Why Are Requests For Plastic Surgery Reversals On The Rise?

As an influencer and aesthetician, Ryan Ruckledge spends a lot of time thinking about beauty and looking at beauty content on TikTok. It was there that the 30-year-old came across a trending cosmetic enhancement that would give his face the "lifted, feline look" he’d long desired: the 'fox eye' thread lift.

"It’s that snatched look all the celebrities have at the moment, with the lifted eyes and eyebrows. I thought that whole vibe was just amazing," he tells Refinery29.   

The procedure involves some pretty hardcore work, pulling someone’s eyebrows and eyelids up at an unnatural angle. Celebrities like Kendall Jenner and Doja Cat often serve as inspiration for the look, which can be done nonsurgically (often using dissolvable threads) or surgically. But even the nonsurgical option risks permanent damage, pain, bruising, infection and scarring.

If you have TikTok and have succumbed to browsing the more intense side of the cosmetics community, you’ll have seen this look many times before. It’s the surgery that’s rumored to have kickstarted Bella Hadid’s modeling career (she has said that she has not had an eye lift but, instead, that she uses face tape) and be behind Ariana Grande’s change in appearance recently. It's reportedly one of the most in-demand surgeries of last year, it remains so in 2022. 

Consultant ophthalmic and oculoplastic surgeon Dr. Elizabeth Hawkes tells Refinery29 that the procedure was originally marketed as an anti-aging treatment to lift the skin around the eye area and upper eyelids. "However," she explains, "it became popular with a younger audience who wanted to alter their appearance and emulate the looks of celebrities," much like Ruckledge. 

But like a wedge sneaker, the fox eye seems to be going out of fashion. Instead, shapes like 'doe eyes' (for some reason, people want to look like woodland creatures now) are dominating the For You Pages on TikTok. Once scarily prevalent fox eye 'before and after' videos are becoming scarcer. The term 'doe eyes', for example, has 388.3 million posts tagged on TikTok. In comparison, #foxeye has 306.5 million.

What happens when the work you've had done to your face or body is no longer in style?

Dr. Hawkes tells Refinery29 that she’s received a significant uptick in requests for reversals of fox eye thread lift surgery. However, while a tattoo can be removed and you can simply stop wearing and buying wedges, an eye lift carries serious risks — and can leave permanent scars.

"Fox eye thread lift procedures were a trend that was very popular last year, but now fortunately seems to be going out of fashion," says Dr. Hawkes. The hype, she says, was most likely a result of filters and apps, which alter the shape and size of the eyes. "But it's a very unnatural look based on a social media trend and generally it looks awful." Dr. Hawkes explains that the brow is supposed to sit just above the bone and the arch should be in line with the socket of the eyeball — markers of a natural face.

Dr. Hawkes adds that when her own patients want to reduce signs of aging around their eyes, she chooses other, safer treatments due to fox eye threads being so risky. "In many cases the threads used don’t dissolve naturally in the body and so patients are left with permanent lumps caused by the scarring underneath the skin," she tells Refinery29.

This is something that Ruckledge came to understand when, six months after his fox eye procedure, his body rejected his undissolved threads. He began to pick them out from under his own skin. "I didn’t really think anything [of the potential dangers]," he says. "Obviously with the way that the media and stuff is now, people portray this certain look, and there's new trends. I just thought, I'm gonna get it, and I didn't think too much into it."  

"My thread was being rejected by my body because it didn’t dissolve, so then I got a bad infection," continues Ruckledge. "Eventually I was on drips, antibiotics, steroids, saline flushes, and I was admitted to the hospital several times. The last result was to actually get them surgically removed, which I didn't end up doing because I would have been left with more scars. So I just had to keep on prolonging taking medication." Now, as he gears up for corrective surgery to reduce the "droopy, sagging eye" his faulty fox eye thread has left him with, Ruckledge regrets buying into the trend. "I’m so insecure about it and can’t wait to get it sorted."

Ruckledge has since used his TikTok account, where he has 66k followers, to warn people off the fox eye procedure. But it’s not just fox eye thread lifts that are wreaking havoc once they stop trending.

Thirty-year-old Karina* had her nose done in 2016. "At the time, the noses I was seeing on social media were what they call 'ski slope' noses – basically a little turned up and very cutesy and pinched in," she explains. "I remember asking the surgeon for a 'Kim Kardashian nose' and that's what I now have."

