The head of the aesthetic division at Malta’s leading private hospital has attributed a surge in the number of young people getting plastic surgery to social media.

Speaking to Times of Malta, Saint James Hospital Niumee aesthetic hub CEO Maria Bugeja said there had been a “noticeable increase” in the number of 16 to 25-year-olds – mainly women – opting for cosmetic procedures.

“The younger cohort is more aware of the procedures available to them, and we have seen a noticeable increase in interest from this age group for med-aesthetic [non-surgical] treatments,” she said.

She said lip augmentation and non-surgical rhinoplasty – commonly referred to as a ‘15-minute nose job’ – were proving especially popular. Both procedures involve injecting a ‘filler’ substance such as collagen to change the shape of the lips or the nose.

The chief of Saint James Hospital’s aesthetic hub Maria Bugeja said social media and online bullying were to blame for the rise.The chief of Saint James Hospital’s aesthetic hub Maria Bugeja said social media and online bullying were to blame for the rise.

Attributing the surge to social media platforms such as Instagram, TikTok and Facebook, “especially those showing video content”, Bugeja warned the increasing popularity of such procedures was warping beauty standards.

“As of recently, we are facing an era of over-injecting and looking fake. The desire to look younger and beautiful is almost becoming an addiction as well as a fashion statement,” she said.

“Not all specialists advise against over-injecting, which is a pity... The human brain can judge faces with remarkable ease and unfortunately the fake-looking ones are instantly recognisable,” warned Bugeja.

“It is also very sad to see the increased number of teenagers who feel the need to pump toxins [Botox] in their faces to feel confident at such an early stage in life.”

The hospital chief said younger people were spending an average of just over €200 per procedure.

Clinics offering non-surgical treatments were “sprouting at every village corner” offering cheaper prices but with potentially higher risks, she said.  

“Unfortunately, these procedures are also being performed by non-medical ‘injectors’ who are not regulated by the same terms and conditions and can therefore afford to offer their services at cheaper prices,” she said. 

“This is increasing the number of complications being seen locally.”

Botched jobs abroad

Cases of operations gone wrong were becoming increasingly common, with those done abroad frequently to blame, Bugeja warned.

“I am still stunned by the substantial number of patients travelling overseas to undergo procedures in countries where our language is barely spoken or whose standards of care is considerably lower than they are locally,” she said.

Stressing that the incidents of complications following surgery were higher for operations abroad than for those done locally, Bugeja said the lack of information available to Maltese physicians treating such cases was also a major concern.

Such complications were “at times serious, irreversible or might require the patient to go back to the operating theatre,” she said, adding that social media was once again playing a role.

“Social media groups discussing med-aesthetic treatments and surgical procedures are another platform that is making it easier to entice patients to undergo these procedure.

Explaining that such groups frequently involved users asking those claiming to be former patients about their experiences, Bugeja warned, however, that not all recommendations were genuine.

“Patients all too often do not carry out adequate checks prior to believing all they read,” she said.

When asked if any country in particular was responsible for a higher number of botched operations, Bugeja replied “with confidence that Turkey tops the list”.

She identified “infections, bad workmanship and cheap implants” as leading causes of complications, in addition to patients travelling too soon after surgery.

Surgeon and eye specialist Maria Agius also linked the higher prevalence of cosmetic surgery among younger people to social media.

Noting that lip augmentation and botox injections were proving especially popular, she told Times of Malta that “social media and selfies are driving demand.”

While Saint James was seeing a rising number of enquiries from men, four out of five procedures were for women.

Long-established procedures such as breast augmentation (‘boob jobs’), rhinoplasty (‘nose jobs’) and abdominoplasty (‘tummy tucks’) remained among the most popular operations overall, though non-surgical procedures were quickly catching up.

Bugeja noted that for those aged 16 and 17, consent was required from the plastic surgeon in addition to the patient, who must be deemed mentally fit to undergo treatment.

One 19-year-old student told Times of Malta that at least two of her friends had opted for lip augmentations, a procedure she described as “very common” these days.

“It’s very normalised now – it’s become a lot cheaper and more accessible,” she said, describing it as “reasonably common” among her peers at the University of Malta.

Echoing Bugeja’s words, she said many young women were being influenced by “constantly seeing so many perfect models on Instagram,” describing the platform as “creating a false sense of self”.

She said that, for some, cosmetic procedures seemed to have “become an addiction,” with some ending up “looking like dolls.”

However, when asked if young women were facing resistance from their parents, she explained that, to the contrary, most parents seemed supportive of it.

“They think that if it’s going to make their kids feel better about themselves, what’s the problem,” she said, adding “many parents are getting it too.”

Driven by bullying

Highlighting another side to the role social media plays in younger people’s desire to undergo surgery, Bugeja noted that some were being driven to it by online bullying.

“Some cases are genuine, especially when the need to undergo surgery is driven by extreme bullying that causes mental health issues to the victim, or health issues in a minority of cases,” she said.

“It is sad to accept the need for surgery at such a young age but also a reality that bullying is difficult to control and extremely damaging to one’s self esteem.”

Bugeja said this was especially true when the bullying took place on social media – which she said younger audiences were readily convinced by – where “hate speech is written without the thought of how it will make the other person feel”.

She added that the standards the hospital placed on accessibility to surgery, however, helped to delay young people getting surgery.

Money no object

Last February, Saint James Hospital and BOV announced they had teamed up to offer financing for medical and med-aesthetic procedures.

According to the BOV website, amidst “shifting consumer attitudes and trends about health and wellbeing, such procedures are becoming more common, and more customers are turning to specialised clinics and hospitals to have such procedures done”.

While BOV already offers personal loans, the offering sees Saint James Hospital covering the processing fees for such loans, which are available up to €25,000.

Asked about the popularity of the loans, Bugeja said their take-up had been “pretty low” for plastic surgery but more popular for weight-loss surgery such as gastric bypasses.

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