Digital Appearance Manipulation Increases Consideration of Cosmetic Surgery: A Prospective Cohort Study.

Social media has gained significant popularity over the last decade. We now have the opportunity to digitally enhance our physical appearance using a variety of applications in the palm of our hands. One app, in particular, Facetune2, allows one to smooth skin, alter the size and shape of our nose, and even enhance our jaw line. (1) To assess whether using a digital appearance manipulation (DAM) application directly causes increased acceptance of cosmetic surgery and (2) to measure the impact photograph editing has on an individual's self-esteem, self-rated attractiveness, and self-rated personality traits. Prospective cohort study. A total of 20 subjects were recruited to participate in this study between July 25 and September 24, 2019, using University e-mail list invitations. Subjects first completed a basic intake questionnaire that included demographic information as well as baseline acceptance of cosmetic surgery, Rosenberg self-esteem, and self-perception scores. Subjects then had two sets of headshots taken (neutral and smile) and provided an introduction on the use of the Facetune2 app. Subjects received a digital copy of their photographs and were asked to download the free mobile app. After 1 week of appearance manipulation, subjects submitted their best edited photographs and completed the same three questionnaires. Wilcoxon signed rank test analysis was then used to assess for changes before and after DAM. Overall, study participants indicated increased consideration of cosmetic surgery on the acceptance of cosmetic surgery scale after DAM (+3.45,  = 0.04). When divided by gender, females further signified increased consideration of cosmetic surgery to keep looking young (+1.4,  = 0.04). Males indicated increased social motivation for cosmetic surgery after DAM (+1.5,  = 0.04). Both males (+1.0,  = 0.04) and females (+0.8,  = 0.03) indicated that they "could end up having some kind of cosmetic surgery" in the future. Comparison of the personality perception and Rosenberg self-esteem scores for all study participants before and after DAM showed no significant changes. The results of this study suggest that DAM can directly lead to increased consideration of cosmetic surgery for both males and females without affecting self-esteem.