Steffanie Jacobson is packed up and ready to go to Colombia for a cosmetic surgery getaway.
"I'll be getting a breast augmentation and a thigh lift with a doctor I've read a lot of great reviews on," Jacobson said.
She says the surgery is a reward for weight loss, and it's the result of lots of research.
"My doctor has a very heavy online presence, and he had a lot of before and after photos," Jacobson said. His team was incredibly responsive."
She took Scripps News along for the journey, then we caught up with her a few months later.
"I feel great," Jacobson said. "The doctors were great. The staff was amazing."
Jacobson lives in Miami, Florida. She says cosmetic surgery is a part of life there.
"Everywhere you turn is a different doctor's walking billboard," she said.
Once a tool of the elite, cosmetic surgery is now available to people everywhere.
"We have seen a huge boom in plastic surgery and specifically aesthetic surgery since COVID," said Dr. Ashley Amalfi, a clinical assistant professor of surgery at University of Rochester.
In 2020, there were 2.3 million cosmetic procedures done in the U.S. The total cost of all of that is around $16 billion, according to the American Society of Plastic Surgeons.
"I really think what we're seeing is a change in people's mindsets," Amalfi said."People are now looking at the world differently. Their ideals are different. They realize that life is short."
That normalization is partly due to social media, where people can get step by step videos on building their new self.
In fact, its influence on beauty standards has led to the term "Instagram face," where people start to look somewhat similar thanks to filters, makeup and plastic surgery.
While doctors have turned to social media to advertise their work, there's still a growing list of doctors hoping to debunk anything too good to be true.
"If I can get a person happy with how they look and how they feel about themselves and not put them under the risk of surgery, then that's really the thing to do," said Dr. Anthony Youn, a board-certified plastic surgeon.
Surgeons Scripps News spoke to are quick to remind people cosmetic surgery is still surgery.
"Whenever somebody asks me, 'What's the worst thing that can happen if I have plastic surgery?' The answer always has to start out with, 'You could die,'" Youn said. "Now, it's very, very unlikely that this can happen, but that's the worst thing that can happen."
They say it's important to do your research, and that's more than checking out before and after photos.
"People are posting their best pictures of their best outcomes, and a lot of times photo editing comes into play or trick photography to make it look better," said Dr. Michael Ingargiola, a board-certified plastic surgeon.
"If the lighting is different, if the setting is different, there might be something misleading about that," Amalfi said.
According to a study published in the medical journal Plastic and Reconstructive Surgery, 62% of the American Board of Cosmetic Surgery diplomates, which is a designation different from a board-certified plastic surgeon, advertised surgical operations beyond the scope of their residency training.
"Doctors are ditching their chosen professions to masquerade as plastic surgeons," Youn said. "Any doctor can perform any procedure on you as long as you sign on the dotted line. It is perfectly legal to do that."
"I did four years of undergraduate, four years of medical school, and then six years of specialty training in plastic surgery, and that's what you want," Amalfi said.
It's not just surgeons: In December 2021, a Florida mother died following cosmetic surgery after never waking from anesthesia. The person administering anesthesia that day was actually a certified OBGYN.
While a lot of the cosmetic surgery legal world is a bit of a gray area, there are some laws.
In 2009, then California Gov. Arnold Schwarzenegger signed the Donda West Law, requiring medical clearance before a surgery.
It's named after the late mother of rapper Ye who died following plastic surgery complications.
Medical professionals say physical and mental well-being are important, and so is being realistic.
"When you see patients that try to just strive for complete perfection, it's a red flag because we'll never attain complete perfection, even with surgeries," Ingargiola said.
"Plastic surgery is not about making someone who looks like this look completely different," Amalfi said. "It's about making you the best version of yourself."
Jacobson says she's happy with her and her doctor's joint decision not to go any further with the surgery.
"Don't just always go with what's trendy because looks always change. Trends always change," Jacobson said.
It's especially true in a world where beauty seems to not only in the eyes of the beholder, but also in the eyes of millions online.
Amber Strong
