WOMEN IN AESTHETIC MEDICINE
ALTERED REALITY
Are AI and image editing tools harmless fun, or can they be misleading? Vicky Eldridge asked the WIAM board for their views
Recently, a friend and I were laughing about a picture we appeared in together at an industry event. Someone had enthusiastically applied a filter to the image and performed a bit of face tuning before posting it online. The result? My face looked almost unrecognisable, like a waxwork or caricature. My skin was tanned, my chin was significantly pointier, and I looked like I had had Turkey teeth, a facelift and a set of caterpillarlike fake eyelashes. I found it funny, but at the same time, it got me thinking about how much filters (and even more so AI) can alter how we present ourselves online.
I haven’t used filters on my own images for years, but like many people, I do enjoy a good viral AI trend when it comes around. Who else turned themselves into a doll in a box, created a candy cane Christmas image or made a cartoon that represented their work life? All a bit of harmless fun, you might say (although there’s a whole other story about how much energy generating these images consumes and its impact on the environment).1
Aesthetics is an industry built on trust, where visual outcomes are the end goal, so we have to ask: when is it ok to use filters and AI-generated imagery, and when is it crossing the line into being misleading?
While this is not something that only affects women, the fact that the majority of patients in aesthetics are women makes the topic a female-centric one. Research by Rosalind Gill of City University London found that 90% of young women report using filters to edit their photos before posting them online.2 There’s a darker side to the conversation too. Earlier this year, reports showed that Grok, the AI chatbot on X, had dehumanised and caused distress to women by removing clothing from their images to show them in bikinis, in sexual positions.3
THE EXPECTATION GAP
Let’s be honest – filters are everywhere. From Instagram smoothing tools and FaceTune edits to the subtle “appearance enhancement” features built into Zoom and other video platforms, most of us encounter or use some form of digital enhancement on a daily basis. But one of the biggest concerns raised in conversation with the WIAM board was how altered imagery can influence patient expectations.4
Patients scroll through endless pictures and videos of filtered faces and AI-generated beauty standards before they ever walk through a clinic door. The risk is that this creates a gap between what people believe is achievable and what can be realistically achieved.
In fact, a growing body of research is beginning to explore how social media filters are shaping perceptions of beauty and influencing demand for cosmetic procedures.5 One recent paper highlighted how platforms such as Instagram and TikTok have normalised digitally altered appearances. As a result, some patients are now presenting to clinics with reference images that reflect these edited versions of themselves, rather than their natural features.
Because when expectations are built on unrealistic imagery, even really good clinical outcomes may feel disappointing.
AN UNEVEN PLAYING FIELD
One area where editing imagery is a no-no is clinical before-and-afters.
Edited imagery can create the impression that one practitioner is achieving dramatically better outcomes than another, even if they are using the same protocols.
Not only is this very misleading, but it’s also extremely frustrating for practitioners who present honest, unedited outcomes online.
As The Aesthetic Consultant Vanessa Bird points out, presenting altered results can ultimately backfire. “You could be setting yourself up for bad reviews, refunds and low patient retention,” she warns.
WHEN PERCEPTION BECOMES DISTORTED
While most practitioners would agree that editing or filtering clinical before-and-after images is a no-go, things become cloudier when it comes to editing pictures of themselves.
Adjusting the lighting, removing a messy background or even lightly smoothing skin can feel fairly harmless and is something many people do without thinking. The question is whether it sits comfortably when we are representing an industry where outcomes matter. If the images patients see online of their practitioners are consistently flawless and polished in a way that doesn’t quite reflect reality, is that unintentionally setting a standard that real skin simply can’t live up to?
Another, more uncomfortable layer to this discussion is the impact that altered imagery has on practitioners themselves.
Working in aesthetics does not make anyone immune to the pressures of appearance culture. If anything, the opposite can be true.
Bird raised an important point: “Just because someone works in aesthetics and is medical doesn’t mean they aren’t susceptible to their own issues about how they look,” she said.
When editing tools are so easily accessible, perception drift can occur almost without realising it. Subtle adjustments can gradually become normalised until the edited version begins to feel more “accurate” than the real one.
ADDING AI INTO THE CONVERSATION
While filters may blur the line between reality and enhancement, artificial intelligence takes things to the next level.
AI-generated images are becoming so realistic that it’s hard to tell them apart from real images. There are loads of amazing uses for AI imagery – provided it is clearly labelled as such. I’ve used AI to help generate a stock image when I couldn’t find what I was looking for, and the results blew me away.
But the problem arises when AI imagery is presented as real and used to represent results, patients or outcomes.
INTENT MATTERS
So where should the line be drawn? Anna Dobbie believes it’s all about intent. “The key thing is motivation – what is your end goal?” she said. “Is it to mislead people into buying something that you have advertised falsely?”
That question is perhaps the most important one practitioners can ask themselves when posting online.
Editing for composition or clarity is one thing. Altering treatment results or body features in a way that misrepresents reality is another entirely.
As Tracey Dennison sums it up: “Filters may be fine for fun, but not in contexts where they could be misconstrued as real.”
AUTHENTICITY MATTERS
Ultimately, aesthetics is a profession that is built on trust and the images that you share online are often the first step in building that relationship.
For practitioners, this means taking a conscious decision to present authentic imagery – real skin, real lighting, real results.
That doesn’t mean abandoning creativity or humour online. Social said. media can and should still be engaging. But there is a clear difference between playful digital content that taps into a trend and the representation of clinical outcomes.
One of the reasons I stopped using filters a few years ago was that I ran into someone I hadn’t seen for a while and didn’t recognise her as I had only seen Snapchat filtered images of her online for years. It was a poignant reminder of how easily digital versions of ourselves can drift away from reality.
Used in the right ways, AI and filters can be fun and harmless, but used in the wrong way, they can contribute to unrealistic expectations and even distorted self-image. If you are using AI, let people know, and if you want to see how to do it in a way that’s light-hearted and entertaining, check out Vanessa Bird’s Instagram and see a three-armed version of her dangling from a helicopter.7