By Digital Presenter and Producer Mojo Abidi
Plastic surgeons are using TikTok to promote their procedures to young teenagers, despite the app banning cosmetic surgery adverts.
Videos showing plastic surgery are appearing on the For You page of children as young as 14, which mental health experts say is "deeply problematic".
Videos of cosmetic surgery transformations have become a viral trend on the app.
The hashtag #nosejob has over 1.9 billion views, and #plasticsurgery has accumulated more than 4.5 billion views.
Even though plastic surgeons cannot pay for advertisements on TikTok, they can post free videos of the before-and-after of their procedures, which quickly go viral on the app.
To test how available these videos are to young teenagers, ITV News created a TikTok account as a 14-year-old female.
We scrolled through the For You page, TikTok’s personalised feed of recommended videos, to see what appeared.
Within 15 minutes, three videos promoting lip fillers, breast augmentation and rhinoplasty were promoted to the account.
One video was captioned: “This is your sign to get a boob job!”
Dr Antonis Kousoulis, director at the Mental Health Foundation, says the promotion of plastic surgery to teenagers is deeply problematic.
“Social media is very influential on young people on so many levels, it affects their confidence, image, language and more,” he said.
“So presenting them with lots of cosmetic surgery videos will normalise the practice.
“We also know a lot of these surgeons use predatory techniques when promoting their work on social media. They weaponise mental health, and say the operations will solve your problems and make you feel better.”
But Dr Kousoulis argues the videos don’t show the pain, the long recovery process or the surgeries that go wrong.
He says: “For those who are under 18, it is completely unacceptable. I can find no justification for showing cosmetic surgery videos to under 18s.
“Tiktok needs to take more responsibility to prevent harm on the app.”
These plastic surgeons are even enlisting the help of marketing firms to promote their procedures to young TikTok users.
The U.S. digital marketing agency Sagapixel has published a guide helping cosmetic surgeons go viral on the app.
It says that “procedures that are most popular for younger audiences will perform the best on TikTok”, recommending videos about “breast augmentations or nose surgery” over facelifts.
“By continually showing up on potential customers’ For You page with quality content, you will stay at the forefront of consumers’ minds,” the website reads.
On one marketing video posted to TikTok by a plastic surgeon, a 17-year-old commented: “Can you tell me what the price would be, I really want to know so I can save up.”
“I can’t believe I have to wait four more years,” wrote a 14-year-old with a crying face emoji.
And a 16-year-old said: “This is the exact nose I want.”
There is even a specific sound created for patients to show off their rhinoplasty operations.
The sound encourages users to video their nose pre-surgery, then covered in bandages, and finally the reshaped post-surgery nose.
More than 115,000 TikTok users have created videos using this ‘nose job check’ sound since October 2019.
Including the platform’s most followed user, 16-year-old Charli D’Amelio. Her nose transformation video has received more than 15 million likes.
A spokesperson for TikTok said: “TikTok was built to provide a positive place for creativity, and we prioritise the safety and wellbeing of our users.
“We do not allow advertisements for cosmetic surgery or weight-loss supplements as they don't support the positive, inclusive safe space we strive for on TikTok.”
The spokesperson also suggested young TikTok users enable ‘Restricted Mode’.
They said: “Parents and guardians can also enable Restricted Mode, which limits the appearance of content that may not be appropriate for all audiences.
“We are constantly enhancing our safety policies and features to ensure that TikTok can continue to be a safe and fun home for creative expression."
ITV News enabled Restricted Mode on the account we created. Within two minutes, a rhinoplasty video and a promotional video for a plastic surgeon appeared on the For You page.
Dr Kousoulis says it is important parents speak to teenagers who might be feeling insecure because of these videos: “Have conversations where you listen to your child’s concerns and expose them to the issues in the beauty and social media industry.”
A spokesperson from Childline said: “This content may make them want to change the way they look, a feeling that could be heightened with the additional time they are spending online due to the pandemic and the lockdown restrictions.
“If you know a young person struggling with this issue, remind them of the trusted adults in their life who they can talk to. You should also point out that nobody is perfect and we are all different and unique in our own way, and sometimes images online are altered or airbrushed.”