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Is "Snapchat Dysmorphia" a Real Issue?

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Abstract

It was observed that in early 2018, several newspapers raised a concern about the negative effects of social media applications, such as Snapchat and Instagram, on users related to the choice of plastic surgeries. Several plastic surgeons have shared their experiences whereby they encountered requests sounding similar to what a "filtered" Snapchat picture would look like, with one plastic surgeon even having a patient who actually produced a "filtered" image. There are several red flags to look out for in such patients, and proper management in those cases should include counseling and not plastic surgery.
Received 02/24/2018
Review began 02/24/2018
Review ended 02/28/2018
Published 03/03/2018
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Is "Snapchat Dysmorphia" a Real Issue?
Kamleshun Ramphul , Stephanie G. Mejias
1. Department of Pediatrics, Shanghai Xin Hua Hospital Affiliated to Shanghai Jiao Tong University
School of Medicine, Shanghai, People's Republic of China 2. Department of Pediatrics, Robert Reid Cabral
Children's Hospital Affiliated to the University Iberoamericana Unibe School of Medicine
Corresponding author: Kamleshun Ramphul, adramphul@hotmail.com
Disclosures can be found in Additional Information at the end of the article
Abstract
It was observed that in early 2018, several newspapers raised a concern about the negative
effects of social media applications, such as Snapchat and Instagram, on users related to the
choice of plastic surgeries. Several plastic surgeons have shared their experiences whereby they
encountered requests sounding similar to what a "filtered" Snapchat picture would look like,
with one plastic surgeon even having a patient who actually produced a "filtered" image. There
are several red flags to look out for in such patients, and proper management in those cases
should include counseling and not plastic surgery.
Categories: Dermatology, Plastic Surgery, Psychiatry
Keywords: body dysmorphic syndrome, snapchat, instagram
Editorial
In early 2018, multiple newspaper outlets published several articles questioning the current
impact of social media applications, such as Snapchat and Instagram, related to the choice of
plastic surgeries. The term "Snapchat Dysmorphia" was also coined, and we cannot help wonder
how much these social applications are actually influencing the common man.
According to the American Psychiatric Association (APA) and Diagnostic and Statistical Manual
of Mental Disorders (DSM-5), body dysmorphic disorder (BDD) is classified along the obsessive-
compulsive Spectrum. Those suffering from BDD are preoccupied with at least one nonexistent
or slight defect in physical appearance. This can lead them to think about the defect for at least
one hour a day, therefore impacting their social, occupational, and other levels of functioning.
The individual also should have repetitive and compulsive behaviors due to concerns arising
from their appearances. This includes mirror checking and reassurance seeking among
others [1]. Currently, one in 50 Americans suffers from BDD [2].
The two main applications in question included Snapchat and Instagram, both of which have
187-million and 600-million daily active users. These two applications provide filters that
allow users to change their skin tone, soften fine lines and wrinkles, alter the size of their eyes,
lips, and cheeks, and change various aspects of their physical appearance. Dr. Yagoda, a plastic
surgeon, told the Huffington Post that he had observed many of his clients describing their
desired changes, which corresponded to what the filters on these two applications could
provide [3]. This claim was also supported by another plastic surgeon, Dr. Schulman. Renee
Engeln, Professor of Psychology at Northwestern University, has also pointed out that the
common man is losing perspectives on what he/she actually looks like due to these two social
media applications [4]. The term "Snapchat Dysmorphia" was thus brought to life.
1 2
Open Access
Editorial DOI: 10.7759/cureus.2263
How to cite this article
Ramphul K, Mejias S G (March 03, 2018) Is "Snapchat Dysmorphia" a Real Issue?. Cureus 10(3): e2263.
DOI 10.7759/cureus.2263
Another article published by The Independent reported a case whereby a plastic surgeon was
requested to make a patient exactly like one of her "filtered" pictures. Dr. Esho politely declined
and offered the patient some counseling help, which she eventually took. He also reported that
the patient felt better with the help she received and is now making great progress. Moreover,
he advised many physicians to look out for any red flags from patients who might have any
underlying signs of body dysmorphia [5]. The outcomes of such plastic surgeries are usually
unrealistic. This latest trend among millennials has been evolving for some time, but it is
strange. Many factors may influence someone to opt for a surgical intervention to alter their
appearance, consequently making psychological support a great help for the concerned person.
