|Year : 2023 | Volume
| Issue : 1 | Page : 29-33
The use of photograph editing applications among patients underwent cosmetic rhinoplasty surgery: A cross-sectional study
Faisal M Obeid1, Hatan Mortada2, Fatimah Al Mazrou3, Nawaf Alhindi4, Khalid Arab5
1 Department of Surgery, College of Medicine, Imam Mohammad Ibn Saud Islamic University Riyadh, Saudi Arabia
2 Department of Surgery, King Saud University Medical City, King Saud University; Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia
3 College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
4 Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia
5 Department of Surgery, Division of Plastic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
|Date of Submission||29-Aug-2022|
|Date of Decision||21-Sep-2022|
|Date of Acceptance||01-Oct-2022|
|Date of Web Publication||01-Feb-2023|
Dr. Faisal M Obeid
Division of Plastic Surgery, Department of Surgery, College of Medicine, Imam Mohammad Ibn Saud Islamic University Riyadh
Source of Support: None, Conflict of Interest: None
Rhinoplasty is a type of plastic surgery that might be motivated by the desire to change nose appearance, improve breathing, or both. Social media is considered nowadays one of the major aspects of the internet. It is not deniable that we depend on using social media on a daily basis to enhance our communication and represent ourselves. Recently, the demand on editing applications like Snapchat has increased, and studies have shown the association between developing low self-esteem and the usage of editing applications. The aim of this study was to assess the relationship between self-esteem and photograph edits on social media applications in young women who underwent rhinoplasty. A single-centered retrospective cross-sectional study was conducted at Ajmal clinic, Riyadh, Saudi Arabia. Data were obtained through a self-structured online questionnaire distributed online to patients who underwent rhinoplasty between 2020 and 2021. The study included 205 participants aged above 18 years old with a predominance of female gender (91.2%). Editing was performed frequently by 33.2% of the participants. However, 40.0% of respondents claimed that they rarely edited their photographs before posting online. Factors associated with using Snapchat as the most editing application have been assessed. Snapchat use was significantly associated with age and female gender. The extensive usage of editing applications was significantly associated with most of the demographic data including age, female gender, low to middle income, single relationship status, and employment status.
Keywords: Attitude, photograph, photograph editing applications, rhinoplasty, self-esteem
|How to cite this article:|
Obeid FM, Mortada H, Al Mazrou F, Alhindi N, Arab K. The use of photograph editing applications among patients underwent cosmetic rhinoplasty surgery: A cross-sectional study. Saudi J Otorhinolaryngol Head Neck Surg 2023;25:29-33
|How to cite this URL:|
Obeid FM, Mortada H, Al Mazrou F, Alhindi N, Arab K. The use of photograph editing applications among patients underwent cosmetic rhinoplasty surgery: A cross-sectional study. Saudi J Otorhinolaryngol Head Neck Surg [serial online] 2023 [cited 2023 Jun 4];25:29-33. Available from: https://www.sjohns.org/text.asp?2023/25/1/29/369033
| Introduction|| |
Rhinoplasty is known to be the second most common cosmetic surgical procedure in plastic surgery following breast augmentation, with over 250 thousand performed in 2010. Since that time, it kept increasing in popularity to become the most common cosmetic surgical procedure, with more than 350 thousand performed in 2020 followed by blepharoplasty, facelift, and liposuction. Several studies suggested body image dissatisfaction and seeking perfection in association with the increase of social media diversity and popularity as one of the factors that contributed to this increase of popularity of cosmetic procedures. Some of the recent trends in social media applications (Instagram, Snapchat, or Tiktok) are the ability of using a customized face filters, in addition to the specific editing tools that allow users to change shapes and sizes of nose, eyes, or lips, in addition to hiding facial wrinkles, scars, or other skin abnormalities. In 2019, a cross-sectional study investigated the influence of using photograph editing or customized filter on the user desire to undergo cosmetic surgery; they found that Snapchat filter users had a more significant acceptance to undergo plastic surgery procedure, and Instagram filter users have greater considerations for cosmetic surgeries than their peers not using filters. Other studies suggested a coexistence of body dysmorphic disorder among the previously mentioned platform users that have been encouraged using filters and that might progress to do unnecessary invasive cosmetic procedures.,,,, “Snapchat dysmorphia” is a newly described term known among cosmetic surgeons used to describe a group of patients seeking cosmetic procedures to look like their edited selfies rather than to look like a certain celebrity or models. Many articles investigated the influence of social media on the field of cosmetic surgery. However, only few focused on the photograph editing part of using social media. The present study is the first in the literature to attempt to determine the attitude and use of photograph editing applications on social media among patients who underwent surgical cosmetic rhinoplasty in Saudi Arabia.
