In a recent article on news.com.au, Sydney Plastic Surgeon, Dr Naveen Somia, PhD., FRACS, Specialist Plastic Surgeon explains how the easily accessible viral content on social media platforms, slowly but incrementally acts to undermine the risk of cosmetic procedures by distorting facts and blurring boundaries.
The cosmetic surgery industry is becoming increasingly defined by consumers who have had ‘botched’ experiences, due to lack of research into the procedures or practitioners, or by simply being falsely marketed to and misled online. A lack of research often results in poor outcomes, life-changing deformities and in some extreme cases, death.
In this blog post, ASAPS member and Sydney based Specialist plastic surgeon Dr. Naveen Somia, urges consumers to act with caution when using social media to research aesthetic procedures, and aligns with the broader patient safety advocacy activities of ASAPS.
Dr Naveen Somia, Sydney based registered Plastic Surgeon, says:
Jessie Carr, a 21-year-old gym receptionist from Sydney, underwent a fox eye thread lift after seeing Bella Hadid’s results online. After googling the procedure, and browsing photos on various clinic pages, a before and after image of Bella Hadid was one of the main images they used to advertise the fox eye threads. In fact, the Tiktok video in question has since amassed over 20,000 likes.
Had Jessie Carr searched for this procedure on leading cosmetic surgery websites like ASAPS (asaps.org.au) or that of any registered specialist plastic surgeon, she would have realised that this procedure is not offered by Plastic Surgeons who are experts in the field. This should have sent alarm bells ringing, why aren’t registered specialist surgeons who are experts in the field talking about Fox Eye Lift procedures, and offering this?
With increased consumption comes increased acceptance and normalisation.
The problem is that many of the so-called ‘experts’ who promote cosmetic procedures on social media may not be registered specialists with appropriate level of expertise. The advice they give is of debatable accuracy that may potentially cause harm.
As the demand for cosmetic surgery rises, social media is flooded with face tuned and filtered photographs. As there are no barriers to prevent access to photos and videos of cosmetic procedures or cosmetic surgery on social media, or online in general, the consumption is increased. With increased consumption comes increased acceptance and normalisation.
With reality shows documenting celebrities’ cosmetic procedures, children have been exposed to the idea of cosmetic surgery at a young age. The result is cosmetic surgery or cosmetic procedures now being normalised in the eyes of our youth. It is important for our society to be aware of the psychological effects and body image issues that social media has on our younger generation.
There are so many ‘unseen risks’ to this procedure, and others such as fillers and thread lifts, that are not mentioned on social media platforms, which limits the consumers ability to make an informed decision ahead of undertaking such procedures. Specialist Plastic Surgeons see patients who need additional treatment or surgical revisions when these seemingly innocent and “quick fixes” go wrong.
What even is a Fox Eye Lift?
The Fox Eye lift is a brow lift performed with a stitch, a procedure where surgical stitches or ‘threads’ are used to pull the brow area taut, resulting in an upward-slanting look to the eyes. The fox eye lift bears no resemblance to an existing surgical procedure nor is it supported by evidence. It is a catchy marketing term to glamorise a complex medical term by downplaying the risks, with the sole intent of selling the procedure. The fox eye lift is also not tailored to the individual, it is a cookie cutter, one size fits all, poorly designed and likely to end in disaster – as many patients have witnessed.
The eyebrow and the eyelid aesthetics are complex because of the intricate anatomy and nuanced aesthetics that are unique to everyone. This complex area can take an experienced plastic surgeon years to master, but for the novice non-surgeon, it is a treacherous area where things can go wrong easily, and with great risks. Eyelid and eyebrow aesthetics are individualised and vary from person to person based on gender, ethnicity and age, and it should come as no surprise that a cookie-cutter approach is unlikely to achieve a good outcome.
This isn’t a procedure that most plastic surgeons would advertise, and the majority of ads offering this are by practitioners who are not registered surgeons, or in some cases, not even registered doctors.
The truth behind the Fox Eye Lift.
While the procedure is credited with giving the likes of Kendall Jenner and Bella Hadid their reinvented eye shape, it must be noted that the trend has been deemed by many to be an offensive cultural appropriation of Asian facial features, and widely criticised. Regardless of the controversy surrounding the procedure, the hashtag #foxeyethreads has over 36 million views on social media, and, according to beauty brand Tanologist, searches for “fox eye makeup” have grown by 319 per cent.
However, a quick search for ‘fox eye lift’ on The US national library of medicine, the authority website that houses 33 million scientific articles (pubmed.gov) returned ZERO results. In contrast to this, a search on Google returned zero websites of registered specialist plastic surgeons offering a fox eye lift. Medicine is meant to be evidence based and decisions ought to be data driven. In this instance we see neither. The ultimate price is paid by the patient.
The Fox Eye Lift is not so innocent.
The procedure is in the same non-surgical category as dermal fillers and anti-wrinkle neurotoxins. This automatically mis-informs the patient, by putting it into a “safer” bracket of treatments – but it isn’t the case. The Fox Eye Lift is priced higher than dermal fillers and anti-wrinkle neurotoxins, and its risk and safety profile is vastly different. Dermal fillers and anti-wrinkle neurotoxins are well established products with an excellent safety profile that produces reliable, and repeatable results consistently.
As a result, consumers expect that all non-surgical treatments will, like Botox and fillers, produce consistent results. This in turn makes them more willing to try newer treatments as they hit the market, when they’re really just there to capitalise on patient expectations.
The results produced and the duration for which results last from Botox and fillers do not vary between age, gender, and ethnicity; the same cannot be said for fox eye thread lifts. The threads are inserted into an area that is near the eyes, where numerous nerves, arteries, veins, and muscles are not only critical for normal function, but for aesthetics as well. This means that most results from a fox eye lift will be different, as all eye areas are subjective to that patient’s age, gender or ethnicity. In Jesse Carr’s case, she was left with extreme swelling, permanent scarring, and protruding ‘horn-like’ puckered skin around the site of the procedure.
The growing risks of unrestricted access to social media
There is growing concern among professionals about the rising numbers of young women and girls getting information about cosmetic procedures from social media platforms. While it is natural to look at images of perfect eyes, perfect noses, and lips online and make an unworthy comparison, this is now starting at a much younger age of 10 or 11. Having unrestricted and easy access to cosmetic surgery, or cosmetic procedures at a very young age is bound to have repercussions.
If you speak to girls as young as 12, you will be surprised at the depth of knowledge they have about cosmetic procedures and celebrities, based on what is being fed to them on social media platforms.
What more can we do as surgeons, or as patients?
More should be done to restrict children’s access to cosmetic content online. This will involve dialogue between the government and social media tech giants such as Instagram and Tik Tok. Individual businesses cannot be prevented from posting content on social media, but practitioners telling the truth about their education and levels of qualification should be mandated by AHPRA if it is a medical practice, and ACCC if it is business.
I also urge anyone looking at images on social media to consider the various elements of deceit that could be at play. For example, your favourite celebrity endorsing a product or treatment or a social media influencer promoting a treatment without declaring the conflict of interest are important factors to consider.
Prospective patients should consider the use of filters, a change in lighting in before and after imagery and, especially where celebrities have been used as a comparison, to ensure that the content is factually correct. Before and After photographs alone conceal much of the entire process, such as the consultation process, operation preparation, recovery times and the aftercare processes involved.
It is important to remember that these procedures will be marketed as quick and easy fixes, to make them sellable, when this isn’t always the case. For Jessie, who is still dealing with the results of her botched fox eye threads, sharing her story is a community service for women or girls who might be considering having the procedure done.