While the term "Snapchat Dysmorphia" might be too early to be brought into play, the risk of
these patients turning to Snapchat and Instagram filters as a source of inspiration for their
desired plastic surgeries is a big issue. There are already some ongoing legal issues about the
use of Snapchat in the operating room by some plastic surgeons but none currently involving
any patients accusing Snapchat of giving them a false perception of themselves yet. The proper
code of ethics among plastic surgeons should be respected and an early detection of associated
symptoms in such patients might help provide them with the appropriate counseling and help
they need.
Additional Information
Disclosures
Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors
declare the following: Payment/services info: All authors have declared that no financial
support was received from any organization for the submitted work. Financial relationships:
All authors have declared that they have no financial relationships at present or within the
previous three years with any organizations that might have an interest in the submitted work.
Other relationships: All authors have declared that there are no other relationships or
activities that could appear to have influenced the submitted work.
References
1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders .
Washington, D.C.; 2013. 10.1176/appi.books.9780890425596
2. Prevalence of BDD. (2018). Accessed: February 24, 2018:
http://bdd.iocdf.org/professionals/prevalence/.
3. ‘Snapchat dysmorphia’ points to a troubling new trend in plastic surgery . (2018). Accessed:
February 24, 2018: https://www.huffingtonpost.com/entry/snapchat-
dysmorphia_us_5a8d8168e4b0273053a680f6.
4. 'Snapchat dysmorphia' causing young people to seek plastic surgery. (2018). Accessed:
February 24, 2018: http://www.foxnews.com/lifestyle/2018/02/22/snapchat-dysmorphia-
causing-young-people-to-seek-plastic-surgery.html.
5. More people want surgery to look like a filtered version of themselves, rather than a celebrity,
cosmetic doctor says. (2018). Accessed: February 24, 2018:
http://www.independent.co.uk/life-style/cosmetic-surgery-snapchat-instagram-filters-
demand-celebrities-doctor-dr-esho-london-a8197001.html.
2018 Ramphul et al. Cureus 10(3): e2263. DOI 10.7759/cureus.2263 2 of 2
... Now, Snapchat has a "Story" feature, where users can share photos and videos with a broader audience for 24 hours (Habib et al., 2019). Snapchat also offers filters that allow users to change their skin tone, the size of their facial features, and even their voice, as well as soften their fine lines and wrinkles (Ramphul & Mejias, 2018). ...
... Snapchat is now one of the most popular social networking applications, and its use has grown rapidly (Piwek & Joinson, 2016). Snapchat offers users filters to change their features, such as skin tone, eyes, nose, cheeks, lips, fine lines, wrinkles, and even voice (Ramphul & Mejias, 2018). Taking and editing selfies has been shown to have a significant influence on negative body image (Mills et al., 2018). ...
... When one is not satisfied with one's body, one might want to beautify one's features and have cosmetic procedures. As frequently asserted by plastic surgeons, many patients have requested to have cosmetic procedures to look like their filtered images (Ramphul & Mejias, 2018). ...
Article
Within the history of social networking applications the use of Snapchat has risen rapidly. Users of Snapchat can apply filters to change their appearance before they share photos. The present study aimed at assessing body dysmorphic features among Snapchat users of “Beauty-Retouching of Selfies” and its relationship with quality of life. A total of 507 Arab females participated in this study by responding to the Quality of Life (QOL) and Body Dysmorphic Features (BDF) scales as well as some demographic questions. Results showed that the mean of the body dysmorphic features was slightly above the theoretical mean of the BDF scale, which indicates that females who use Snapchat Beauty-Retouching features have a high tendency toward body dysmorphic features. Additionally, the quality of life mean was clearly above the theoretical mean of the QOL, which means that participants in general have a good quality of life. The study found a fundamental relationship between the two variables, QOL and BDF, and the relationship is in the negative direction. The results indicated that the relationship between BDF and QOL changes with age, educational levels, and social status. This study proposes further research to focus on identifying the most noteworthy factors influencing body image and QOL.