| Materials and Methods|| |
This single-centered cross-sectional study was conducted in private practice in Riyadh, Saudi Arabia, after obtaining the institutional review board approval. The inclusion criteria of our study involve all adult patients (>18 years old), male and female, who underwent rhinoplasty by the senior author (F. A) between 2018 and 2022. On the other hand, all patients who underwent rhinoplasty before 2018 and under 18 years old were excluded from this study. The data collection was done between January and February 2022. The response collection was based on a self-structured online questionnaire which was composed of two sections covering the following aspects: basic demographics and their attitude and the use of editing applications. Two consultants revised the survey and its objectivity in the field of plastic surgery. The study sample size is 205 patients, and patients were selected using the nonprobability consecutive sampling method. Patients were informed that no identification data was required, and all provided information would be strictly confidential with only authorized access. Statistical analysis was performed using the Statistical Package for the Social Sciences (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY, USA: IBM Corp). Categorical data were described using frequencies and percentages. Univariate association analysis was carried out using Chi-squared test. The significantly associated factors in the univariate analysis were entered into multivariate, binominal logistic regression models to investigate the independent relationships between variables. The outcomes of the regression analysis were interpreted as the odds ratio (OR) and the respective 95% confidence interval (CI). A P value was deemed to indicate statistical significance.
| Results|| |
A total of 205 participants provided valid responses on the online platform. More than half of the respondents aged 26–35 years (54.1%) and were single (54.1%) and employed (61.5%). The majority of them were female (91.2%), had a bachelor's degree (80.5%), and were residing in the central region (71.7%). More details about the demographic characteristics are provided in [Table 1].
The practice of editing and the associated factors
In general, photograph editing was performed frequently or always by 68 participants (33.2%), while 82 participants (40.0%) indicated that they had ever or rarely edited their photographs before posting online. Frequent photograph editing was significantly associated with the female gender (36.4% vs. 0% among males, P = 0.002). Other demographic characteristics were not associated with editing [Table 2].
|Table 2: The association between participants' demographic characteristics and editing|
Click here to view
Patterns of mobile application usage for editing
Respondents reported that the most frequently used mobile application (very often or always) for editing was Snapchat (60.0%) and other applications (25.8%). The AirBrush and Wonder apps had never been used by 84.4% and 80.5% of the participants, respectively [Figure 1]. To further investigate the factors associated with using the most common mobile application, we assessed the demographic correlates of Snapchat use [Table 3]. Results showed that Snapchat use was significantly associated with the (P = 0.009), gender (P = 0.003), marital status (P = 0.003), employment status (P = 0.001), residing in the Southern region (P = 0.022), and household income (P < 0.0001).
|Figure 1: Participants' responses regarding the patterns of mobile application usage for editing|
Click here to view
|Table 3: Factors associated with the frequent use of Snapchat use among patients who underwent rhinoplasty surgeries|
Click here to view
To get an insight into the independently associated factors with the frequent use of Snapchat, we constructed a logistic regression model with the use of Snapchat variable as a dependent variable and the significantly associated factors as independent variables. The outcomes indicated the following independent predictors of frequent Snapchat use: female gender (OR = 10.6, 95% CI, 2.1–55.2, P = 0.005), residing in the Eastern region (OR = 6.6, 95% CI, 1.3–32.8, P = 0.022), and having a household income of 5000–10,000 SR (OR = 14.7, 95% CI, 4.1–53.7, P < 0.0001) or <5000 SR [OR = 15.3, 95% CI, 3.6–64.3, P < 0.0001, [Table 4]].
