The TikTok logo is displayed outside a TikTok office on December 20, 2022 in Culver City, California. Credit: Mario Tama/Getty Images via TNS

When social media users are bombarded with beauty-related content, one’s self-confidence can be affected. 

In the U.S. alone, the #beauty hashtag has a staggering 156 billion views on TikTok at the time of publication, according to TikTok for Business Creative Center. The #plasticsurgery hashtag has also accumulated 17 billion views. The videos with these hashtags can lead to unhealthy comparisons, Kyla Brathwaite, a Ph.D. candidate in the School of Communication who researches body image and positivity, said. 

Objectification theory may help explain why self-deprecation increases during or after social media use for women in particular, Brathwaite said. The theory suggests women are more susceptible to analyzing their own bodies because of the correlation between matching beauty ideals and receiving positive treatment from society, she said.

“You’re getting body-oriented messaging about what you should wear, what you should look like and what trends you should follow,” Brathwaite said. “We have our phones at our fingertips. We have that ability to ruminate over our appearance.”

Social comparison theory — the idea that people assess their personal need for improvement via comparison to others — is relevant to conversations surrounding insecurity online, Brathwaite said. Upward comparisons occur in an aspirational vein, as these comparisons involve looking up to someone who is conventionally attractive. By contrast, downward comparisons are rooted in self-serving condescension and require an individual to seek out someone they deem less beautiful than themselves, she said.

According to a 2016 study, participants who spent the most time on social media throughout the day had over double the risk of reporting body image concerns. Those who reported checking social media frequently throughout the week had over 2.5 times the risk.   

Such comparisons are made on TikTok in rapid-fire succession, and the popularity of subtle face filters blurs lines further, Brathwaite said.

“You’re not even accounting for the fact that people are using filters,” Braithwaite said. “You’re not even getting an authentic version of what these people look like. You’re getting their idealized version of themselves.”

Beyond filters, TikTok and other social media platforms have a substantial impact on plastic surgery trends, Dr. Craig Lehrman, a board-certified plastic surgeon and an assistant professor of plastic and reconstructive surgery at Ohio State, said.

Lehrman, who is also the director of aesthetic surgery in the Department of Plastic and Reconstructive Surgery at the Wexner Medical Center at Ohio State, said buccal fat removal — in which fat pads are extracted from a patient’s cheeks to achieve a thinner, more defined look — has become an increasingly trendy procedure. 

“I think it started with some celebrities having the procedure, even though they won’t acknowledge it,” Lehrman said. “But it’s fairly visible.”

Since the surgery is not one-size-fits-all and can lead to undesirable outcomes for those without excess buccal fat, Lehrman said seeing its popularization online is somewhat concerning.

“As they age, you’re going to see more hollowing develop there, which will look worse as they become older,” Lehrman said. “There’s not a great way to replace that fat. You can’t just go in there and say, ‘Well I’ll just put some fat in there later, or filler in there later.’”

According to a 2021 study from the University of South Florida, the comparison of pre- and postsurgical patients on TikTok as well as the positive perception of plastic surgeons and on procedures and practices “legitimized the use of plastic surgery to correct beauty imperfections and thus increased the purchase intent to do so.” While the intent has not been directly correlated with users getting procedures done, the intent is being “intensified” over time as the user continues to watch content relating to plastic surgery, which is influenced by the platform’s algorithms, according to the study.  

Breast augmentation, liposuction, rhinoplasty, Botox injections and lip fillers are all commonly requested procedures for people under the age of 25, Lehrman said. Regardless of the specific procedure being considered, potential patients should independently research risks, Lehrman said. 

Wielding a scalpel is not like waving a magic wand, so honesty is needed on both fronts to ensure a surgery’s lasting success, Lehrman said.

“I think that any time you’re changing someone’s appearance, it can be a dangerous thing,” Lehrman said. “I think it all comes down to the discussion about expectations and goals and being fully transparent with each other.” 

Lehrman said he thinks plastic surgery should be about becoming a better version of oneself as opposed to a different person entirely. In terms of the future, Lehrman said understatedness will be desirable.

“I think the trends going forward are going to be people heading toward a more natural appearance,” Lehrman said. “You’re seeing a lot of celebrities tone back the overemphasized features that were kind of more common in the ‘90s and ‘80s.”