... The researchers assert that individuals with low self -esteem tend to participate in the attitude of editing self -images to find more attractive images and appear differently, and this is a form of self -presentation (Lowe-Calverley & Grieve, 2018) and then spread them through social media (Vendemia & DeAndrea, 2018) that allows interaction between individuals to meet their self -esteem (Khanna & Sharma, 2017) because their low self -awareness is distorted (Wendt, 2014) Plastic surgeons indicated that patients make frequent visits to cosmetic clinics to perform operations to change their shape to make it closer to their image, which was edited through social media applications with the aim of improving the aesthetic appearance and feeling satisfied with their external appearance (Brucculieri, 2018). When these images become the basis of social media and in real life, the idea of what is universally attractive also changes, which can affect self -esteem and a lack of personal security, so they feel that they don't match the specializations of the shape they want in the real world (Ramphul & Mejias, 2018) . (Chen et al., 2019) emphasized that the main drive towards plastic surgery is dissatisfaction with body image. ...
... Body image dysmorphic disorder is classified according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V) within the category of obsessive -compulsive disorders, as affected individuals suffer from body dysmorphic disorder with excessive preoccupation, with one or more of the perceived or imagined defects that are not present or may be at least slight in their physical appearance and the sufferer focuses for hours on one of his physical defects that doesn't appear to be a defect at all, perhaps it was so insignificant that he did not draw attention and he might become obsessed with his shape, which leads him to think about this defect and thus affect his social and professional functions (American Psychological Association, 2013). He also engages in repeated behaviors of the fears arising from his appearance, so he does his best to hide the imperfections he imagines, which generates involuntary habits, such as constantly examining his appearance in the mirror, seeking reassurance from others and changing cloths to alleviate his anxiety and tension (Ramphul & Mejias, 2018). ...
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The study aimed to examine the predictive ability of the attitude towards plastic surgeries and self-image editing with symptoms of body dysmorphic disorder among university students. The sample of the study consisted of (1225) male and female students, by 357 males and 868 females. To achieve the objectives of the study, plastic surgeries attitude scale, self – editing behavior scale, and the body image dysmorphic symptom scale were used. The results showed statistically significant differences in the levels of the attitude towards plastic surgeries, the behavior of self – image editing and the body image deformation disorder attributed to gender. The results showed that the attitude towards plastic surgeries and the behavior of self – image editing have predictive ability for the level of symptoms of body dysmorphic disorder among females, an amount was interpreted by (7.1%). In addition, the results indicated that the self – image editing behavior was predictive of the level of male body deformity symptoms, as it interpreted an amount of (7.9%) of the total variance.
... 28 The impact of social media on health can be complex, with evidence ranging from problems related to social harassment and low self-esteem 29 to what was called "Snapchat Dysmorphia" in 2018, which describes the desire for plastic surgeries to alter appearance to look similar to unrealistic photos with digital "filters" used in social media. 30 Besides the impacts of social media on health, other screen time SB activities can be addictive or contribute to preexisting disorders. For example, online shopping has been shown to be associated with more severe cases of buying-shopping disorder. ...
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Sedentary behavior (SB) has become a prevalent behavior amongst several population subgroups worldwide. This increase in SB is alarming, as this behavior has been associated with several adverse health outcomes. With the advancement of technology, the relationship of individuals with SB has become increasingly complex, and available instruments, theories, and research face challenges to keep up with this evolution. Four issues regarding research on SB are discussed in this opinion article: (i) advances in its typology and measure; (ii) health impact of quantitative and qualitative indicators of SB; (iii) the good side of SB; and (iv) challenges and future directions of studies in this field of knowledge. This opinion article raises some questions based on the limitations of current research with its advances and gaps. Some challenges and research recommendations are compiled, and other can be drawn from the ever-growing scientific evidence related to SB across different fields.
