ISSN Online: 2177-1235 | ISSN Print: 1983-5175

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Original Article - Year2024 - Volume39 - Issue 2


Introduction: Over the years and with the proportional growth of social media, focused mainly on the cult of the body and perfection, the demand for plastic surgeries has increased overwhelmingly, awakening an endless desire for body change, most of the time with "unrealistic" promises" from some professionals.
Method: Research consisting of 62 female and male patients, aged between 22 and 61 years, residing in the state of São Paulo, who have already undergone a plastic surgery procedure and/or will undergo plastic surgery and cosmiatry procedures, who responded to the questionnaire "The influence of social media on plastic surgery".
Results: The results demonstrate that the media plays an important role in choosing a plastic surgeon, especially when the success of plastic surgery and cosmetic surgery procedures is demonstrated through before and after photos.
Conclusion: Plastic surgery is a medical specialty that plays a fundamental role in the aesthetic and psychological transformation of many individuals, however, it is important to highlight the need for an ethical approach, to guarantee patients' well-being and excellence in medical practice.

Keywords: Social media; Plastic surgery procedures; Motivation; Ethics; Health's judicialization


Introdução: Com o passar dos anos e o proporcional crescimento das mídia sociais, focado principalmente no culto ao corpo e à perfeição, a procura por cirurgias plásticas vem aumentando de forma avassaladora, despertando um interminável desejo pela mudança corporal, na maioria das vezes com promessas "irreais" de alguns profissionais.
Método: Pesquisa composta por 62 pacientes dos sexos feminino e masculino, com idade entre 22 e 61 anos, residentes no estado de São Paulo, que já se submeteram a um procedimento de cirurgia plástica e/ou ainda passarão por procedimentos de cirurgia plástica e cosmiatria, que responderam ao questionário "A influência das mídias sociais na cirurgia plástica".
Resultados: Os resultados demonstram que a mídia exerce um importante papel na escolha do cirurgião plástico, principalmente quando o sucesso dos procedimentos de cirurgia plástica e cosmiatria é demonstrado através de fotos de antes e depois.
Conclusão: A cirurgia plástica é uma especialidade médica que desempenha um papel fundamental na transformação estética e psicológica de muitos indivíduos, no entanto, é importante ressaltar a necessidade de uma abordagem ética, com o objetivo de garantir o bem-estar dos pacientes e a excelência na prática médica.

Palavras-chave: Mídias sociais; Procedimentos de cirurgia plástica; Motivação; Ética; Judicialização da saúde


There are records about the practice of plastic surgery since many centuries before Christ. It was practiced to correct deformities caused by trauma or physical punishment, as shown in the literature1. However, the consolidation of this specialty occurred after WWI, whose conflicts resulted in seriously injured soldiers and disfigured bodies, making it necessary for them to undergo surgical repairs1.

Since WWII, plastic surgery has expanded its focus, with reconstruction techniques covering the general population. Nowadays, aesthetic procedures are the most sought-after. According to Gracindo1, “the patient seeks with the correction to achieve perfection or a standard of beauty, which is often imposed by society and influenced by the media”.

Body idealization over time

Beauty standards have changed over time. The idealization and perception of the ideal body are influenced by cultural, social, economic, and historical factors2.

Souza et al.3 show that the beauty search, although great in the contemporary era, is not a recent concern, as human beings have sought to represent themselves through the arts for thousands of years.

The authors trace a panorama from Antiquity, when the beauty search began to become rational, passing through the moralism imposed by Christianity in the Middle Ages, Modernity in the 15th century, under the effect of various discoveries of artistic techniques, and beauty understood as an imitation of nature. The standard of beauty was the obese body of the Mona Lisa, or Gioconda, the famous painting by Leonardo da Vinci3.

Souza et al. continue to show the drastic change in the Capitalist System, from the 17th century onwards, in which the body proved to be both oppressed and manipulable, since the evolution of industrial society led to high technical-scientific development3 until reaching Contemporary times with globalization, the consumerism. Stimulated by the media (newspapers, magazines, radio, and cinema), the body is seen as a symbol of vigor and effectiveness, symbolized by sports and cinema icons3.