|Table 4: Predictors of the frequent use of Snapchat use among patients who underwent rhinoplasty|
Click here to view
Patterns of editing distinct body areas
Focusing on self-esteem parameters, participants have frequently edited (Grade 3–5) their lips (16.1%), face (14.7%) and cheeks (9.7%). On the other hand, the majority of respondents have rarely edited the ears (99.1%), shoulders (98.1%), or chest/breasts [98.0%, [Figure 2]].
|Figure 2: Participants' responses regarding the most frequently edited body areas in their photos|
Click here to view
| Discussion|| |
The increased popularity of cosmetic surgeries, especially rhinoplasty, raises many questions among the cosmetic field practitioners over the past 10 years, and many have attempted to investigate this phenomenon to find out the reasons behind it. Several articles suggested that social media has a major role in explaining the increased desire for cosmetic procedures, in particular applications like (Snapchat, Instagram, and TikTok) that allow users to use customized filters and other photograph editing tools.,,,,,,, In this study, we present the first attempt to determine the attitudes and use of photograph editing applications on social media platforms among patients who underwent cosmetic rhinoplasty surgeries in Saudi Arabia. We found that one-third of the participants almost always edit their photographs, 16% change the size, shape, or color of their lips, and the majority give the highest attention to their facial appearance rather than other body parts. On the contrary, a recent study published in 2021 found that 36% edited their photographs to hide skin lesions, whereas only 1.80% used to change shapes of eyes, nose, or lips. However, a retrospective descriptive study conducted in Abha city, Saudi Arabia, revealed that the most commonly used editing application is Snapchat, used by more than half of the patients, which corresponds to our study. Another survey-based study was done to identify the association between photograph editing applications, self-esteem, and acceptance of cosmetic surgery. A higher cosmetic surgery acceptance score was found primarily in Snapchat users. Our study showed a statistical significance of Snapchat usage in female gender and age, especially between 18 and 25 years old. Besides, participants who underwent rhinoplasty continued to frequently edit their face, lips, and cheeks, which shows the negative impact of photograph editing applications on a person's self-esteem. This study needs to address several limitations, including conducting the study in one center and using a single surgeon's patients. Hence, the sample size was not as large as wanted, which may have compromised the study's accuracy. The probability of bias might also increase because of selective memory or social desirability since the data collection method was mainly self-delivered. However, bias is less likely to affect the study results since the questionnaire included many aspects of the desired subject. Finally, the study did not adhere to a specific measurement for self-esteem assessment to identify patients with high or low self-esteem. Regardless of these limitations, the authors believe that this study is of great value as it assesses the use of editing applications among patients who underwent rhinoplasty surgery. This study might help evaluate the need for rhinoplasty procedures, which we believe would be interesting ideas for future work.
| Conclusion|| |
Our study emphasized the wide usage of social media platforms and editing applications by patients who underwent rhinoplasty. The most popular mobile application used to edit photographs is Snapchat, which is significantly associated with most demographic data, including age, female gender, low to middle income, single relationship status, employment status, and people of the Southern region. Regarding the impact of social media on the participants' self-esteem, it was noticed that most rhinoplasty patients had edited their photographs to modify their lips, face, and cheeks. Although this study included no statistical easements for the direct relationship between rhinoplasty and low self-esteem, it can draw the attention of physicians in the future to carefully investigate rhinoplasty patients who are known to have low self-esteem.
Ethical approval and consent to participate
This study has gained the institutional board review approval. The authors declare that it conforms to the Declaration of Helsinki.
