ISSUES
: Body Confidence
Chapter 1: Body Image
21
Smaller nose? Bigger boobs? Flatter
stomach? There’s an app for that
By Kate Harvey, Nuffield Council on Bioethics
T
wo weeks ago, beautiful
Birmingham was home to a
two-day workshop on the
globalisation of beauty.
The workshop – organised by the
network BeautyDemands – saw
presentations from a wide range of
contributors, but it was one issue in
particular which led me to do a little
further digging of my own.
A presentation by Professor
Rosalind Gill focused on aesthetic
entrepreneurship, which highlighted
a body of work around beauty
which she called, ‘The quantified
self’. This session explored, for
example, how self-tracking and
self-monitoring materialise in digital
technologies, and change the way
we may relate to ourselves.
The application of self-tracking and
monitoring is clearly very relevant
to health contexts: for example,
smartphones are optimised to
record how far we walk, how many
calories we consume, or how well
we sleep. However, over the past
few years beauty apps available to
mobile and tablet users have also
suffused the market.
As a relative technophobe who
mainly uses a smartphone to see
if it’s going to rain, and to find my
way to the nearest bus stop (it’s all
glamour), beauty apps were very
much off my radar. So I decided to
find out more about them.
The Nuffield Council’s current
project on cosmetic procedures
will focus primarily on invasive
non-reconstructive
cosmetic
procedures (excluding temporary
changes such as tanning or the
application of make-up), so I
restricted my searches to specific
apps which focus on cosmetic
procedures and surgeries. I gave
myself just one hour to explore,
fearing that weeks of my working
life could quite easily be sucked
into a chasm of curiosity.
One hour later, although significantly
more enlightened on the range of
cosmetic procedure apps, I was
also the proud new owner of a
couple of new frown lines.
The apps I found
According to Reuters, the first
cosmetic surgery app (The Shafer
Plastic Surgery App) was launched
in 2009 by New York plastic surgeon
Dr David Shafer. This app (no longer
available through iTunes) enabled
those
considering
cosmetic
procedures to access over 1,000
FAQs on a range of procedures.
Two years later, a press release from
Medical Tourism NYC reported that
Dr Shafer had developed another
app to facilitate cosmetic procedure
‘tourism’ in New York City, or
according to the press release, to
“empower patients worldwide with
access to information, travel and
the ability to book appointments for
the best aesthetic and surgical care
available”. This app thus clearly
moves from answering questions
to active facilitation of cosmetic
procedures.
Similar facilitation can be found
in other apps, which explicitly link
to surgeons who could undertake
procedures ‘for real’. In a description
of the app Lift/Tuck, for example,
users are invited to “play around
just for fun or send your results to
Beverly Hills Celebrity Cosmetic
Surgeon, Dr Garo Kassabian for a
real life consultation”. Another app,
Breast Augmentation, developed
by Dr Mark Glasgold, invites users
to “download our app to easily
request an appointment, to learn
more about the procedures and
techniques Dr Glasgold uses, and
to view our before and after photos
instantly. We have also included a
treatment or recovery journal, where
you can track your progress and
attach photos easily to view your
procedure outcome.” Descriptions
such as these perhaps indicate that
cosmetic procedure apps are little
more than thinly-veiled marketing
tools.
Other apps attempt to distance
themselves from ‘real’ procedures.
For example, a disclaimer from
the Plastic Surgery Simulator – an
app which uses photo distortion,
where facial features can be
manipulated by dragging a finger
across a touch-sensitive screen –
includes a disclaimer: “There can
be a huge difference between what
can be achieved in the context of
a real plastic surgery, and on this
computer simulation tool. Only
a real, certified surgeon will be
able to assess what is realistically
achievable. Always ask a certified
plastic surgeon about possibilities,
risks and financial cost of plastic
surgery procedures.”
Disclaimers such as these may, in
part, be offered to avoid litigation
should harm come to any of the
apps’ users. Other apps, however,
take the possibility of future harm
from cosmetic procedures as their
sole purpose. Law firms may, for
example, give people planning to
have a procedure the opportunity
to record every element of the
process on an app, so that – should
anything go wrong – they have a
record which may support future
negligence claims.
Just ‘a bit of fun’?
Shortly after the release of the first
Shafer App, iSurgeon was launched
by Dr Michael Salzhauer (author of
My Beautiful Mommy,
a children’s
book focusing on a young girl whose
mother undergoes abdominoplasty
and rhinoplasty; as Zoe Williams
wrote in
The Guardian
at the time,
a book that might begin “Once
upon a time, mommy had a tummy
tuck…”). This app does not answer
questions or facilitate, but rather
invites users to play.
According to iSurgeon’s website,
the app “combines personal image
modification with high tech gaming