Plastic surgery today

For Kataoka et al.4, plastic surgery improves self-esteem and acceptance in a consumerist society that idealizes the cult of the body. “The pressure of consumption and the ease of undergoing a plastic surgery procedure ends up becoming an obsession in these patients’ lives”4.

Over the years and the proportional growth of the media, focused mainly on the cult of the body and perfection, the demand for plastic surgery has increased dramatically. In a scenario in which bloggers and digital influencers are hired by professionals to attract patients who accompany them, awakening an endless desire for body change, most of the time with “unrealistic” promises.

According to the International Association of Plastic Surgery (ISAPS- International Society of Aesthetic Plastic Surgery), as represented in Figure 1 and Figure 2, there was an increase of 19.3% in the total number of procedures performed compared to 2020. More than 12.8 million surgeries and more than 17.5 million aesthetic procedures were performed worldwide in 2021, with liposuction and then primary breast augmentation (implant placement and skin removal) being the most performed procedures5.

Figure 1 - Most performed plastic surgeries in the world in 2021.

Figure 2 - Most performed plastic surgeries in Brazil in 2021.

In Brazil, the 5 most performed surgeries were: 1 - Liposuction, 2 - Primary breast augmentations; 3 - Blepharoplasty, 4 - Abdominoplasty, and5 - Mastopexy. In total, more than one million and six hundred thousand plastic surgery procedures were performed.

Silva et al.6 mention that “the beauty standards imposed daily in the media by celebrities lead to the tireless search to achieve the utopian idea of the perfect image, a fact that results in a great challenge for the doctor to understand the patient’s perception of themselves and what the psychological repercussions of this projection. Body dissatisfaction can cause anguish leading to stressful mental conditions, triggering self-destructive behaviors to achieve an adequate image and be accepted in society, as well as low self-esteem, depression, and anxiety. Comparing the body with other people in the same environment or with standards established by society can exacerbate these disorders.

Most digital influencers and bloggers awaken fantasy in society through the search for cosmetic procedures and aesthetic plastic surgery by showing realities on their digital platforms that, in most cases, contradict the natural processes of life, as if they were a magical change. The posts of photos that show perfect body curvatures, perfect skin, and immediate post-operative surgery “like a magazine cover”, cause an immense desire in people to look like that body shown at all times.

The role of the media in plastic surgery: leveraging pre-and post-operative care as commercial tools

Contemporary plastic surgery is a dynamic and constantly evolving field, driven by technological advances, societal aesthetic demands, and, notably, the growing influence of the media. The intersection between plastic surgery and the media has played a significant role in shaping patient perceptions and expectations, as well as the commercialization of surgical procedures. This integration has been increasingly evident in the emphasis given to the dissemination of pre- and post-operative results, highlighting the promise of aesthetic transformation and improvements in quality of life.

In the contemporary context, the ubiquitous presence of social media and the proliferation of digital platforms have created a scenario in which visibility and accessibility to information about plastic surgery have reached unprecedented levels. Potential patients are exposed to a plethora of images and testimonials that highlight the perceived benefits of aesthetic procedures, often depicting dramatic results and stunning transformations. This constant exposure fuels a growing expectation regarding plastic surgery’s ability to achieve ideal results, shaping individual perceptions of beauty and self-image.

The promotion of these procedures as a quick and effective solution for correcting physical imperfections or for aesthetic enhancement has further boosted the demand for plastic surgery services.

In this digital era, the media plays a crucial role in building the image and reputation of plastic surgery professionals, directly influencing their patient base and financial success. Marketing strategies aimed at promoting impressive results and positive patient experiences are often employed to attract new customers and establish a competitive advantage in the market.


The objective of this study is to investigate the influence of content constantly displayed on social media, especially those related to beauty and cosmetic procedures, on individuals’ decisions to undergo plastic surgery. Furthermore, we seek to evaluate the variables that may affect the choice of professional and understand patients’ expectations concerning obtaining results, considering their perception and objectives in relation to body image.


