Inside the surreal, probably inevitable world of plastic surgery apps

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In the Android mobile game Princess Plastic Surgery, a blond and bug-eyed princess has been cursed by a witch. "The witch made them ugly!", Reads the description of the application. "Only you can help them! Do not miss the opportunity to become a professional plastic surgery doctor." The icon on the application's home screen shows the princess staring at an approaching syringe, her eyes filled with tears. His lips have swollen to take the lower half of his face.
The application, created by Bravo Kids Media, is one of dozens of similar plastic surgery games and applications currently available for download. Nose Doctor Fun Kids Game, an Android application apparently designed for anyone looking for those keywords, says that children "will learn a lot about medicine" by giving a good job to a cartoon character. Celebrity Plastic Surgery Hospital asks you to operate on different parts of an animated woman's body. In the Little Skin Doctor treatment game, you give a cartoony patient a shrug.
Unsurprisingly, these colorful cartoon games, which are often explicitly designed for a younger and more vulnerable public, have met with resistance. The Butterfly Foundation, an organization that works to prevent and treat eating disorders, is currently executing a Change.org petition as part of its Endangered Bodies initiative. The petition, "Stop aesthetic surgery applications aimed at children: #surgeryisnotagame", has garnered more than 119,000 signatures.
Apple and Google have removed at least some of these applications from their app stores in the past. In 2013, an application called Plastic Surgery & Plastic Doctor & Plastic Hospital Office for Barbie was removed from the iTunes Store after a violent online reaction. "This unfortunate girl has so much extra weight that no diet can help her," the description said. "At our clinic, she can undergo a surgery called liposuction that will make her thin and beautiful, we'll have to make small cuts in the problem areas and absorb the extra fat, will you operate her, doctor?" It was recommended for ages nine in ahead.
A liposuction application for over 9 years old was extracted from iTunes
Still, this opposition does not seem to have discouraged application developers. One application that distinguishes the Butterfly Foundation request, Plastic Surgery Simulator ("become Victoria's Secret model immediately"), has been downloaded anywhere between 10,000 and 50,000 times. Bravo Kids Media applications have high ratings and huge download numbers, from Crazy Pregnant Mom Makeover (4.5 stars in App Store) to Clumsy Santa ER Surgery (more than 100,000 Google Play downloads).
Just as reality shows Botched and I Want a Famous Face before them, these applications take advantage of our collective cultural obsession with cosmetic surgery. However, unlike reality TV, there is an explicit gamification in operation: they appear in the App Store and Google Play Store game categories, and promote the idea that a perfect body or face is the goal, that "win" comes Only when you complete a surgery In Princess Plastic Surgery, the patient can choose a ball gown as a reward.
While these applications are not new, they have become more absurd and widespread in recent years. Bravo Kids Media, launched in 2015, has created more than 30 Android applications. (In 2009, Reuters reported that there were only two plastic surgery applications available for the iPhone). Nor are they an independent rarity. They exist in a spectrum of applications, from Photoshop applications that weigh a lot to those that connect users with real surgeons, who have become an important part of the growing culture of life that surrounds cosmetic surgery. Together, everything is part of an online ecosystem that has supercharged society's historic mission of making people feel bad for their bodies and possibly spend money to feel better.

Last year, the Nuffield Council on Bioethics in the United Kingdom, an independent body covering medical topics, published a report on the ethics of cosmetic procedures. He argued that cosmetic surgery applications were part of a worrying and growing trend of "self-control applications", such as calorie counters and sleep cycle applications, because they allow the user to "measure" their face against an ideal.
"The game aspect of some of the applications I found made me uncomfortable," wrote Kate Harvey, a senior researcher who contributed to the Nuffield Council report. "The invasiveness of cosmetic procedures and the possible vulnerabilities of those who could access these procedures means that playing with beauty ideals is a very cautious path."
According to a study published in 2017 by the American Psychological Association, university students currently experience higher levels of anxiety than previous generations, in part due to the need to achieve a "perfect" life such as those carefully selected in networks. social:
Studies indicate that exposure to the self-perfect representations of others within social networks can intensify one's own concerns about body image and sense of social alienation. Other data suggest that young people are struggling to cope with a visual culture that emphasizes unrealistic bodily ideals … Young people seem to have internalized irrational social ideals of the perfectible self that, although unrealistic, are eminently desirable and obtainable for them.
Whether these conditions are the cause or effect of self-modifying applications such as Plastic Surgery Simulator, however, it describes a mature climate for its proliferation.
"One of our concerns was that applications made it easy to create images that would be quite unreachable," Harvey told The Verge. "The images they create lead to unrealistic expectations about what aesthetic surgery can achieve."
"One of our concerns was that the applications facilitated the creation of images that would be quite unreachable"
While most of these plastic surgery applications have a rating of 17+ or T for teens, there is no way to prevent someone younger than 17 from downloading them, unless there are parental controls on the phone. And while children and adolescents may be the most vulnerable to the influence of plastic surgery applications, adults are barely immune to the dream of physical perfection. If weird, cartoonish games are for kids, then a more realistic set of Photoshop apps could appeal to teens who are already used to filtering their selfies perfectly.
That's why filters in applications like Instagram and Snapchat are also part of this ecosystem. Snapchat users, for example, have criticized the company for its "beauty filters" that, instead of highlighting the particular beauty of a user, often brings them closer to a white European ideal by lightening skin tones, Shadow the blue eyes and thin the noses and jaws.
"Selfies have a greater amount of commitment, in terms of likes and comments, than other photos [on Instagram] and filters increase it even more," Yuheng Hu, assistant professor at the University of Illinois, who studies Instagram filters and its effects on users, said The Verge. "And then, once that happens, it encourages users to keep posting selfies."
The relationship between filters, Photoshop applications and plastic surgery applications is certainly correlated, if not causal. Slim & Skinny, a photo editing application, invites users to upload photos of themselves and to alter them digitally. Against a bright pink interface, you are presented with several options, in which "thin" becomes a verb: you can "thin out" your face, "slim" your chin and "slim" your head. The application of plastic surgery eBody offers a virtual tour of the office of a surgeon where you can "make a lipo to your boyfriend and give him the six pack you always wanted" (this would involve uploading a photo of your boyfriend and thinning his torso). .) "For girls, you can have a virtual breast augmentation, buttocks or just a liposuction." (This involves loading a photo of you, of a woman, and manipulating it). As with many of these self-modification applications, the instructions are explicitly addressed to women.

