Beauty standards in the digital age are changing how we look at ourselves – and not just aesthetically

Boring online meetings might be one reason why people are increasingly drawn to cosmetic procedures. On these occasions, our gaze often wanders down to our own image in the corner of the screen and we start worrying about how pale, tired or old we look. This will be enough to motivate some people to have their nose straightened, seek Botox treatment or book an eyelid operation.

Ada Borkenhagen, a German psychoanalyst and professor of psychosomatic medicine, has been researching body image, cosmetic procedures and selfoptimisation for decades. Here, she explains why she believes that our digital appearance has become more important to us than how we look off-screen.

When you walk down a street and observe people, what do you notice?
In Berlin, I often see the so-called “Instagram face” among young women up to the age of 38 – full lips, high cheekbones, big eyes and a clear chin line. This look comes from beauty filters on social-media apps, which offer us a beautified version of our face when we film or take pictures of ourselves.

Do you mean that you see these online faces in real life too?
This kind of face has become a model for many beauty surgeries in what is now a global trend. It seems as though there are more women than ever with filled lips. Don’t be fooled: you probably only notice lip treatments in three out of 10 women who have had them.

So we only recognise interventions when they have been poorly implemented?
Yes. Beauty procedures reveal differences between social classes. If you can afford a good practitioner, they will do procedures that suit your face and will be more careful when it comes to fashion trends such as the Instagram face.

Are those inflatable-boat-like lips that you occasionally see the work of bad surgeons?
The heavily exaggerated duck snouts, the beaks, the ski-jump lips – these are part of fashion. Even a mediocre surgeon can do an Instagram face. But making me look how I did 10 years ago is the high art of aesthetic medicine. And you pay for that – but also for the surgeon who says, ‘We’d rather not do anything here.’

A director of a beauty clinic once said that women essentially get these inflatable lips for other women. He doesn’t know any man who finds them beautiful. What do you think?
I didn’t ask men about it but the fact is that behind this trend are beauty-filter algorithms that are based on universal beauty characteristics: the face should be symmetrical, the skin flawless and the proportions balanced. Women should have a heart-shaped face with large eyes and a narrow chin. Men are considered beautiful when they have a striking jawline. Their eyes might be a little deeper, their nose a little bigger and their eyebrows more pronounced.

When everyone is guided by these universal beauty ideals, don’t faces start looking more and more similar?
Yes. The Instagram face has prevailed. You will see women with it in Zürich, Tokyo, Cape Town, New York and beyond. Is there a difference between on-screen and off-screen beauty? Our virtual lives have become much more important. Today it’s crucial how you look in photos, on the internet and on video calls.

Is this something that you have noticed in your research?
Studies show that young people with high levels of social-media consumption have a greater tendency to have procedures done. Sometimes they come to the surgeon with a photo of themselves that has been beautified with a filter and say, ‘This is what I want to look like.’ In analogue [real] life, you might see yourself in the mirror two or three times per day. That’s different to those who are very active on social networks and constantly see each other through the selfie camera. So it’s only logical that a lot of people want to look better in photos and videos.

Selfies offer a wide-angle perspective, which makes you look different from in a mirror, so you adapt your face to a lens.
Yes. But this doesn’t mean that people don’t care about how they look in real life. It’s just that not everyone can afford a beauty style that looks good both on and off the screen. This reveals differences between social classes.

How does a good doctor deal with a patient who wants an Instagram face?
They would, for example, tell a patient who has quite pronounced cheekbones that if they inject too much, they’ll look like a hamster. But a patient of a cheaper doctor might end up with hamster cheeks because some are willing to simply exaggerate their features.

If it’s about wealth and class, why do so many Hollywood stars have operations done that look so obvious? Surely they could afford to hire the best surgeons?
In the US, different ideals of beauty prevail. Interventions are not really hidden there – they are viewed as a sign that you have money.

Actress Jamie Lee Curtis recently caused a stir when she spoke in an interview about ‘the genocide of a generation of women by the cosmeceutical industrial complex’ and how the filter face had robbed them of their natural appearance. What do you think?
I see it that way too. But it must be said that these women voluntarily underwent their beauty procedures. That is why self-knowledge is important. Beauty ideals change. You have to understand that before you go under the knife. In the 1990s, for example, many women shaved their eyebrows and then tattooed on new ones. Today that seems completely old-fashioned.

The pressure to be beautiful has entered the intimate realm: today some men have their penis enlarged and women have their labia made smaller.
That’s right. The vulva, for example, has become far more publicly visible. Pubic hair has become increasingly scarce. If you only wear a little fabric, you don’t want a huge cloud of it.

What role does pornography play?
The first Playboy featuring a fully shaved woman appeared in 2000. A beauty ideal for a more intimate area emerged.

What is that ideal?
Male genitals should appear large and prominent, while female ones should appear as small and hidden as possible. This ideal has developed in parallel with the depilation imperative for the female body. The moment that areas are no longer covered by clothing, a beauty ideal arises for these body parts. When skirts became shorter, leg hair had to be removed; when armpits became visible, armpit hair had to go. And now that people wear swimsuits with very high leg cutouts, pubic hair has to go.

There is also a trend for intimate shaving among men.
Yes. But the reason for that is different. When a man removes his pubic hair, you can see the entire penis shaft so it looks bigger.

It’s interesting that women seemingly have the opposite impulse: the trend is to think that smaller is better, as the rise of labia reductions shows.
It is certainly the case that a very restrictive ideal of beauty has formed in this respect. But I also see the intimate shave as a form of liberation. Suddenly we are talking about the vulva again. When it comes to their appearance and function, you’ll find very little in gynaecological textbooks until the beginning of the 1990s. There’s a lot to catch up on. For example, we still don’t know what the vulvas of people across the globe look like.