The present study adopted a quantitative approach, using a sample composed of 62 patients of both sexes, aged between 22 and 61 years, all residing in the state of São Paulo. These patients were selected based on specific inclusion and exclusion criteria and had already undergone plastic surgery procedures and/or were planning to undergo plastic surgery and cosmiatry procedures.

It is important to highlight that data collection and analysis were carried out during a pandemic period, characterized by significant changes in society’s behavior and medical practices. The COVID-19 pandemic, with its mobility restrictions, social distancing measures, and impact on health services, may have influenced patients’ perceptions and decisions regarding plastic surgery.

In this context, it is necessary to consider that the exceptional circumstances imposed by the pandemic may have changed patients’ motivations, concerns, and expectations regarding plastic surgery procedures. Therefore, the results obtained in this study must be interpreted taking into account the pandemic context in which they were collected, recognizing the possible influence of this extraordinary period on the participants’ responses and behaviors.

The selection of patients was subject to the following inclusion criteria: patients who have already undergone a plastic surgery procedure or are about to undergo it, aged over 18 years. Patients under 18 years of age were excluded.

Patients who underwent surgery underwent psychological assessment and monitoring throughout the surgical process, and patients who have not yet undergone surgery are undergoing psychological monitoring in the pre-operative period.

Some patients in the study have already undergone surgery with other plastic surgeons and turned to the team to undergo a new surgery due to various complaints that will be explained in the article.

Patients were invited to participate in the study, having received the questionnaire “The influence of social media on plastic surgery”, containing 20 questions asking:

    • If the patient has already undergone an aesthetic surgical procedure, what resources were used to look for a surgeon (Instagram, WhatsApp groups with before and after photos);
    • The evaluation of positive comments on Google; a recommendation from another patient; which content generates more confidence in choosing a professional;
    • If the experiences of other patients with plastic surgery, knowing someone, or seeing photos of results and before and after photos influenced their choice;
    • The results of plastic surgery on digital influencers, famous people, content generators, or people close to them interfere with the choice of professional;
    • If the media influences the search for aesthetic procedures; if the photos presented cause expectations for the result of the surgery that will be performed.


This study included 62 patients, 60 of whom were women (96.8%) and 2 men (3.2%), aged between 22 and 61 years. Of these, 65.8% had already undergone plastic surgery and cosmetic surgery procedures, and 34.2% would still undergo the procedures.

Considering the resources used by patients when searching for a plastic surgeon, 29 patients (48.33%) responded that it was recommended by other patients, 12 patients (20.0%) consulted the Sociedade Brasileira de Cirurgia Plástica website, 9 patients (15.0%) claim to be influenced by WhatsApp groups and photo groups of before and after results, while 7 of the patients (11.67%) look for results on Instagram and only 5 patients (8.33%) check positive ratings and comments from Doctorlaria, as shown in Figure 3.

Figure 3 - Resources used when searching for a plastic surgeon.

Regarding the influence of the media in the search for plastic surgeries, related to posting photos with procedure results and/or before and after photos on patients who made up the sample, 27 (43.5%) said that photos influence 61 to 100%. In the percentage of influence, 12 patients (19.35%) feel 31 to 60% influenced, 7 patients (11.29%) 11 to 30%, while the remaining 16 patients (25.8%) are divided into two egalitarian groups in which the media has an influence of 0% and 1 to 10%, respectively (Figure 4).

Figure 4 - Influence of results photos and before and after photos on the search for plastic surgery.

When asked about their motivation for carrying out a plastic surgery procedure, 43 patients (69.4%) responded that they feel more motivated when seeing photos of results before and after procedures, while 19 patients (30.6%) responded they feel indifferent. However, when asked about the possibility of photos of plastic surgery results being modified by Photoshop or other means, 57 patients (91.9%) said they would not undergo surgery and 5 patients (8.1%) said they would still operate with the professional (Chart 1).

Chart 1 - Photos of plastic surgery results and modifications made by Photoshop.
Photos of results and before and after photos of plastic surgery
When looking at before and after photos on social media If only they knew that the before and after photos were modified by Photoshop, lights, and other means of modification
More motivated to carry out the procedure Se sentem indiferentes Operariam mesmo assim Não operariam
N % N % N % N %
43 69.4% 19 30.6% 5 8.1% 57 91.9%
Chart 1 - Photos of plastic surgery results and modifications made by Photoshop.

