Plastic surgeon Werner Mang has been helping people feel more attractive for 30 years – but these days, it’s not uncommon for him to turn away clients. “This morning I had another 13-year-old girl here who wanted Kylie Jenner’s nose,” he says. Mang, 71, who knows his noses and has even done work on several German celebrities, shakes his head recalling the girl this morning. “ Mark Zuckerberg has created monsters,” he says. Social media and image filters are driving a new craze for beauty – leaving many young people dissatisfied with their looks. Plastic surgeon Alexander Hilpert calls this is a dangerous trend. People who take a lot of photos of themselves also want to look better, he says, adding that the trend has increased significantly in the past few years. He says he fields requests daily from those unhappy with their looks. Selfie identity: teens have plastic surgery to get perfect look No reliable figures are available, according to the German Society for Aesthetic Plastic Surgery (DGAEPC). Only procedures that are performed and the motivation behind them are included in the annual statistics, not queries that plastic surgeons turn down. According to figures from the DGAEPC, patients provided digitally edited images of themselves showing how they wanted to look in 2.3 per cent of cases, a decrease of 11.7 per cent from the year before. Hilpert says that’s only because of the pandemic: he definitely expects this rate to rise again. People are even more likely to spend time online during the pandemic, and they want to resemble the “beautifully morphed role models” they see there, he says, comparing it to people who watch dances on TikTok and then try to imitate them. In 2020, the year the pandemic broke out, young people spent more time on Instagram, Snapchat, TikTok and other social media than the year before, according to a study on youth media use by German researchers. The difference was greatest with TikTok, the platform where users share short, snappy videos. Mask acne, Zoom face: Covid-19 gives a (face) lift to Singapore cosmetic surgeons The app is particularly popular with young people between the ages of 12 and 15, and researchers found that the number of teens who visited the app at least several times a week during the pandemic year rose 19 per cent. Mang and Hilpert say they turn away people who show up wanting surgery so they look more like their role models or selfies they have altered. But obviously they just find another doctor, says Mang. Mang now wants to see tougher criteria for the training of cosmetic surgeons. He says that the numbers are growing rapidly. “You can do a nose operation without ever having done one before during your training,” he says. Mang advises anyone looking for cosmetic surgery to make sure they check that the doctor is a plastic surgeon. A further issue is that many specialists in other fields make extra money on the side through cosmetic surgery, says Hilpert. In Germany, they can call themselves cosmetic surgeons, as the professional title isn’t protected. “Alternative practitioners can even legally provide injections to counter wrinkles – and the training can be done online,” according to Hilpert. Hilpert often suggests young patients come back in a few years and offers a small discount to prevent them from turning to unqualified doctors. ‘Death by selfie’: how one country is trying to combat the killer trend It’s not just young people who are staring at their faces more these days: thanks to the major increase in video conferences because of the pandemic, adults are too. The DGAEPC says that the number of cosmetic procedures focused on the face in 2020 was remarkable. During the pandemic, people were looking at themselves constantly on Zoom , prompting many to seek out surgery, according to Hilpert. Mang agrees, saying that video conferences cast a tough light on users, “mercilessly” revealing their age. A plastic surgeon in the United States has noticed the same phenomenon – which he describes as the “Zoom boom”. Other factors leading people to seek out plastic surgery included that they had saved money they would have otherwise spent dressing up for work or on lunches, plus they had a built-in recovery period at home, says Lee Daniel, a doctor based in Oregon. Thousands upon thousands began seeking plastic surgery during the pandemic, he writes in a blog post for the American Society of Plastic Surgeons. In the Middle East, doctors were surprised by the huge demand for Botox and fillers, Maurizio Viel, a plastic surgeon based in Dubai in the United Arab Emirates, tells Al Arabiya news site. These trends are likely to last, say practitioners, with a US-based industry group expecting jawline contouring to remain popular . Mang is hesitant to embrace these trends. He boasts that he has never been under the knife. “I’m proud of the bags under my eyes,” he says.