Fast-forward to 2022 and Karina is watching as trends change. "People are embracing their large, unique noses on social media," she says. "The Kardashian look is no longer the coolest look. Bumps and other things — which would previously be seen as something to get rid of — are now not just accepted but unique and being celebrated. As a result, I feel as though my nose job is obvious and outdated. Some days I yearn for my old nose!"

Karina is not alone. Bella Hadid has said she regrets the nose job that she had at just 14 years old. "I wish I had kept the nose of my ancestors," Hadid told Vogue. "I think I would have grown into it."

Other surgeries are going out of fashion, too. Also attributed to the Kardashian clan, and the white appropriation of Black features, the Brazilian butt lift (BBL) has the fastest growing uptake in the world compared to any other surgery. It’s also one of the most dangerous and deadly, with a mortality rate of one in 3,000 patients.

Between 2015 and 2019, the number of BBL procedures increased by 90%. A BBL involves the transfer of fat from one part of the body to the bottom. The fat is processed, prepped, then re-injected into the area, which is then closed by suture. It’s definitely not for the fainthearted. The hourglass shape has become a staple on TikTok, with the #BBL hashtag garnering more than 6.8 billion views, filled mostly with BBL 'before and after' shots. 

One of the many people who signed up for this popular tum-to-bum fat transfer is 26-year-old Grace*, a sex worker who spent years saving thousands to pay for the surgery. "I traveled to Turkey to do it in 2018," says Grace, "because it’s cheaper even with the flights and the hotel to do it there. I started getting self-conscious about how small my ass was and how thick that made my waist look, especially when I saw all these girls with huge asses online. I'm not gonna lie, I wanted the massive Kardashian ass so bad. It can be embarrassing being a Black girl with a flat ass. Men have always said stuff to me about it," she explains.

Grace was soon faced with the reality of the situation. "I don’t recommend getting surgery that invasive when you’re so far from home," says Grace. "I’ve never felt so isolated and homesick and the recovery was really embarrassing. I was in a padded diaper and needed someone else to wipe for me."

The worst part? Three years later, Grace has already gone off her BBL. "Now that people shame girls with BBLs on TikTok, it’s so awkward having one. And mine’s obvious. I definitely favor a smaller, cuter butt now too, especially now that the early 2000s, straight look is back and BBLs are starting to go out of fashion. I feel like I paid a lot of money to look lumpy and weird." Grace is saving "all over again" to have the fat transfer removed via liposuction, this time in the UK, where she lives.

Let's remember that BBL mortality rates are high. But fleeting surgery trends, whether for eyes, jawline contouring or nonsurgical nose jobs, are always going to carry a level of danger psychologically. 

Ellen Atlanta, a beauty writer, trend analyst and author of upcoming beauty book Pixel Flesh, says that catering your face to social media comes with huge ramifications.

Speaking to Refinery29, Atlanta says: "There’s been a resurgence in plastic surgery trends, thanks to the increased availability of cosmetic enhancements and tweakments (quick treatments you can have done on your lunch break)." The frustrating thing, says Atlanta, is that we know arbitrary beauty standards and expectations harm women. "Now we’re not just dealing with magazines and billboard covers. We immerse ourselves in thousands of unattainable, edited images of undisclosed augmented bodies daily."

Atlanta points out that in the early '00s, rates of depression, anxiety, and self-harm in adolescent girls surged in tandem with the rise of social media. "With the advent of social media, influencers, and the circulation of beauty images (more than we could ever have imagined or been prepared to see), trendy plastic surgeries are back."

Atlanta explains that there’s currently a specific fashion for "exaggerated features" which look better on the small squares in our Instagram grids. Though bigger features certainly capture more visibility in a saturated online space, Instagram face doesn't necessarily look good in real life.

According to the International Society of Aesthetic Plastic Surgery’s Global Survey, over 53,000 nonsurgical treatments were carried out in the UK in 2019. If you search #kyliejennerpackage on Instagram, you’ll be met with thousands of offers from practitioners promising cheek, jawline, chin, and lip enhancements inspired by the face of the billionaire.