Regarding plastic surgery groups and their influence on the choice of a plastic surgery specialist, 14 patients (45.2%) responded that the groups influence 61 to 100%, 14 patients (22.6%) responded that the media influences 31 to 60%, 9 patients (14.5%) responded that the groups influence 11 to 30%, 5 patients (8.1%) responded that plastic surgery groups influence 1 to 10%, and 6 patients (9.7%) %) responded that plastic surgery groups do not influence their decisions regarding the choice of a plastic surgeon (Chart 2).

Chart 2 - Influence of plastic surgery groups on the choice of plastic surgeon.
The influence of (unknown) patients and plastic surgery groups interferes with the choice of plastic surgeon
Influence of plastic surgery groups in percentage Quantity of patients in numbers who responded Quantity of patients in percentage
0% 6 9.7%
1 a 10% 5 8.1%
11 a 30% 9 14.5%
31 to 60% 14 22.6%
61 to 100% 28 45.2%
Chart 2 - Influence of plastic surgery groups on the choice of plastic surgeon.

Regarding the questions related to the absence of before and after photos, as well as the lack of recommendation of a certain professional by someone close to them, 41 patients (66.1%) said they would not undergo surgery, 17 patients (27.4%) would undergo surgery, and 4 patients (6.5%) would undergo surgery, but it would depend on the amount charged by the plastic surgeon (Figure 5).

Figure 5 - Absence of comments and before and after photos from patients.

In the answers related to the final result of plastic surgery, whether 100% would be achieved after choosing the plastic surgeon, 39 patients (62.9%) said no, and 23 patients (37.7%) said that the result of the surgery would reach 100% (Figure 6).

Figure 6 - Surgery result will be achieved in 100%.


The Federal Council of Medicine recently published Resolution CFM 2336/23, which deals with medical advertising issues, providing doctors with greater freedom in presenting their professional practices7. However, it is essential to highlight that this freedom is not restricted only to the exposure of positive results; any disclosure of results must be accompanied by the exposure of possible complications and risks inherent to the procedures performed.

When it comes to publishing photos, it is imperative that they not only highlight the visual results but also provide information about the consequences, risks, and benefits associated with the procedure in question, considering different patient profiles, age groups, and possible changes resulting from the procedure. intervention. The change in legislation reflects the growing responsibility of healthcare professionals to provide a complete and transparent representation of their procedures, highlighting not only aesthetic results but also aspects related to safety and possible benefits perceived by patients.

Therefore, the flexibility granted by the new legislation requires a responsible approach on the part of doctors, who must ensure that their disclosures are ethical and informative, providing a comprehensive and balanced view of the procedures performed, taking into account ethnic diversity and the particularities of each group demographic served.

The results of the study show that the media plays an important role in choosing a plastic surgeon, especially when the success of plastic surgery and cosmetic surgery procedures is demonstrated through before and after photos. However, it is paradoxical to note that, despite this influence, the patients interviewed expressed reluctance in procedures whose postoperative photos were clearly manipulated by Photoshop. This phenomenon suggests that before and after images are not only a visual representation of expected results but also play an important role in constructing patients’ expectations and forming a beauty ideal to be achieved.

However, it is crucial to note that the decision to undergo plastic surgery is not determined exclusively by the media. Opinions from those close to us, experiences shared by those who have already undergone the procedure, and social support play a significant role in shaping patients’ decisions.

The observed phenomenon, related to the impact of results images and before and after photos in plastic surgery, can be explained by the creation of high expectations in patients. These expectations, when not met, can lead to feelings of frustration and negatively affect self-esteem.

The standardization of beauty ideals conveyed by the media can contribute to the internalization of these standards and, consequently, to body dissatisfaction in certain populations.

Some psychopathologies, such as body dysmorphism, can increase dissatisfaction with the surgical procedure. Even after achieving an excellent result, patients living with this psychopathology are unable to see a satisfactory result with the proposed procedure. This may be the explanation for the fact that 62.9% of the patients in the sample stated that they had doubts about achieving 100% of the final result.