As plastic surgery becomes safer and more accessible, it is also becoming more penetrating. In 2016, Americans spent more than $ 16 billion on plastic surgery procedures. The trend is also global. In a 2013 report for The Atlantic, Zara Stone details how K-pop stars influence aesthetics in South Korea, where one in five women has undergone cosmetic surgery. A recently popular procedure among K-pop stars, online surgery, involves shaving the jaw to create a V-shaped face. Technically called "corrective jaw surgery," it is a procedure that requires the jaw to be Cable closure for six weeks and may cause permanent numbness or death.
But thanks to technological advances, what is at stake has decreased for many procedures, making cosmetic surgery more attractive to a wider potential clientele. According to a 2017 report from the American Society of Plastic Surgeons, "minimally invasive cosmetic fat injections" increased 13 percent between 2016 and 2017; while facelifts have increased by 4 percent since 2015. As noted by Annie Lowrey at The Cut in 2016, the prevalence of injectables and lasers in Hollywood has made it difficult to say what "natural" looks now. "Patients are captivated by instant improvements in the face," said ASPS President Debra Johnson in the 2017 report. "It is evident in the popularity of applications and filters that change the way we can shape and shadow our faces. "
That popularity of those applications is not limited to simple games. In the digital age, medical professionals have begun designing and using legitimate plastic surgery applications that allow potential patients to visualize or even plan operations to alter the body. Often linked to the office of a specific surgeon, these applications offer users price quotes for procedures and the option to request consultations.
"[These apps] are to improve communication with the patient: his idea of ​​a subtle change and my idea could be very different," Dr. Richard Rival, a plastic surgeon in Toronto, told The Verge. Rival has had a customized application for approximately two years that allows his patients to see what they would look like after a particular surgery. "Our ideas [of a feminine-looking” nose] can be very different, with applications, it's likely that [more] is on the same page."
For patients, it is about visualizing their options before going under the knife. For doctors, it's about making sure patients get what they're looking for. Dozens of surgeons offer applications like this, which are similar to software already in use in their offices.
"At the end of the day, elective surgery is a business," says Hisham Al-Shurafa, founder of Pixineers, the medical software company that created the Rival application. Al-Shurafa, whose company has created more than 20 applications for surgeon clients, explains that these applications are intended to encourage more hesitant potential patients. "Some clinics approach it from a type of heavy sales, so this application gives people the opportunity to explore the option without the pressure or without having to go through any obstacles."
But even when applications relieve pressure for some, they can increase it for others. "It's always a concern, especially among the younger ones," says Rival. "I do not market [the app]people really only come through my website, so they're already interested in rhinoplasty, it's not that the application creates that insecurity, the insecurity is already there."

"It is important to distinguish between some applications managed by cosmetic surgeons that are more of a marketing tool and applications that are presented as more than one game," says Harvey. "There has been very little empirical research on the effects that these [games] have on people, even if they are really motivated to undergo a cosmetic procedure, but what we can say is that playing with appearance in this way and encouraging people to manipulate their appearance according to social norms is detrimental to appearance [confidence in]. "
"It's not as if the application created that insecurity, insecurity is already there"
While medical applications can help solve a communication problem and prevent aggressive sales tactics, games and filter applications can simply aggravate a problem that already exists. Cosmetic surgery applications are just one aspect of a culture that prioritizes youth and beauty, especially women, in almost everything else. And as long as there is a financial incentive to continue prioritizing it, the products will probably continue to exist.
Or, as Benjamin Melki, creator of the Face and Body Photo Editor application, says: "I knew there was a market for this, because the concept was based on the fact that people want to be beautiful."

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