Dr. Paul Banwell, a leading cosmetic surgeon and visiting professor of plastic surgery at Harvard Medical School, has seen a frightening hike in the number of patients specifically requesting 'Instagram Face' from him lately. "This is when people are seeking surgery to change their face largely because of current fashion seen on social media," he explains to Refinery29.

Twenty-four-year-old flight attendant Fran* spent over £5,000 ($6,012.50) in 2018 trying to achieve Instagram Face. "I've had Botox, dermal filler, weight loss injections, microblading, microneedling, and facial contouring. I also regularly get lash extensions and tape extensions." Fran says she loved the whole look of the "snatched, perfect Instagram Face". She adds: "I didn’t want to spend hours making it happen in the morning. I’d rather spend hundreds on treatments that are going to make me wake up like that, rather than spend more time and money on makeup." 

Fran tells Refinery29 that her friends (and the influencers she followed on Instagram and TikTok) soon ditched the snatched look in favor of the Glossier-esque, effortless vibe. "I felt like a bit of a clown when people started going natural and just wearing tinted concealer and doing the soap brows, while mine were tattooed on. I was still giving Bratz Doll."

Ultimately, Fran still loves her Instagram Face and is keeping it a while longer. "I can’t pretend I’m not tempted to reverse my Instagram Face for the new trends. I’m desperate to have that effortless, pale, freckled, messy brows, and shiny lips look that’s all over TikTok. But my mum pointed out that I already got so many treatments based on trends and I probably shouldn’t stop — or start others — based on another fashion. I definitely need to work out what I actually like on my face."

Dr. Banwell says that socializing online with filtered images may massively warp our idea of beauty. "Filters and apps used to completely reshape the face and body have become the norm among influencers and celebrities. Seeing faces through a filtered reality does alter people’s perception of what normal beauty is." Dr. Banwell now refers 30% of his patients to psychologists, rather than treating them. He was also one of the first UK surgeons to employ a psychologist to work alongside him in his practice. "I firmly believe that patients need to be supported from an emotional and a psychological perspective." Cosmetic surgery is very different from nonsurgical injectable treatments, says Dr. Banwell, but both categories need equal support.

A consultation process with an intrinsic focus on a patient’s psychological reasoning for any cosmetic treatment, whether surgical or not, is absolutely vital, says Dr. Banwell. He adds: "Surgeons and aestheticians need to be on the lookout for red flags signaling patients who are seeking alterations for trend-based or social media-rooted reasons." He often turns patients away when he cannot meet their expectations.

Based on what he is hearing from clients, Dr. Banwell says that people are now "definitely looking for a more natural look, rather than visibly changing their appearance".

Requests for procedure reversals are on the rise, too. "Reversals are not something we commonly needed to perform previously," he explains. "This has changed for two reasons. Firstly, as the number of patients wanting lip filler has increased exponentially it makes sense that some patients simply do not like the look of their lips and want to change, and so reversals are increasing in frequency, too. Secondly — and perhaps more concerningly — many patients now actually know this is possible so some play around with different looks as a 'fashion' and expect to dissolve their lips on a regular basis."

"However," he urges, "just as there are complications with injecting lip filler, there are also complications arising from dissolving lip filler."

"This is a potential disaster waiting to happen as significant fluctuations in volume to tissues can result in laxity and a poor aesthetic outcome. So the moral of the story is do not have lip filler lightly, choose your practitioner very carefully and observe the concept of natural proportions."

This applies to other procedures, too. A thread lift, a nose job or a BBL may not be so easy to undo, however.

Certain bodies, and by extension plastic surgery, will always weave in and out of fashion over time. We’ve got used to seeing headlines such as "Big Boobs Are Over" and "How To Get Bigger Hips Naturally" dominating the internet. There's a new ideal every other month. As a result, the UK government is cracking down on unregulated cosmetic procedures performed by unqualified experts. It has also introduced the Save Face campaign, which aims to ensure that people understand the risks of cosmetic procedures and know where to find the information they need to make informed decisions about their care.

Trend-based surgeries are not necessarily safe ones. We have to acknowledge that while cosmetic surgery can be empowering, and beneficial to a person’s confidence and self-esteem, it's an enormous decision. Trends and preferences change but once you've altered your appearance, it can't always be easily changed back.