Instagram Vs. Reality: Assessment of the Representation of Lip Aesthetic Subtypes on Social Media Using the Lip Classification of Tubercles System

Abstract Background Social media platforms, particularly Instagram appear to be influencing contemporary beauty standards, especially concerning lip enhancements. Understanding the prevalent lip types showcased can offer valuable insights into evolving aesthetic ideals to inform both patients and practitioners. Objectives This study aims to analyse lip types associated with minimally invasive lip enhancements on Instagram (Meta, Menlo Park, CA) and compare these findings with classifications from a patient clinic using the Lip Classification of Tubercles (LCT) system. Methods A within-subjects design was employed to examine 120 "Before and After" images from four trending Instagram hashtags related to lip enhancements. Four expert examiners performed the classification, and inter-rater reliability was assessed. Data from a previous study involving patients from an aesthetic clinic (N = 214) were incorporated to compare the frequencies of lip types in the clinic and on Instagram. Results The inter-rater reliability for lip classification on Instagram was very good (Fleiss’ Kappa: pre-treatment k = 0.817; post-treatment k = 0.837). The most common lip type pre-treatment was 1A, which dramatically shifted to type 3A post-treatment. The comparison with the patient clinic revealed that while type 1A was the most prevalent in both datasets, Instagram exhibited lower variability, with only 10 unique types identified pre-treatment and a predominant type 3A post-treatment. Conclusions The representations of lip enhancements on Instagram reflect a narrower range of lip types compared to clinical findings, including a dramatic shift toward a type 3A lip shape. This standardisation of beauty ideal highlights the need for further exploration of social media's influence on lip enhancement preferences and the associated risks, as well as how these trends shape patient expectations in aesthetic practices.