F**k 2020.



Remember all the memes about how much 2020 sucked? Think about our naive excitement to ring in the new year in 2019. A few months later, so much changed, and so quickly. Just weeks into the madness, we all longed to go back to normal. 

But slowly, lockdowns, social distancing, masking, remote work/school, and videoconferencing made it harder to recall what normal even was. For as much as we hated the changes happening around us, we were changing too. 

The Shift

As an aesthetic provider, I became acutely aware of a societal change in self-perception. Despite the morbid realities of Covid and the limited ability to be seen in-office, the number of patients seeking to improve their appearance skyrocketed. 

Dermatologist Shadi Kourosh and her colleagues examined the trend and published their findings in Facial Plastic Surgery & Aesthetic Medicine. [1]

Their research confirmed what many theorized: Cosmetic consults have surged, at least in part due to hours and hours of videoconferencing. They dubbed the phenomenon "Zoom Dysmorphia," explaining that we never see ourselves quite the way we do on a videoconference…

“Zoom adds an additional level of complexity by displaying one's emotions in real-time, leading users to watch themselves speak and react to others, which may cause a person to notice expression lines and wrinkles they are not used to seeing while looking in the mirror. Additionally, one's reflection is displayed side by side to other members of the call, allowing for easy comparison and self-judgment…

…as patients remain unaware of how cameras can distort and degrade video quality and inaccurately represent one's true appearance… the result is an overall more rounded face, wider set eyes, broader nose, taller forehead, and disappearing ears obscured by cheeks…”

[1] Shauna M. Rice, Julia A. Siegel, Tiffany Libby, Emmy Graber, Arianne Shadi Kourosh,

Zooming into cosmetic procedures during the COVID-19 pandemic: The provider’s perspective,

International Journal of Women's Dermatology,

Volume 7, Issue 2,

2021,

Pages 213-216,

ISSN 2352-6475

As if staring at this funhouse mirror version of ourselves isn't bad enough, we can't help but feel we're being watched. And unlike in real-life settings, we can't actually know who may or may not be watching! (Truthfully, people are likely just as preoccupied with their own unsympathetic reflection.)

To Make Matters Worse

The increased time at home meant social media use was at an all-time high. After hours of staring at a Bizzaro World webcam version of one's face, many would pour over perfectly staged, Facetuned, and filtered photos on platforms like Instagram. For young females especially, this slowly reinforced ideas about what they "ought" to look like.

Remember Snapchat Dysmorphia? The term was coined by psychologists in 2015 to describe the preponderance of aesthetic or plastic surgery patients seeking treatment to resemble the tuned-up, unrealistic selfies they'd create (in apps like Snapchat). 

Perhaps the ability to control our appearance on social media made the loss of control we experienced on Zoom all the more upsetting. Sure, we have little control over our appearance in real life, but at least we can run and hide! (Not to mention, the typical in-person meeting doesn't involve everyone in attendance staring at one another blankly.)

The Impact 

While lots of us are uncomfortable with videoconferencing, a subset of individuals finds it downright debilitating. Studies say 1 in 50 people suffer from Body Dysmorphic Disorder, a body-image disorder characterized by persistent, intrusive thoughts about an imagined or minor defect of the face or body. Given the shame inherent to the condition, the numbers of those affected are likely even higher.

The average person is self-conscious about some aspect of their appearance. Still, people with BDD have an all-consuming preoccupation with the supposed flaw, causing significant emotional distress and impairment. As many as 24-28% will attempt suicide.[1]
[1] Phillips K. A. (2007). Suicidality in Body Dysmorphic Disorder. Primary psychiatry, 14(12), 58–66.

The virtual mirror of videoconferencing is traumatizing for folks with BDD, and experts now believe it can trigger BDD in those susceptible. Meanwhile, it looks like these virtual meetups aren’t going anywhere any time soon. 

The Future

As vaccinations offer the promise of a waning pandemic, Kourosh et al. (2021) determined that returning to more in-person interaction is something many, especially young people, are anxious about. The researchers blame videoconferencing for exacerbating that anxiety…[1]

[1] Channi Silence, Shauna M. Rice, Samara Pollock, Janet E. Lubov, Linda O. Oyesiku, Sonya Ganeshram, Alexa Mendez, Freyja Feeney, Arianne Shadi Kourosh,

Life After Lockdown: Zooming Out on Perceptions in the Post-Videoconferencing Era,

International Journal of Women's Dermatology,

2021,

“Three in ten said they planned to invest in their appearance as a coping strategy to deal with returning to in-person events…

…Those who spent more time staring into the "technological mirror" expressed more anxiety…”

[1] Phillips K. A. (2007). Suicidality in Body Dysmorphic Disorder. Primary psychiatry, 14(12), 58–66.

[1] Channi Silence, Shauna M. Rice, Samara Pollock, Janet E. Lubov, Linda O. Oyesiku, Sonya Ganeshram, Alexa Mendez, Freyja Feeney, Arianne Shadi Kourosh,

Life After Lockdown: Zooming Out on Perceptions in the Post-Videoconferencing Era,

International Journal of Women's Dermatology,

2021,

To Cope