerned that people may be driven to edit their own faces because they feel inadequate compared to impossibly pristine faces that stream across their phones.

Experts said the new research, published today in JAMA Facial Plastic Surgery, ‘should be commended’ for highlighting how something as seemingly innocuous as a filter could sew the seeds for deep-rooted insecurities.

The rise in facial cosmetic surgery comes amid a rise in social media use and a rise in mental health disorders (file image)

‘From the perspective of the viewer, seeing an idealized photograph almost always results in upward comparison, leading to an overall increase in anxiety and depression among social media users,’ Georgetown University surgeons Michael J. Reilly, Keon M. Parsa, and Matthew Biel – who were not involved in the study – wrote in an accompanying editorial for JAMA.

They added: ‘Facial plastic surgeons are uniquely positioned both to directly help our patients improve self-esteem and to refer for mental health care when there are concerns that go beyond the knife and needle.’  

This is hardly the first study to find a link between using filters and being interested in cosmetic surgery. 

In 2016, JAMA published a study that found low self-esteem was a common reason for people getting plastic surgery. 

Last year, another study, also published in JAMA, found a rise in patients coming to surgeons with pictures of themselves that had been edited with filters on Snapchat and Instagram, asking for the doctor to make them look like that in real life.

And the industry has leaned into social media’s self-conscious arena in many ways. It’s not uncommon for surgeons to have Instagram accounts, and there is a trend of surgeons streaming surgeries live on Snapchat. attended a live-streamed-and-Snapchatted surgery on 25-year-old Henny, who underwent a Brazilian butt lift in New York as a graduation present to herself.

Henny said she found the self-proclaimed Snapchat Surgeon, Dr Matthew Schulman, on the app, and it was precisely those spine-tinglingly graphic videos drew her to him. 

‘As soon as I met Dr Schulman, I was sure,’ Henny said. 

‘He was exactly the same in person as he was on his Snapchat. He knew what he was doing, and I’d seen him do it. I felt like I was in safe hands, and he was familiar.’ 

Social media apps like Snapchat and Instagram do have an air of immediacy and authenticity, particularly the Story aspect. 

If you watch an Instagram Story, you feel you are with that person in the moment. It feels real.  

But it’s not only fertile ground for airbrushing: you cannot post an Instagram photo or video without first being taken through ‘filter’ stages, with a myriad of options of ways to doctor your post.

The filters on Snapchat or Instagram stories take up the bottom fifth of the screen. 

That’s beyond all the external apps – such as FaceTune – where you can airbrush or entirely transform a picture, before uploading it to said app.  

The rise in spending is driven by both soaring demand and climbing rates

The rise in spending is driven by both soaring demand and climbing rates


Americans spent more than $16.5 billion on cosmetic plastic surgery and fillers in 2018 – up four percent from last year, a report revealed in April.

Botox, though one of the least expensive procedures at $397 a pop, was the biggest money grabber: Americans spent $2.95 billion on the injections that paralyze facial muscles to smooth out wrinkles.

Breast augmentations, which cost $3,000-$8,000, were the most lucrative of the invasive procedures, raking in $1.9 billion for plastic surgeons.

Rhinoplasties (nose jobs) and hyaluronic acid fillers were the next big sellers, with customers spending around $1.5 billion on each last year.

The rise in spending is driven by both soaring demand and climbing rates – a trend which analysts do not expect to wane any time soon.  

It’s no wonder, then, that Dr Schulman says he no longer sees patients coming in with celebrity wish pics – as they did with Jennifer Lopez and Kim Kardashian in the early 2000s. 

They bring screenshots of random people from Instagram – or of themselves, filtered.

‘They all bring the same pics of the same people on Instagram. They’re all 18-inch waist, big tight round butt.

‘Yes that’s why they call it a “wish pic”. But that’s not realistic and I tell them that from the start.’

The new study attempts to bring more attention to this connection as rates of plastic surgery, rates of social media use, and mental health disorders rise in unison. 

The cohort was small and niche – most of the 252 participants interviewed online last summer were white women, with an average age of 25.

But the approach was rigorous, and applauded in a peer-reviewed editorial. 

Through a series of questions about social media, self-esteem, appearance, and surgery, they gauged each person’s self-esteem, measured on two recognized scales: the Rosenberg Scale (0-30, with 0 being the lowest) and the Contingencies of Self-worth Scale (1-7, with 1 being the lowest). 

Those who were most enthusiastic about cosmetic surgery scored a 7 on a scale of 1-7. 

They then contrasted these scores with the apps they used, and whether they used filters.

Ultimately, they managed to map out how much a person was invested in a given social media app, and how strongly they felt about wanted to tweak their own faces.

They found all apps seemed to grate at self-esteem. Those who used WhatsApp and Adobe Photoshop had low self-esteem levels. 

But those who used apps that had a selfie element – Tinder, YouTube, Instagram, or Snapchat – were most inclined to feel that they may want or need cosmetic surgery down the line. 

It’s something social media bosses say they are aware of. 

Earlier this week, the CEO of Instagram Adam Mosseri said the company’s ‘number one priority’ is ‘well-being’, and to do away with ‘social comparison’.

But, the Georgetown surgeons wrote in their JAMA editorial, there is only so much you can do to curtail human nature on an app designed to show ourselves off and ogle at others. 

‘Humans possess a fundamental drive to compare themselves with others, and social networking sites can serve as a basis for amplifying these comparisons,’ the Georgetown surgeons wrote. 

They add: ‘It appears that social media platforms have provided a highly comparative environment that exists primarily outside the constraints of reality and have incentivized largely unhealthy behaviors. 

‘In this setting, the competition to produce maximally flattering—and often unrealistic—images has flourished, despite the evidence that it comes at the expense of the self-esteem of both the producers and the consumers of the content.’