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23 April 2021

How facial anxiety is triggering a cosmetic surgery boom

A year of Zoom meetings and face filters has distorted our view of ourselves. Now cosmetic clinics are seeing a jump in bookings before the June reopening. 

By Sarah Manavis

If I wanted to, I could probably calculate exactly how many days I’ve had good skin as an adult. It’d roughly equate to six months: from the end of summer 2019 – when an aesthetician convinced me to stop using the aggressive skincare products I was accustomed to – until March 2020. You can already guess what ended it: the pandemic destroyed any sense of balance in my life, including on my face. From spring last year, I had skin like an unlucky teenage boy, with acne across my chin and cheeks that, even if I didn’t aggravate it, still managed to stick around for weeks and scar. 

After months of trial and error, my skin’s balance has returned, but the hyper-pigmentation from a year of extreme breakouts is still visible even through make-up. Until now, this wasn’t something I had to worry about – I could soften my features on Zoom and use the Instagram “Paris” filter if I ever posted a selfie. But the return to normal life has me researching laser facials costing thousands of pounds, wondering if the expense would be worth it to stop worrying about how bad my skin looks.  

In the last year, we have spent more time looking at ourselves than any human being should ever need to. Work meetings, Zoom quizzes, and family Skype calls have meant that our own faces constantly hover in our eyeline. Now we don’t just know what we look like in the mirror, but how we look during the minutiae of our facial movements; when we nod, when we rest our cheek against our hand, when we turn and are seen in profile. 

This perpetual reflection has coincided with the rise of Instagram plastic surgery face filters – a trend I thought had already become pretty extreme when I wrote about it in 2019. Looking back on that piece now, two things stand out: that some celebrities were using these filters despite already having had plastic surgery, and the concern expressed by professor of psychology, Melissa Atkinson, that we would soon become reliant on these filters. In just 18 months, both of these things have become the norm. 

Now, across the country, plastic surgeons and beauty clinics are recording a spike in requests for cosmetic procedures – both surgical and non-surgical – ahead of a full reopening in England, currently planned for 21 June. Botox, fillers, nose jobs and full face and neck lifts are all in high demand. The industry had a quiet 2020, due to lockdowns, but now some practices are registering increases in requests for facial surgery, in some cases of as high as 200 per cent. 

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Surgeons are noticing that many of their clients view 21 June as a deadline, and the reason for booking an appointment. “There is absolutely an element of pressure on people to look a certain way as we emerge from lockdown,” says London-based oculoplastic and ophthalmic surgeon Dr Elizabeth Hawkes. “We’re also unfortunately seeing a very imbalanced view of beauty at the moment.

[see also: I check my inbox at 11.30pm and read an email about returning to the office. Disquiet sets in…]

“We’re spending a lot of time scrolling through filtered images online instead of interacting with people in person due to the current restrictions,” she says. “The stress of the pandemic, coupled with us seeing a permanent reflection of ourselves on Zoom calls, has absolutely been a catalyst.”

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Dr Hawkes says she has noticed a particular increase in requests for blepharoplasty surgery – an operation on the eyelids to make them less droopy, giving the appearance of being more alert and, subsequently, looking younger. She adds that this has been especially popular among her male clients concerned about looking too old, and believes mask-wearing has increased the focus on how our eyes should look. 

Looking younger – despite the knowledge that we’re all still living through the same gruelling pandemic, and that time has, indeed, passed – is a major concern among people seeking cosmetic surgery.  “Many of my patients feel that they have aged at an accelerated rate during the last 12 months,” says Dr John Quinn, a cosmetic surgeon at Quinn Clinics in Bristol. He cites the stress of recurrent lockdowns, isolation, and the pressure of home working, home schooling, and job insecurity as the main reasons for his clients’ perception that they look much older. However, he notes, it is simply a perception. “Using detailed complexion analysis and 3D imaging, for most of my patients this just does not fit with reality,” he says. 

Some surgeons believe that extreme anxiety is ultimately why a significant number of people are seeking their services, and that this anxiety needs to be addressed first. “The ageing process hasn’t necessarily sped up, we are simply a lot more stressed and more self-critical,” Dr Quinn says. “If you are suffering with symptoms relating to anxiety and/or depression, this may need assessment and treatment first.”

[see also: It’s not just you: Why the current lockdown is having an extreme effect on mental health]

The face filters that have triggered this increased interest in cosmetic surgery all display a very singular type of European beauty: cat-like eyes, small noses, full lips, and a pointy face, a look popularised by supermodel Kendall Jenner (who has had cosmetic surgery herself and regularly uses face filters). It’s hard to find a mainstream influencer or celebrity who doesn’t use at least some form of face-sculpting filter when posting selfies or speaking to camera. And of course, these are only the filters Instagram flags to us – there is a whole market of apps (like FaceTune) that filter faces and bodies in pictures and in videos which can then be uploaded undetected on social media. 

Dr Paul Banwell, a plastic surgeon and the founder of multiple cosmetic clinics across south-east England, thinks these filters are causing an increase in cosmetic surgery enquiries – particularly, he says, among young women. The average age of his clients continues to fall. 

“Socialising online with filtered images throughout the pandemic has massively warped our idea of beauty,” he says. “We’ve only seen other people through a filtered reality for a very long time and we’re forgetting what ‘normal’ beauty looks like.” 

For some, this risk of “forgetting normal” may take them to breaking point. A number of reality stars – including Love Island’s Molly-Mae Hague and The Only Way Is Essex’s Megan McKenna – have begun to document for their followers how they are undoing their cosmetic procedures, dissolving lip fillers and removing implants. “I had a bit of body dysmorphia,” McKenna said on Good Morning Britain at the start of March, adding that she couldn’t remember what a “normal face looked like”.

But while some celebrities may be moving away from this standard of beauty, in general, the trend is only getting more extreme – with popular filters altering our faces to fit an ever-more unachievable ideal. The cheekbones are higher, the noses are smaller, the pouts are even more inflated. 

“We’re creating a single, cyborgian face,” Dr Banwell says. “And if you look at ‘weird’ for long enough, it changes what you perceive as normal.”