Scrolling Instagram For A Plastic Surgeon? Don’t.

Hashtags like #ad and #spon have become increasingly common on social media. 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 and cosmetic-surgery clinics, doctors, beauticians and beyond — are being used more and more 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 recent study out of Northwestern University found that the majority of providers who market their aesthetic-surgery services on Instagram are not board-certified plastic surgeons.

According to the report, fewer than 18% of all the posts advertising cosmetic surgery on Instagram were placed by legit 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 senior study author Clark Schierle, MD, PhD, FACS. “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 cosmetic-surgery horrors that result in irreversible damage to the patient's face or body — and, in some extreme cases, even death. 30-year-old Siobhan Phelan of the UK nearly lost her entire upper lip after an unlicensed cosmetician botched her procedure; The Sun reported that she had paid just £125, or around $165, after spotting an ad on Facebook. Prices usually start at double that. Meanwhile, in New York, a 31-year-old mother of two died after receiving butt-enhancement injections, which she reportedly received in a residential apartment building.

“Although there are possible risks related to all surgeries, the risks are greater when visiting an unregistered or unlicensed surgeon, or a clinic facility abroad,” explains a representative from 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 plenty of properly certified doctors who use the social-media platform to advertise their services. After all, in 2017, it would be weirder not to have a social media presence.

As 28-year-old Melissa* from London tells Refinery29: “Cosmetic surgery is all results and process-based, so you want to be able to see ‘step by steps,' the before and after, and end results. Instagram is a great visual portfolio for that."

“I had been thinking about getting Botox for a while, and Instagram became my go-to for research and verifying results from various cosmetic surgeons,” she says.“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. 29-year-old Emma*, who says she's 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 gratification, selfie culture, and Kardashian-esque "perfection," the temptation can be hard to ignore. Especially when those "after" images and ads come up mid-scroll.

These aspirational images can absolutely 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.) Melissa found her surgeon through the Instagram of one of the stars of British reality show Love Island. “Having seen Olivia on the show and on Instagram, I thought she looked gorgeous," she says. "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."

UK-based cosmetic doctor Dr. Tijion Esho is a reality star in his own right: He has over 20,000 followers and stars on E4's Body Fixers. Speaking from his own experience, Dr. Esho emphasizes 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," he says. "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 trivialize procedures, leading to the patient not being prepared for the possible outcomes before booking their treatment,” Dr. Esho adds.

Considering that the average age for those seeking cosmetic surgery has dropped dramatically over recent years, and the age restrictions on Instagram are limited to 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,” says the representative from Mya. “Low prices and time-limited offers — which are against UK marketing regulations for cosmetic surgery — should be clear signs of untrustworthy providers.”

You just can't overestimate the importance of doing your research. Anyone who's considering plastic surgery should ensure they do some serious recon as opposed to a cursory Instagram stalk; looking at the pictures is not enough. After all, cosmetic surgery is for life, not just for a selfie — despite what our scrolling habits might suggest.