Hashtags like #ad and #spon have become increasingly common on social media apps like Instagram. Is that a fashion blogger just going about her normal day with a good “detox” tea? Or is it just an(other) #ad?
Instagram has been tightening up its rules regarding advertising on the platform. Which is good. But in a world where social media profiles – from makeup artists to graphic designers, food bloggers, cosmetic surgery clinics, doctors, beauticians and beyond – are increasingly used as visual CVs, is it ever going to be possible to regulate everything?
One area where this is particularly dangerous is in the cosmetic surgery industry. In fact, a new study, carried out by researchers at Northwestern University, found that the majority of cosmetic surgery providers who market their services on Instagram don’t technically have the necessary certifications.
According to the report, fewer than 18% of all the posts for cosmetic surgery on Instagram were placed by board-certified plastic surgeons; many of the procedures were offered by other types of physicians, as well as barbers, dentists and at least one hair salon. What’s more, posts from other providers were found to be a lot more visible than those from certified cosmetic surgeons, who were more likely to use less search-friendly terms like #augmentationmammoplasty, as opposed to #boobjob.
“The confusing marketing on social media is putting people at risk,” wrote Dr. Clark Schierle, senior author of the Northwestern study. “There have been many recent reports of patient harm and deaths resulting from inexperienced providers offering services outside of their area of expertise.”
Indeed, news stories abound of horror cosmetic surgery procedures that result in irreversible damage to the patient's face or body, and sometimes even death. 30-year-old UK-based Siobhan Phelan nearly lost her entire upper lip after an unlicensed cosmetician botched her procedure. The Sun reported that she had paid just £125 (prices usually start at £300) after spotting an ad on Facebook. Meanwhile in the US, a 31-year-old mother of two died from enhancement injections to her bum, which she reportedly received in a residential apartment building.
“Although there are possible risks related to all surgery, the risks are greater when visiting an unregistered or unlicensed surgeon, or clinic facility abroad,” explained London-based cosmetic surgery clinic Mya. “Likely risks would be infection or undesirable results to name a few, plus unlicensed surgeons would also not provide comprehensive aftercare so if anything were to go wrong, you would have to pay for further surgery from another provider.”
The thing is, finding your surgeon on Instagram isn’t necessarily the problem, it’s what you do after that. There are tons of properly certified doctors who use the social media platform to advertise their services, posting to their at times millions of followers. After all, in 2017 it would be weirder not to have a social media presence.
As 28-year-old Melissa* from London – who recently had Botox with the same cosmetic surgeon as Love Island’s Olivia – told Refinery29: “Cosmetic surgery is all results and process-based, so you want to be able to see ‘step by steps’, before and after and end results; Instagram is a great visual portfolio for that.”
“I had been thinking about getting it for a while and IG became my go-to for research and verifying results from various cosmetic surgeons,” she explained.“I would often be served images or videos in my discover feed that made me feel confident that I wanted to move forward with it.”
Indeed, for many, it’s precisely the ease, simplicity and straightforwardness of Instagram that proves so appealing. Emma*, who is 29 and lives in London, and is currently saving up for a number of procedures, told us: “It’s a before and after; I am the before, and it’s showing me that I can be the after.”
In this world of seemingly instant pleasure, selfies and Kardashian-esque ‘perfection’, the temptation can be hard to ignore. Especially when those ‘after’ images and ads come up mid-envy-inducing scroll.
Indeed, these aspirational images can influence whether someone wants to get work done in the first place, as well as who they choose to wield the knife (a 2015 study found that 40% of patients said social media strongly influenced their choice of doctor). “Having seen Olivia on the show and on Instagram, I thought she looked gorgeous; then I saw that her cosmetic surgeon did the treatment I wanted in the price bracket I wanted and thought I would like to move forward with her,” explained Melissa.
UK-based cosmetic doctor, Dr. Tijion Esho, who has over 20,000 followers on Instagram and appears on E4’s Body Fixers, emphasises the importance of posting responsibly: “On my account I only use the original, untouched images so patients can see a true representation of my work; I have seen many accounts where images have been altered using Instagram filters and apps which give potential clients unrealistic expectations of the results which can be achieved.”
“I also regularly share posts that explain procedures, including what can go wrong. This is important as some accounts can trivialise procedures leading to the patient not being prepared for the possible outcomes before booking their treatment,” he added.
Indeed, with the average age for those seeking cosmetic surgery having dropped over recent years, and age restrictions on Instagram a very young 13+, it’s particularly important to increase awareness and education of the dangers, and ensure that prospective patients do their due diligence in researching both the person and the clinic behind the marketing.
“Any cosmetic or plastic surgery social media accounts advertising based on price should be seen as a red flag,” explained Mya. “Low prices and time-limited offers (which are against UK marketing regulations for cosmetic surgery) should be clear signs of untrustworthy providers.”
In the UK, all surgical clinics should be registered with the Care Quality Commission (CQC), while surgeons should be registered with the Royal College of Surgeons or the British Association of Aesthetic Plastic Surgeons and be on the General Medical Council (GMC) surgical specialist register.
For non-surgical treatments, the NHS recommends these be carried out by doctors, dentists or nurses, who should all be registered with their respective body (doctors: GMC; dentists: General Dental Council (GDC): nurses: Nursing and Midwifery Council (NMC)). Insurance cover should also be checked to make sure it is in place and up-to-date for both surgical and non-surgical procedures.
All of this information is readily available on the internet, and any prospective patients should ensure they do some serious googling as opposed to a cursory Instagram stalk. After all, cosmetic surgery is for life, not just for a selfie – despite what our scrolling habits might suggest.
*Names have been changed