Cosmetic surgery and the secret world of Instagram dolls


They call themselves dolls. These are cosmetic surgery patients who document their desires and results on Instagram, but only, most say, for other patients or prospective clients. They use names and hashtags that connect the work to their provider. So, for example, KathySmithDoll would be a woman who underwent surgery with a Dr. Kathy Smith.

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In an era of patient empowerment, these pages – they’re called “Sx pages,” with Sx mimicking the prescriptive “Rx” – form a just-out-of-sight Instagram community. They serve as a cosmetic surgery shopping guide, a best-practices education system, and can also sound the alarm about bad experiences with practitioners. Some presurgery doll pages are more like inspiration pages or mood boards, collecting images of desired shapes.

That way, “other girls doing research can find someone with a similar build to theirs and follow their journey for a glimpse at what they might look like if they got similar procedures,” said Tai Hall, a massage therapist in Maryland. On her Instagram page, she showcases before-and-after body-contouring results; in her Facebook group, she teaches postoperative self-massage and how people can best take care of themselves while healing.

These Instagram pages, she said, “are really big deals.”

The Sx Instagram pages are private and anonymous, to some extent, and follow strict rules to stay that way, particularly since many feature nudity. (As a social media practice, Sx pages are fairly similar to teenager’s private “finsta” friends-only accounts. They are similarly unverified and what they report is unverifiable.) Many of the bios on these pages indicate they won’t allow access to men.

Each Instagram page bio often unveils elaborate details, often including height and weight. The patient – the doll – will list surgery dates and tag her surgeon, recovery house, any postoperative care specialists or private nurses, and her postoperative massage therapist.

Recovery houses, surgery providers, and massage therapists also use the hashtags to promote their services. Some of these are flooded with ads or spam. Some are used by practitioners for education about surgery.

The surgery age

According to the American Society of Plastic Surgeons, more than 1.8 million cosmetic surgeries were performed in the United States in 2018. Breast augmentation and liposuction accounted for about a third of those.

And the number of “cosmetic minimally invasive procedures” – Botox, laser hair removal, soft-tissue fillers, and more – has grown rapidly in the United States. There were fewer than 5 million procedures in 2000. In 2018, there were nearly 16 million. (Almost half of those procedures are Botox treatments.)

Cosmetic procedures are also becoming more popular among people of color. The American Society for Aesthetic Plastic Surgery reports that cosmetic augmentation, like liposuctions and buttocks lifts, increased 56% among African Americans from 2005 to 2013, and is still rising.

As the number of savvy customers grows, doll pages provide a useful glimpse into the less-glamorous side of before and after – the details that people like to overlook, like bruising, drainage, and the often painfully long process of healing after significant surgeries.

Patients become online advertisements for their surgeons. Surgeons develop a reputation on social media for being the best at certain procedures, for delivering a desired look, or for working with certain ethnic groups and body types.

“They’ll cry and upload videos of pain and success and their struggles, or whatever they’re going through, and their surgery sisters help uplift them,” Ms. Hall said.

And there is a lot to talk about, from surgeons to procedures to recovery houses to advice on how to travel with the least hassle from airport security or airline staff when patients are clad in fajas – a kind of postoperative girdle – or other foam paddings.


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