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Dysmorhpia, Fillerexia and the Selfie Syndrome

Dysmorhpia, Fillerexia and the Selfie Syndrome

When is enough, enough and who should decide?

The non-invasive cosmetics market can have a polarising effect, and recently fillers and injectables have been in the spotlight for the entirely wrong reason. However, whichever side you fall on, there does come a point where the desire to freshen your look transforms from reasonable into full blown dysmorphia.

Now, I am a big believer in the right to make your own decisions when it comes to treatments - however as a Dermatologist my concern is first and foremost with health (both of the body and of the mind).

Ensuring my patients achieve the results they desire, as well as letting them know when something is unnecessary is par for the course. My responsibility to my patients as a health care professional is not to just fill ‘em up until they say stop - but rather offer an expert opinion; sound medical counsel and to reinforce boundaries when necessary.

So what’s driving this change in how we perceive beauty and the lengths we will go to to attain it?

The pressure to be perfect.

I have seen first hand the transformative effect that injectables and aesthetic treatments can have on someone’s confidence in a positive way. This is especially the case when used in moderation and to correct/fix anatomical ageing or defects.

That being said, There is a fine line between enhancing and correcting the ageing process and overt distortion. Now, more than ever, there is the expectation for perfection. It’s something I talk about extensively when it comes to the facial symmetry myth (read here).

The drive behind this demand is the overwhelming power of social media, and reality TV. The Portrayal of individuals leading unrealistic lives with perfect appearances glamourises the excessive measures taken to achieve them. This doesn’t even take into account the filters and editing that goes into creating a world that doesn’t reflect reality. What does this lead to? Dysmorphia, the selfie syndrome and fillerexia.

The Reality of Dysmorphia and the Selfie Syndrome

As a practicing specialist I have literally had a patient tell me that they like how they look in the mirror BUT not in their selfie. We call this the ‘selfie syndrome’ and in many ways it is a form of dysmorphia. Dysmorphia is an abnormality in the perception of the shape or size of a body part or a disconnect between reality and what a patient thinks they see. This condition can be thanked for the epidemic of overdone lips, and oversized Brazilian butt lifts.

In fact the trend of clients requesting procedures because of a perceived imperfection they have picked up on their social media accounts, or an issue with their selfie is on the rise. In these cases, the explanation that the way a selfie is taken automatically creates a false image of how you look in real life, won’t change their mind.

Another increasing trend is patient’s wanting to look like someone else altogether. This is being fuelled by reality TV stars like the Kardashians, who are normalising the process of changing every aspect of your appearance with cosmetic procedures. The over the top looks encourage young people to want to copy them, hoping that it will lead to the same ‘glamourous’ life.

However, the truth is that drastically changing your appearance, whether it’s over the top lips or insane breast/butt enhancements is not going to get you a wardrobe of Chanel or a penthouse in the Bahamas. What it will create is a gravitational issues ten years later as your implants head south.

This is not to say that cosmetic surgery addicts haven’t existed until now, however the combination of

  1. The ‘selfie syndrome’; with
  2. The pressures of reality TV’s extreme make overs, and
  3. The increase of discount providers without the proper credentials,

is contributing to a phenomenon being coined as fillerexia. 

So what is fillerexia?

Fillerexia is an obsessive and addictive tendency to undergo procedures and fillers that change your appearance in such a way that it distorts your features rather than enhances them.

Similar to other disorders, it pushes features ‘beyond perfection’ so that the work is overtly noticeable with the belief it represents a sign of success, status, fame and wealth. Scarily this is starting to occur in young people in their early twenties, who have no signs of ageing or genuine issues.

The reason this is a problem in such young people is that it creates a demand for discount providers who don’t have the same qualifications; respect for duty of care or training that an experienced injector or specialist has.

A little known fact is that medical doctors receive under graduate training in psychology which helps us recognise when there may be issues that goes beyond skin deep.

There is far more to injecting than simply pointing a needle, and the cost of having these products injected into the wrong area can cause serious issues further down the track.

Some of the side effects can include a ptosis (lazy eye), facial drooping or even in rare cases blindness. For a long time now, mass providers have perpetuated the idea that getting your injectables should have as much thought put into it as a getting a haircut,  a facial, or your brows tinted - I’m here to tell you this is NOT the case.

So from a dermatologist’s perspective what are the tips when it comes to cosmetic injectables.

It all comes down to understanding what is realistic and being fully informed. It is not enough to simply walk into a consultation room and ask “what would you fix?”. First you need to have a healthy understanding of your facial aesthetics, and this includes making a list of things you love about your face, as well as the small tweaks you may want to have done. The attitude of “I hate my lips, I need more volume” is the first step down a path that can lead to an over-inflated, weird look.