Gonzaga & Araújo8 emphasize that each individual is unique, with the body being made up of two unequal halves. Therefore, “predetermining certain results in the face of this natural sealing of the human organism from bodily asymmetry would be an attack on human nature itself”8.

Medicine is not an exact science, each organism reacts in an individualized and very personal way, there is no possibility of mathematically predicting a result for any and all surgical practices, as results cannot be guaranteed due to the unpredictability that can occur post-operatively.

The Consumer Protection Code (CDC)9, established by Law No. 8,078/1990, is legislation that establishes the rights of consumers and the responsibilities of suppliers. Article 30 deals with the obligations and responsibilities of those who convey information or advertising and Article 37, in items 1 to 3, clearly prohibits misleading or abusive advertising.

Many professionals display photos of plastic surgery results that have been manipulated by the media, in addition to not explaining to patients the possible complications, such as swelling, bruises, healing time, and body asymmetry, as well as the relationship between the results of the procedures and the patient’s lifestyle habits.

According to Kataoka et al., “the ‘media’ effect generates sometimes ‘surreal’ expectations or even sublimation of results”.4 Plastic surgery is a medical specialty that plays a fundamental role in the aesthetic and psychological transformation of many individuals. Whether to correct physical imperfections, restore the function of body parts, or improve self-esteem, plastic surgery offers a reliable and safe solution. However, it is important to highlight the need for an ethical approach, to ensure the well-being of patients and excellence in medical practice.


1. Gracindo GCL. A moralidade das intervenções cirúrgicas com fins estéticos de acordo com a bioética principialista. Rev Bioét. 2015;23(3):524-34. DOI:

2. Cardoso J. Implicações padrão Barbie: sentidos que meninas adolescentes atribuem aos padrões de estética e idealização do corpo [Trabalho de Conclusão de Curso]. Palhoça: UNISUL; 2018.

3. Souza JC, Lopes LHB, Souza VCRP. A Dimensão do Belo no Tempo. Rev Psicol Saúde. 2018;10(3):87-94.

4. Kataoka A, Lage RR, Mendes CCS, Soares NG. O Transtorno Dismórfico Corporal e a influência da mídia na procura por cirurgia plástica: a importância da avaliação adequada. Rev Bras Cir Plást. 2023;38(1):e0645.

5. International Society of Aesthetic Plastic Surgery (ISAPS). Global Survey 2021. Mount Royal: ISAPS; 2022. Disponível em:

6. Silva WR, Barra JV Neves AN, Marôco J, Campos JADB. Sociocultural pressure: a model of body dissatisfaction for young women. Cad Saúde Pública. 2020;36(11):e00059220. DOI:

7. Brasil. Conselho Federal de Medicina. Resolução CFM Nº 2.336/2023. Brasília: Conselho Federal de Medicina; 2023 [citado 13 set 2023]. Disponível em:

8. Gonzaga AA, Araújo LA. Igualdade: fundamentos filosóficos. In: Campilongo CF, Gonzaga AA, Freire AL, coords. Enciclopédia jurídica da PUC-SP. Balera W, Lima CAS, coords. Tomo: Direitos Humanos. 1ª ed. São Paulo: Pontifícia Universidade Católica de São Paulo; 2017. Disponível em:

9. PROCON. Código de Proteção e Defesa do Consumidor. São Paulo: Instituto de Defesa do Consumidor - PROCON/SP; 2023.

1. Hospital Ruben Berta, São Paulo, SP, Brazil
2. Fundação Hospitalar do Estado de Minas Gerais, Hospital João XXIII, Belo Horizonte, MG, Brazil

Corresponding author: Alexandre Kataoka Av. Antártico, 381, Cj. 108, Jardim do Mar, São Bernardo do Campo, SP, Brazil. Zip Code: 09726-150, E-mail:

Article received: July 29, 2023.
Article accepted: April 30, 2024.

Conflicts of interest: none.

Institution: Hospital Ruben Berta, São Paulo, SP, Brazil.


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