FA: Concept, design, definition of intellectual content, literature search, clinical studies, data acquisition, data analysis, statistical analysis, manuscript editing, and manuscript review.
HM: Concept, design, definition of intellectual content, literature search, clinical studies, experimental studies, manuscript editing, and manuscript review.
FM: Literature search, clinical studies, manuscript preparation, manuscript editing, and manuscript review.
NH: Concept, design, definition of intellectual content, literature search, clinical studies, data acquisition, data analysis, statistical analysis, manuscript editing, and manuscript review.
KA: Concept, design, definition of intellectual content, literature search, clinical studies, experimental studies, manuscript editing, and manuscript review.
We would like to thank Maha Alsulaiman, Ghada AlSwaji, Lujain Alotaibi, and Othillah Moazin for helping in the data collection.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Sorice SC, Li AY, Gilstrap J, Canales FL, Furnas HJ. Social media and the plastic surgery patient. Plast Reconstr Surg 2017;140:1047-56.
Chen J, Ishii M, Bater KL, Darrach H, Liao D, Huynh PP, et al
. Association between the use of social media and photograph editing applications, self-esteem, and cosmetic surgery acceptance. JAMA Facial Plast Surg 2019;21:361-7.
Weiss F. Exacting beauty: Theory, assessment, and treatment of body image disturbance. Am J Psychother 2000;54:131-2. [doi: 10.1176/appi.psychotherapy. 2000.54.1.131].
Durkin SJ, Paxton SJ, Sorbello M. An integrative model of the impact of exposure to idealized female images on adolescent girls' body satisfaction. J Appl Soc Psychol 2007;37:1092-117. [doi: 10.1111/j. 1559-1816.2007.00201.x.].
Halliwell E, Easun A, Harcourt D. Body dissatisfaction: Can a short media literacy message reduce negative media exposure effects amongst adolescent girls? Br J Health Psychol 2011;16:396-403.
McLean SA, Paxton SJ, Wertheim EH. Mediators of the relationship between media literacy and body dissatisfaction in early adolescent girls: Implications for prevention. Body Image 2013;10:282-9.
Calado M, Lameiras M, Sepulveda AR, Rodriguez Y, Carrera MV. The association between exposure to mass media and body dissatisfaction among Spanish adolescents. Womens Health Issues 2011;21:390-9.
Ramphul K, Mejias SG. Is “Snapchat Dysmorphia” a real issue? Cureus 2018;10:e2263.
Chowdhury S, Verma S, Debnath T. Self-esteem in rhinoplasty patients: A comparative study. Indian J Otolaryngol Head Neck Surg Publ online 2021;120-5. [doi: 10.1007/s12070-021-02734-2].
Baykal B, Erdim I, Ozbay I, Oghan F, Oncu F, Erdogdu Z, et al
. Evaluation of relationship between body dysmorphic disorder and self-esteem in rhinoplasty candidates. J Craniofac Surg 2015;26:2339-41.
Xiao L, Chu D, Wang F, Yang Y. Editing the self in pictures: Selfie editing promotes self-objectification among Chinese. Curr Psychol Publ online 2021;300-21. [doi: 10.1007/s12144-021-02327-w].
Alghamdi W. Effect of social media on decision to undergo rhinoplasty. Glob J Otolaryngol 2020;8:35-64. [doi: 10.19080/gjo. 2020.22.556094].
Agrawal H, Agrawal S. Impact of social media and photo-editing practice on seeking cosmetic dermatology care. Clin Cosmet Investig Dermatol 2021;14:1377-85.
Alghonaim Y, Arafat A, Aldeghaither S, Alsugheir S, Aldekhayel S. Social media impact on aesthetic procedures among females in Riyadh, Saudi Arabia. Cureus 2019;11:e6008.
Shome D, Vadera S, Male SR, Kapoor R. Does taking selfies lead to increased desire to undergo cosmetic surgery. J Cosmet Dermatol 2020;19:2025-32.
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4]