Understand your injector’s aesthetic and speciality.

Not all injectors are equal in their skill set or specialty. I’ve said this before, however injectables is a legislative grey area especially in NSW. My advice, is always go into a consultation with the thought that just because this person can inject - doesn’t mean they should.

Ask them questions about their approach; talk to people who may have already seen them and in some cases request to see photos of their work. In the age of social media chances are they will have an account you can check out before you book in.

The consultation process should never feel like you are being sold to, and if it does get out of there! My recommendation is always to start conservatively, add more if needed, and ALWAYS keep a picture of yourself prior treatment, without anything, as a reference - we call it baseline.

Read my guide on how to approach cosmetic injectables here.

What to do when it all goes wrong.

In all cosmetic treatments there is an element of risk involved which you should be informed of before the procedure. There are strict pre and post care guidelines that should be followed, and if they are not followed this may cause an adverse reaction or undesirable results. In this instance it is vital that you work with your provider, follow a plan and in the worst case scenario seek a more advanced opinion on how to fix the problem.

If the issue is caused by negligence, inexperience or sheer stupidity - go somewhere else and If you haven’t already - see a specialist! When you have an adverse reaction to any cosmetic treatment, and it has been undertaken in a clinic without a doctor or specialist present seek expert advice. If, in the rare case, you experience an adverse reaction at the hands of an expert, listen to their advice and if their treatment plan is not working, seek a second opinion.

Compliment your treatments with the right skincare

After all is said and done no treatment will deliver the same results as a lifetime of looking after your skin with the right clinical strength skincare. After all, your skin is the largest organ, and in the same way that we need to eat a balanced diet to nourish it from the inside, we need to be applying topical ingredients to protect and repair it from the outside.The past 8-10 years have seen enormous advancements in the industry - just remember to research your ingredients and look for proven formulations.

We also know that the single most effective thing you can do to look healthy and youthful is to have clear glowing skin.

Shop the range of clinical strength skincare here.

More than skin deep

On a final note its important to remind ourselves that not everything is about whats going on on the outside. Although its important to look after ourselves by staying fit and taking care of our skin,  who we are on the inside is equally important. Never minimise your self worth purely on how you look (after all, in the long run those Hollywood stars often end up in rehab to work the inside out).

Comments on this post (6)

  • Oct 18, 2018

    Thank you for writing this very honest and informative article Natasha.
    I hope that your message reaches the wider younger targeted group whom have no signs of ageing however are making ridiculous decisions to be injected with fillers, Botox and all, in the hope to reach that look of Beyond Perfection. It worries me, that when these younger people do reach the age where their skin naturally ages and starts to sag, wrinkle and all, what treatment will they then expect?

    Additionally, I wish people understood the difference between a doctor with an “Interest in Skin Doctor” and a “A Skin Specialist – Dermatologist” !!! There are too many shonks out there now purporting to be ’skin specialists whom are actually not a dermatologist’, they are simply a doctor with an interest in skin. A true Skin Specialist is a Dermatologist. Same said for Beauticians.

    — Charmaine Cregan

  • Oct 18, 2018

    Really loved reading this blog, everything you have written is just so true! Its a shame our young people get influenced this way, its not going to change with all the social platforms out there now its only going to have stronger effect on appearances. That is why I have found this blog so amazing coming from Dr. Natasha Cook as she is giving real advice its not about changing your face to something fake its about helping you inside out on certain decisions. Thanks very much!

    — A.E

  • Oct 18, 2018

    Thanks Natasha, it was such a refreshing read.

    — Mary

  • Oct 18, 2018

    Dear Natasha,

    Excellent article that hit the nail right on the head. I’m always shocked that not only 20 somethings are going way overboard to the point they look deformed, but so are women in their 30’s and 40’s.
    I’m 46 with a lot of sun damage and wrinkles, yes hate to admit it, but from smoking. All I’m ever after is a ‘fresher’ looking me, still with some wrinkles, but softened, as if I’ve just had a holiday. A woman my age is deluding herself if she honestly thinks she can look like a 22 year old again with injectables.
    I also can’t understand, even with the cut price providers, how the hell do these young women, not far into their careers afford all those mls of filler! I’m on 6 figures and I still have to budget hard to get my twice yearly 4ml (applied in many places).
    Keep up the great articles and thank christ there is a specialist who is not only qualified and down to earth, but is keeping it real.

    — Selina Tosh

  • Oct 18, 2018

    A great message from Natasha.
    One hopes many read and follow the sound advice

    — Carmel Mcmahon

  • Oct 18, 2018

    Excellent article Natasha.

    — Joanne Arkley

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