Instagram's New Policy on Cosmetic Surgery and Weight-Loss Content for Minors
“THIS IS ENORMOUS NEWS,” wrote actress and activist Jameela Jamil on Instagram last Wednesday. “After a great deal of shouting, yelling, and petitioning … we have managed to draw the attention of the top officials, and they have heard us and wish to protect us.” Jamil was, of course, responding to Instagram’s declaration earlier that day that it will censor—and in some instances remove—any content promoting weight-loss products or cosmetic procedures to users under the age of 18.
Under the fresh policy, any post that advertises weight-loss products or cosmetic surgery with a price or other purchasing inducement will be concealed from underage users. Content linked to a commercial offer for weight-loss and diet products, including discount codes, or that makes an “extraordinary” claim about results will be eliminated from Instagram altogether.
The news arrives as Instagram persists in grappling with the influence of influencer sponsorships and advertising and the strong connection of social media to mental health. Many believe this alteration has been overdue and that it will aid in promoting body positivity among teenagers while safeguarding them from potentially detrimental information. But when considering how vital these social platforms have become for the expanding plastic surgery domain and the participants within it, others ponder what the actual implications will be on the industry.
“The new ban is undoubtedly a stride in the correct direction,” states Dr. Eva Krumhuber, a lecturer in experimental psychology at the University College of London. Alongside three other scholars, Dr. Krumhuber carried out a study earlier this year that explored the effects of social media usage on young women’s aspiration for cosmetic surgery. The findings indicated that “viewing images of females who have undergone cosmetic enhancements influenced young women’s desire for cosmetic surgery, especially if they spent a considerable amount of time on social media, followed numerous accounts and were less content with their appearance.” Despite this connection, however, Dr. Krumhuber and others are aware that a social media ban is not the solution. “From existing research, we know that aside from social media use there are several sociocultural factors [that] predict young people’s inclination to undergo cosmetic surgery,” she says.
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The majority of plastic surgeons we conversed with stated they generally would not carry out any cosmetic surgeries on patients under the age of 18, but that does not imply that there are no other plastic surgery procedures suitable for teenagers. “The sole procedures we perform on children are otoplasty, to pin back prominent ears, and suturing facial lacerations if a kid falls or gets struck in the face,” says New York City plastic surgeon Dr. David Shafer. These surgeries are not typically the ones posted on social media, he explains, “but when they are posted, it is usually not for attracting new patients but for raising awareness.”
Nevertheless, there are some exceptional cases where cosmetic surgery is provided to underage patients. “There might be circumstances where there is an issue that has significantly impacted a teenager’s self-esteem and cosmetic surgery can bring about substantial improvement in their life,” says Dr. Matthew Schulman, a New York City plastic surgeon, noting that this can occur when teens are bullied due to a physical characteristic. “But the decision to operate on someone under 18 years old is a decision that is made on a case-by-case basis and depends on discussions between the doctor, patient and parents.”
The medical community seemingly concurs that Instagram’s action is intended to target influencers, but they fret that along the way it might affect board-certified plastic surgeons who use the platform responsibly. “Social media is significant for educating patients and spreading awareness about new products and procedures,” says Dr. Shafer. “However, it’s a double-edged blade. There are many individuals on social media who are unqualified and not even doctors, in many instances, who are promoting treatments and procedures that carry real risks, and there is no quality control or accountability for those who post false results or unrealistic outcomes.” Dr. Shafer hopes the ban will mainly impact influencer types and non plastic surgeons who build their practices on false hype and false expectations, but he does believe that additional regulations should be implemented to safeguard the genuine and beneficial use of the platform. “Posting plastic surgery stories and pictures should not be prohibited, as there are legitimate patient-education and awareness benefits to social media posts,” he says. “So perhaps requiring posting credentials, years of practice or other elements would be appropriate.”
Although it is still too early to determine what Instagram’s new policy will precisely look like in practice, many are concerned that it might result in further intrusive rules. “I think this is a slippery path,” says Dr. Schulman. “I think it is well-intentioned and is designed to stop posts that sensationalize cosmetic treatments targeting teens—however, my worry is that it will also target posts that are educational in nature.” Dr. Schulman also anticipates that the ban will considerably reduce the number of before-and-after posts on Instagram and will cause many plastic surgeons’ accounts to focus more on lifestyle posts instead of surgical posts.
Most successful plastic surgery practices would continue to flourish even without social media, but the platform has played a crucial role in shaping the industry in recent years. “There is some aspect of attracting new patients from social media and other sources,” says Dr. Shafer. But beyond that, social media has helped shape the general public’s understanding and perception of plastics. “Plastic surgery, as an industry, has a long history of being stigmatized and silenced to the extent that it has been driven to backstreets and black markets—sometimes with fatal consequences,” wrote Dr. Lara Devgan, a New York City board-certified plastic surgeon, on an Instagram post over the weekend. “Adding censorship and opacity—rather than correct and transparent information exchange—will likely lead more people into harmful situations.”
Dr. Devgan also fears that Instagram’s ban would impede the dissemination of information and, consequently, the development of new practices. “The marketplace of ideas flourishes when information is shared,” she wrote. “We can observe examples of the good, the bad and the average. We can understand personal journeys. We can see recovery processes. We can quickly share information about new techniques and new products. For both plastic surgeons and people interested in plastic surgery, the ease of information sharing improves outcomes and safety.”
Instagram’s new policy may or may not assist in preventing irresponsible behavior and the inappropriate targeting of underage users, but doctors think the action will not truly reverse consumer trends. “This decision won’t change consumer interest in medical aesthetics,” wrote Dr. Devgan. “What it will change is the ease of access to safe and reliable information on which to make sound decisions.”