What do you mean?
In the EU, people know exactly what the average cucumber looks like – what curvature it has, how big it is. The same applies to the penis: we have known what the average is like since the 18th century. But with women? In Europe, there have been only two major investigations: one involving just 50 women in the UK and another in Austria with 150 women. That’s a joke.

Does the fact that we don’t know what an average vulva looks like fuel an uncertainty that plastic surgery exploits?
Yes, then suddenly norms are established about the ideal female genitals without knowing whether it’s actually reflective of the truth.

All procedures, including those in intimate areas, are presumably based on a desire to comply with a supposed standard. But are people actually happier after having cosmetic surgery?
If the expectations for the procedure are realistic, a qualified plastic surgeon performs it and the healing process goes well, then most patients are satisfied afterwards. But there is also the repeat effect: if you start having beauty procedures, you want more. We have to distinguish between cases. If I decide to inject Botox in my fifties, the effect wears off after a few months and I have to inject it again. I would therefore be considered a repeater. It’s like hair colouring; for a good result, I have to refresh the roots every few weeks.

In which cases should a patient consult a psychologist rather than a surgeon?
When someone wants a completely different body or chases a Barbie-like ideal. These people won’t be satisfied even after numerous operations. Imagine, say, someone who wants to look like Claudia Schiffer because they want to have a life like hers. That’s an illusion. Ultimately we all have to accept that our bodies age. You can make someone look 10 or 15 years younger but the ageing process continues.

Most people who opt for these interventions claim that they only have them done for themselves – rather than to look more beautiful to others. Are beauty surgeries really acts of self-determination?
Think of it this way: our bodies are no longer our destiny. But we must also be aware that physical attractiveness is one of the greatest factors for inequality in Western societies. Attractive people earn more, get milder judgments on crimes and even get better school grades.

So it’s less about self-acceptance than getting a better deal because of your looks?
No, many people are interested in accepting themselves and I won’t deny them that. But I can imagine that women are more likely to undergo such procedures to please other women than to appeal to men because most men won’t even notice the embellishments. After I’ve been to the hairdresser, my partner will see that it looks good but he might not notice that I’ve streaked my hair.

Is it really an act of freedom to change your body surgically?
Optimising ourselves is our time’s promise of salvation. If you commit to this logic, you feel permanent pressure.

Some say that the upswing of the beauty industry also has to do with the higher number of single people today because they have to remain competitive. Is that true?
My investigations from 2015 on women between the ages of 35 and 60 who had hyaluronic acid and Botox injected in Berlin showed that most were in a relationship. Of course, separations often trigger a desire to change something but among the big reasons for the boom in the industry, in my opinion, are the rising importance of appearance and the fact that we are increasingly communicating with selfies.

But aren’t single people also likely to boost the beauty industry?
They are but this also has to do with how many of us have to present ourselves to the partner market several times in our lives. And what matters today in that context? The photo. Our appearance decides our relationship possibilities, so we try to look good for as long as possible.

You once said that beauty procedures allow a 50-year-old woman to participate in society. But that means women who don’t have anything done to them lose their social connection in old age.
The ageing woman has long been invisible in our society. With today’s procedures, a woman can now maintain a youthful appearance for longer. But the ageing woman nevertheless remains invisible. We see women who are ageing but only those who don’t look like they are. Unlike in men, grey hair and wrinkles are not considered sexy in women. They used to be considered old at 35 and no longer desirable. This has changed, with the effect that women no longer simply disappear from society.

In the future, will we have to make excuses for ourselves if we look 50 years old when we actually are 50?
Yes. But men also know this. The pressure also increases for them to have thick hair until old age and not have bags under their eyes. On the other hand, they can simply grow a beard over the hanging turkey neck.

On average, men perceive themselves as slimmer than women. Are they putting less pressure on themselves?
That’s right. And we must not forget that men can still compensate for a lower attractiveness with status, power and money. This isn’t possible for women to the same extent. Society judges them much more harshly on their appearance.

What will it do to a society when surgically beautified bodies become the norm?
Differences between social classes will become even clearer. To maintain the most attractive appearance, you’ll need knowledge and money over a long period of time. The middle classes already educate their children in this way: they teach them to eat healthily, to exercise, to apply sunscreen in the summer.

Aren’t those for health reasons?
Yes, but there is also a beauty factor. Another example is braces. In Germany, you hardly see any young people with crooked teeth because that’s paid for by health insurance and straight teeth have become an ideal of beauty.

Perfectly shaped breasts, a tight belly, no cellulite – what body image do children grow up with when their mothers are not allowed to look like mothers?
All of this increases the pressure on young women to look at least as good as their mothers. Let’s think of Heidi Klum: in her 50s, she has a more beautiful body than many women do at the age of 20. Of course, this triggers uncertainty.

What advice would you give an 18-year-old who comes to you with a desire for surgery?
First, I would explore with her what she expects to gain from it. If it’s really just about fixing a specific flaw – protruding ears, a hooked nose, crooked teeth – you can do something about that. But I would also emphasise that it will not suddenly solve all of her other problems.

Do you think that cosmetic surgery will one day be as normal as wearing braces?
I would say that it already is almost as normal. But there will be counter-movements with regard to these short-term ideals of beauty. Back to a more natural look? In a way, that might be happening already. But in terms of the ageing face, it will be more like a well-preserved vintage designer bag – you can see that it has been worn but it is high quality and well maintained.