The selfie-generation has become something we accept as much as we enjoy to joke about. Selfie-oriented beauty tutorials are the subject of love, hate and mockery. Shameless selfie is a hashtag. ‘Feeling myself’ a brush off reference to Beyonce rather than an acknowledgement of our self-obsession and desire for societal acceptance. Beauty tutorials on YouTube and Instagram have become a source of plastic surgery and botox inspiration, influence and—more importantly, education.

According to a 2017 survey by The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), 55 percent of plastic surgeons reported that their patients desired to look better in selfies. The trend was first identified by the surgeon society three years ago and has been on an average 13 percent increase per year since. BUT With online beauty influencers leading this change, what exactly is their influence providing those seeking advice, reliable information and support ahead of such robust, expensive and life-altering decisions?

AAFPRS President, William H. Truswell, said that “More and more of our patients are using social media as a forum to gain a sense of solidarity when undergoing a major, potentially life-changing procedure. Consumers are only a swipe away from finding love and a new look, and this movement is only going to get stronger.” The main issue is that surgery influencers and advocates often represent only a fragment of the whole process; the final result, the beginning of a happier life; the start of self-confidence never experienced before. Just a few weeks ago the Evening Standard reported that “Superdrug launched its own Botox and fillers service” as a result of what “experts have linked to the popularity of Love Island.” Supposedly watching 20-year-olds with lip fillers frolicking around a villa in Spain for 8 weeks is enough to convince an entire generation of beauty-thirsty millennials that aesthetic surgery is the answer. And don’t get me wrong, it could be for some. But what I’m more concerned about is the information available on what these procedures really mean.

The kind of information currently circulating through botox advocates and Instagram surgeons like Dr Six and his peers happens to be much more hollow and at times inaccurate than we’re led to believe. Just two weeks ago, a study was published by Rutgers University—the first of its kind—titled ‘Assessment of YouTube as an Informative Resource on Facial Plastic Surgery Procedures’. The study saw researchers analysing thousands of “facial plastic surgery procedures, patient experiences, and medical commentary” on YouTube and Instagram to evaluate the “video quality and creator qualification”. By analysing the top 240 videos that came up to an array of keywords such as ‘lip fillers’, ‘facial fillers’ and ‘eyelid surgery’, researchers concluded that these videos accumulate a combined 158 million views. All the videos were given a credibility and reliability score from between 1 (very low) to 5 (high) and the results, worryingly yet somewhat unsurprisingly, ranged between 2.75 at the top range and 1.55 for the low ranking videos.

It’s hard to believe that watching DIY plastic surgery advice, procedure and before-and-after videos will have such visible influence on an entire generation. But when there’s no limitation and, crucially, no regulation in the era of influencers we are living through—essentially “The Age of Influence” as the cover of Business of Fashion’s May issue read under Kim Kardashian’s perfectly symmetrical face—the question is, what are the limits to influence?

You’ve heard of social media influencers, but have you ever heard of a social media influencer among the gastroenterology community? Probably not, and yet it is certainly a thing. Dr Austin Chiang is a gastroenterologist who studied at Harvard, but he also is the first Chief Medical Social Media Officer at the Thomas Jefferson University Hospital, in Philadelphia. In other words, part of his job is to get doctors and other health professionals on social media to drown out health misinformation by posting large quantities of posts that are fact checked and, well, not fake. The idea of doctors having a presence on social media sounds unconventional at first, so it makes sense that people might wonder why exactly Dr Chiang’s job was created.

Just like fake news, fake health news come mainly from social media accounts sharing information that is not based on any medical research. And just like much of the speculative and factually inaccurate content shared on social networks, many people ultimately believe it. This is where Dr Chiang’s accounts come as a remedy. His main platform is Instagram but you can also find him on Twitter, Facebook and LinkedIn. On Instagram, Dr Chiang has more than 22,000 followers—making him the most followed medical influencer outside the world of plastic surgery and nutritional well-being—and his content represents his two favourite things: medicine and social media.

Every few days Dr Chiang posts a picture of himself with captions about the latest research or advice to patients trying to navigate between real information and rumours. And where do those rumours come from? According to Dr Chiang, from public figures like the 1.9 million Instagram followers and #1 NY Times Bestselling Author Anthony William, also known as the Medical Medium, famous for his book Celery Juice: The Most Powerful Medicine Of Our Time Healing Millions Worldwide.

When looking at William’s online presence, especially his Instagram account, many questions come to mind, mainly how someone with no medical background has harnessed so much credibility by the public. William’s entire Instagram feed looks like a bad infomercial for a blender or an eczema miracle cream and the consistent use of #healing makes for a cocktail of unease and suspicion. Call me crazy, but I’d like to think that if you proclaim yourself as a ‘medical medium’ without any diploma to show for yourself, you are most likely a crook that sees himself as a spiritual saviour.

Anti-vaccination content is another example of fake health news spreading through social media, with communities and groups preaching to anyone willing to believe that vaccination causes autism—a theory that has never been medically proven. Some people go as far as giving a ‘cure’ for autism in the form of an industrial-strength bleach.

Bearing witness to this kind of content online, Dr Chiang’s CEO Steve Klasko came up with the idea of creating a well-needed medical presence on social media with the help of Dr Chiang’s Instagram and hashtags like #verifyhealthcare and #dontgoviral. The solution to this frightening misinformation is providing young people with the right information, and allowing them to access it easily, which means publishing it on social media, where it is known that under 35s spend a large chunk of their time and where they get their news and information.

At the moment, Thomas Jefferson University Hospital’s goal is to have approximately 3,000 doctors participating on social media, which sounds like a good start. Help from the government (or social media companies like Instagram, Facebook and Twitter) in regulating false information could also soon be a necessity. Until then, don’t believe everything you read on the internet and please stay away from Medical Medium.