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This Is What Plastic Surgery Looks Like Today

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Illustration by Tristan Offit.
Social media has brought the idea of plastic surgery into the spotlight in a way that was inconceivable just 10 years ago. Way back when, if a famous celebrity got a little bit of work done (or a lot, no shade), they'd hole up in a hotel room under an alias through their recovery, only to emerge looking refreshed a few weeks later. But thanks to stars and their fans constantly being plugged into Snapchat and Instagram, there's a visual archive that didn't exist before. We know when someone has gotten their lips plumped, because we can scroll back through their Instagram history and see the evolution.
The overexposure we're all acutely aware of is affecting the plastic surgery field in a surprising way — namely, how people actually go about adjusting things. Dara Liotta, MD, a plastic surgeon on Manhattan's Upper East Side, claims that she's seen an uptick in internet personalities as part of her clientele — specifically Instagrammers and YouTubers. What makes these men and women different is timing: Since so much of their business has to do with their faces, they can't afford to take the traditional few weeks off for recovery. "In the past, you'd get a surgical rhinoplasty (a.k.a. nose job) that involved a general anaesthesia, two weeks of black-and-blue, and up to a year to see your full results," Dr. Liotta says. "That's not realistic for people who need to be in front of a camera."

Instead, these folk are flocking to her for non-surgical procedures that require zero downtime — things like cheek fillers and lip injections. "What's interesting is that these are not anti-aging procedures, as has been the norm in plastic surgery," Dr. Liotta says. "The top three [procedures] for men and women that I see are non-surgical rhinoplasty, cheek injections, and chin injections." And the rate of these procedures has spiked. Three years ago, Dr. Liotta performed one non-surgical rhinoplasty a month. Now, she performs five in a week.

So how exactly are non-surgical treatments different than traditional plastic surgery? "Non-surgical procedures are aimed at producing a similar result [as surgical intervention] by using Botox and fillers," Dr. Liotta explains. Which sounds fantastic, but how, exactly, do Botox and fillers smooth out a bump on the nose or make a cheekbone pop? Dr. Liotta uses the example of a rhinoplasty. Say an individual has a pretty obvious lump on their nose they're not ecstatic about. Dr. Liotta would, in that case, fill the skin on the top and bottom of the lump to smooth it out and then use a little Botox to lift the tip of the nose. "We try to give them dramatic results that approximate surgery," she explains.
While the results are temporary, they're still significant — depending on how fast your body metabolises the fillers, the results can last anywhere from one to three years, according to Dr. Liotta. And there's the added benefit of reversal — something that isn't available with a traditional rhinoplasty. Since Dr. Liotta uses a hyaluronic acid filler, it can be easily dissolved with another injection if you aren't thrilled with your results, with little-to-no downtime. "People come in in the morning and then go out on a date later that night," Dr. Liotta says.

They're also getting these temporary procedures done for special events. Lisa Jane Parsons, a beauty YouTuber, had her lips filled this past May. "It had to do with my upcoming wedding," she explained. "I'd been looking into lip fillers for a while, and I knew it was sort of temporary. So if it wound up going wrong, it wouldn't be a permanent thing." She opted for Juvederm, which utilises hyaluronic acid to plump the lips, and then filmed a video explaining the procedure once it was done.
Parsons told Refinery29 that self-esteem or pressure had nothing to do with her decision to get Juvederm — it was just something she wanted to do. "I like to experiment with things, especially for my channel, and I'd always been interested in getting my lips done," she said. And it seems like others are interested, too. Her lip-filler segment has the most views of all of the posts on her channel. Parsons says that she actually used YouTube to do her research ahead of her injections, and wanted to give others information she hadn't yet seen in other videos.
This type of self-education is a common practice among Dr. Liotta's patients, as well. "Most of them come in knowing what they want to do, which is a change from the way things used to be," she says. Instead of showing pictures of celebrities, they use their own photos to illustrate what they want — everything from FaceTuned photos to images on Instagram where the light is hitting them just so.

"I'd say 85% of the time, they've researched the procedure [they want] online and they know what their individual fix is," Dr. Liotta says. "They're aware of their face and angles, but they are also savvy and are looking on websites and on YouTube, so they already know most of what I'm telling them." There are a lot of people who will point to that as the problem — we can't all look like Instagram filters in real life. They'll argue that there's something vain about looking at a photo of yourself, deciding that's how you look your best, and then relying on surgical intervention to get there. But what Dr. Liotta and Parsons seem to agree on is that this criticism doesn't come from outside sources — it comes more from within.

"I think that people have always been aware of how they look and what they'd like to change," Dr. Liotta says. "I think it's pretty naive to think that people didn't have this self-awareness before social media. It's just that now they have the opportunity to fix what they perceive as a flaw, and it's low-risk, temporary, and quick." In fact, Dr. Liotta sees it as being an extension of one's makeup routine — and Parsons agrees. "I consider it like semi-permanent makeup," she said.

And it's women like Parsons who are helping to remove the stigma of plastic surgery by being open about their procedures. Because of this openness, Dr. Liotta only sees this trend becoming even more commonplace. "I actually had a patient from Saudi Arabia [snap] her entire Kybella experience recently," Dr. Liotta says. "Now, I've got some of her followers flying in from Kuwait to have it done, too."
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