The Last Word: Video Calls and Aesthetic Treatments

By Dr Yiannis Valilas and Jacqui Finnigan / 27 Nov 2020

Dr Yiannis Valilas and psychologist Jacqui Finnigan explain how the ‘Zoom phenomenon’ could be contributing to a rise in patients

Video calling is now part of our everyday routine. It has enriched our lives during lockdown, ensuring we can still see our loved ones and has even allowed us to secretly wear pyjamas in business meetings! But despite video calling enabling good, solid communication between us during the lockdown period, it has also potentially had a negative impact on our wellbeing.

“Oh No, I look old!”, “Is that a new spot on my face?”, “I’m getting a double chin!”, “Gosh, I look tired today.” Does this sound familiar? From speaking with our friends, family and patients, these are just some of the things people are saying to themselves internally whilst on a video call. While we should be focusing on the person who’s actually speaking, instead we can be too consumed by our own appearance on the video. And it is this affect that is leading to many people now seeking aesthetic treatments.

Cosmetic surgeon and spokesperson for the British Association of Aesthetic Plastic Surgeons (BAAPS) Mr Gerard Lambe has voiced that he agrees that the use of video calling has led to more people seeking to change their appearance. Mr Lambe describes this as ‘the ‘Zoom factor’.1 People using cameras more than ever and their visual appearance being scrutinised on apps has certainly boosted enquiries for cosmetic tweaks and procedures. In addition, Mr Lambe argues that with many people working from home long-term, they will likely have more time to start planning their ‘dream procedures’.2 Although a demand in treatments is good news to practitioners, we highly believe the reasons behind the rise need to be considered, especially when consulting with new patients.

Mood and self esteem

Interestingly, there is psychology behind the trend, as using video conferencing is essentially the same as mirror gazing, which has been shown to have negative psychological impacts.3 When some people look at their reflection it can lead to a lot of self-criticism, leading them to compare themselves to other people. This is especially so if they are someone who has low self-esteem and focused on appearance or grooming. Having to sit in front of a mirror, all day, would potentially lead to that person becoming more anxious and depressed about their appearance.4

Studies have demonstrated that prolonged periods of mirror gazing increases distress, causing more dissatisfaction with one’s appearance, while also increasing sadness.5 This is because the patient is spending more time checking, comparing, critiquing and criticising themselves. In one study in particular, participants mirror gazed for just two minutes and afterwards rated themselves as being more dissatisfied with their appearence.6

Mood can really influence how people think they look, especially if they already have low self-esteem. In one study, a standard mood-induction procedure was used to induce positive, negative, or neutral moods in low self-esteem and high self-esteem groups. They were asked to evaluate their specific qualities and characteristics, such as ‘How smart are you?’ and ‘How kind are you?’. Both self-esteem groups evaluated themselves favorably in a positive mood, but the low self-esteem group lowered their self-evaluations when in a negative mood.7

It is also important to find out where patients are sourcing their self-esteem from. How one looks is important, of course, but there are lots of other important things that should contribute to good self-esteem such as relationships and how well people are doing in their professional life, as well as in their social life and hobbies. Appearance is important and there is nothing wrong in taking pride in it and having aesthetic treatments, but it mustn’t be the only thing that boosts patients’ self-esteem. If video calling has made patients aware of new skin concerns, then conducting a thorough consultation, where self-esteem and video conferencing are discussed, could be hugely beneficial.

In consultations

If patients come to the clinic for treatment saying that video calls make them feel insecure about their appearance, and that’s why they want the procedure, then a thorough consultation needs to take place, to see if aesthetic treatment is warranted or if, in fact, the patient would be better seeking treatment with a trained counsellor. Screening for body dysmorphic disorder, we believe, should always be part of the initital consultation process as standard. Patients need to understand that cameras, angles, lighting, screens, different resolutions and colouring can accentuate certain facial features. This is not the way they appear in real life and video calling is only one way to interact with people. An injectable therapy or two will never solve complex psychological issues.

Overall, we have a responsibility to make our patients feel good about themselves and help them to appreciate their individuality, while encouraging them to develop a stronger sense of self-compassion. When consulting with patients, we should educate them that perfection does not exist; uniqueness is far more beautiful. We have the responsibility to steer them away from unnecessary procedures they may want but don’t need, refusing to treat when necessary. Patients should also be given enough time to process all information related to the treatment and encouraged to ask questions.

Patients need to be heard, feel appreciated and feel good about the way they look. They should only begin their facial aesthetics journey if they’re emotionally stable and realise how far this journey can take them.


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