Filtered face, when there is demand in the clinic
In recent years, a demand has emerged in my clinic that fits the description of an "Instagram filter face": excessively full lips, very high cheekbones, a narrow jaw, large eyes, and flawless skin. This face is anatomically impossible; it is merely a digital distortion. Patients requesting this aesthetic in the clinic has even given rise to a medical phenomenon: "Snapchat dysmorphia." In this situation, the patient experiences psychological distress due to the difference between their face in the mirror and their face altered by digital filters.
A good physician does not simply meet this demand as it comes. Doing everything requested with the phrase "It suits you" is a commercial gain in the short term, but a regret for both the patient and the physician in the long term. In the clinic, I generally draw a polite but clear line against this demand.
Not a filter; guidance
I have a phrase I tell my patients about this: "Don't envy your filtered image; because that image is not yours." This sentence is the beginning of this process. Afterwards, we set a realistic goal together: the most balanced, vibrant, and harmonious version of your face. This goal is truly achievable; it can be more satisfying than a filter.
This guidance approach is a medical responsibility. Otherwise, the patient will visit every clinic and try to approach a goal that gets further away each time. This path is a clinical dead end. A good physician is one who can stop their patient before they embark on this path.
Clinical note:Instagram or TikTok making you feel "inadequate" is not an aesthetic diagnosis; it is a psychological condition. Clinical decisions should not be made on this basis. First, solidify the foundation.
BDD and psychological evaluation
Body Dysmorphic Disorder (BDD) — perceiving a non-existent or very minor flaw in one's body as a major problem — is a condition that should not be overlooked in aesthetic consultations. Aesthetic procedures in patients suspected of BDD may reinforce the problem instead of solving it. The correct path for these patients is psychological support first, and then aesthetic planning if necessary.
The diagnosis of BDD is certainly not the job of an aesthetic physician; however, being aware of it and referring suspected patients to the appropriate place is the responsibility of a good physician. In the clinic, I allocate particularly careful initial evaluation time for such patients.
- Is the complaint noticed by the patient's surroundings, or only by the patient?
- How much time does the patient spend on the complaint? (hours a day?)
- How many procedures has the patient had from how many places before?
- Motivation: for themselves, or to show someone else?
- Is it possible to set a realistic goal?