... There are several red flags to look out for in such patients, and proper management in those cases should include counseling and not plastic surgery. (Ramphul and Mejias 2018) The stresses of an unrealistic expectation of how one appears, leads to self-destructive outcomes, particularly for young girls. Snapchat Dysmorphia applies primarily to youth but can affect adults to a lesser degree. ...
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Throughout the previous century, medical professionals aimed to ease the inner tensions found within transgender individuals by conforming their outer appearances to their preferred gender identities. Repeated studies have found a reduction of gender dysphoria through sex reassignment surgeries and hormone therapies. Although well-intentioned, these efforts were on their own insufficient for relieving the underlying distress caused by gender dysphoria. Moreover, transgender individuals, even after sex reassignment procedures, have higher risks of mortality, neoplasms, suicidal behaviors, and psychiatric morbidity than the general population. Faith-based conversion therapies double the morbidity rates of transgender individuals. A religious approach not based on medical science produces worse outcomes than providing no support at all. A lack of family and communal support of transgender youths leads to increased homelessness, prostitution, and substance abuse. The uncompromising, tough-love approach does not lead to positive outcomes for many transgender youths. Medical evidence from the previous decade suggests a neurodevelopmental cause for transgender identities; however, studies on Rapid-Onset Gender Dysphoria point to social causes for the spike of adolescents identifying as transgender. While high rates of pre-adolescent children diagnosed as transgender desist in their dysphoria, some studies have shown that adolescents who take hormone blockers do not desist into their early twenties. Longer-term follow-up studies are needed to know the effects hormone blockers have on desisting when prescribed early. Nominalist gender theorists have integrated transgender identities into their ideology, whereby the body, mind, and spirit are not essentially united. Although these ideologies attempt to liberate individuals from restrictions of biological realism, this ideology has not offered transgender people an inner sense of peace. According to a 2018 Human Rights Campaign study, individuals who identify as non-binary and other newly named gender identities suffer from the highest levels of depression, anxiety, and suicide attempts. Under the transgender umbrella are three groups of people: (1) those with early-onset gender dysphoria, (2) those with Rapid Onset Gender Dysphoria, and (3) gender theorists who are part of the 4th wave of feminism. Those with early-onset gender dysphoria suffer from a medical condition that desists at a rate of 80% by adolescence—the 20% who persist benefit from some form of social transformation into the opposite sex. The vast majority of people calling themselves transgender are from the second category who are mostly adolescent females. Like self-harm and eating disorders, this social contagion peaks at seventeen years of age, desisting in adulthood. Autistic young people are significantly affected. This group is primarily looking for an identity and supportive community. The gender theorist has capitalized on this chaos and effectively presented the transgender identity as a way of reinvention. Those with gender dysphoria require support, those with gender confusion need guidance, and gender theorists need to be philosophically challenged. Thomistic realism offers additional resources for transgender individuals, which secular science cannot offer on its own. Thomism embraces all disciplines of science and the humanities to present a holistic expression of the truth. The Thomistic heuristic utilizes medical science and seeking to restore nature by the least invasive means while depending on virtues and grace to provide wisdom and character to overcome obstacles. This book argues that using a Thomistic heuristic in line with church teaching is better than medical therapies alone, faith-based conversion therapy, or adopting a nominalist-based gender theory ideology.
... These filters have even been a driving force for some of its users to pursue cosmetic modifications. This phenomenon known as "Snapchat dysmorphia" has led to patient encounters with plastic surgeons, and likely dermatologists, singularly focused on cosmesis to resemble these filtered images [53]. Understanding the basis of these requests may help guide clinicians during these encounters, as these may be particularly challenging or unrealistic expectations to meet. ...
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Accessed: February 24
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Prevalence of BDD. (2018). Accessed: February 24, 2018: http://bdd.iocdf.org/professionals/prevalence/.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. Washington, D.C.; 2013. 10.1176/appi.books.9780890425596
  • Ramphul
Ramphul et al. Cureus 10(3): e2263. DOI 10.7759/cureus.2263 2 of 2