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Instagram Influencers Are Selling Their Lips

Regulators are struggling to enforce rules around sponsored posts as the market for cosmetic ‘tweakments’ like fillers booms

Photo: Anna Sastre on Unsplash

AtAt the top of Marla’s Instagram profile is page after page of story highlights: her tiny New York apartment, Game of Thrones commentary, dogs, matcha, step-by-step cooking videos.

Marla, 30, has been working on growing her following since she quit her job at an online review company earlier this year. “I’m going to talk about anything that comes up in my life. If you can relate, then that’s great — and that’s why you’d follow me.”

But one question, in particular, comes up regularly from her 4,000-odd followers: “Where did you get your lips done?”

“I get it all the time,” she says. “The other day I was tasting in a cooking video, and someone was like, ‘oh my god, you have the best lips.’”

Though Marla posts openly about her cosmetic procedures — she’s had fillers in her lips and nose, as well as a breast augmentation — she says she is more often asked about them in response to unrelated posts. “Any time I post ‘I’m at Dr. So-and-So’s office,’ I don’t ever get anybody asking. It’s just when I’m like, cooking, you know?”

Marla’s story captures a central tension of the booming “influencer economy:” the difficulty in gauging what’s really being sold on social media, when nearly everything can be interpreted as an ad — even your face.

As native advertising on social media has become mainstream, the marketing of cosmetic procedures has exploded. In recent years this has been driven by dermal fillers, an immediate and often inexpensive way of making lips bigger, reshaping a bumpy nose, or smoothing lines without the need for surgery. According to the latest figures from the American Society of Plastic Surgeons, there was a 228% increase in fillers and other “minimally-invasive procedures” from 2000 to 2018, compared to a 5% fall in surgical procedures.

The rise in these so-called tweakments has been blamed on celebrity culture and social media, and embodied by Kylie Jenner, who has shared freely about her late-night lip “touch-ups” with her more than 140 million followers on Instagram. The platform can effectively serve as a catalog for cosmetic procedures, with 1.3 million posts hashtagged fillers, 1.2 million with #juvederm (one of the most popular brands), and 1 million for #lipfillers.

Scrolling through those hashtags, replete with before-and-after shots, is akin to flicking through a look book, except more immediate, with an appointment only a few taps away. It’s no wonder that doctors have thought to market themselves where their best advertisements — their clients — are already actively sharing their work, in selfies of newly smoothed, perfectly plumped faces.

Companies even exist to act as go-betweens — like Plastic Surgery Studios in California, a stable of “marketers, web designers and writers” with specific expertise in digital marketing for cosmetic clinics — though it is common for clinics to approach influencers themselves.

The FTC has been trying to rein in this sort of marketing since 2017, reminding influencers that any “material connection […] must be conspicuously disclosed” — for example, by using the hashtags ad or sponsored.

Six months ago Alexandra Cane, a former contestant of the British reality show Love Island, said she had been inundated with unsolicited offers of complimentary procedures in exchange for promotion to her 1.2 million followers on Instagram. Kanvas Cosmetics, a nationwide company that offered Cane fillers “for a collaboration of social media posts,” said in a statement to Sky News: “In an industry with so many grey areas and lack of regulation, honest reviews from influencers […] is what the public needs to find a reputable aesthetics company. When we come across influencers who have an avid interest in the beauty industry, we do reach out. However, more frequently we do have celebrities and influencers approach us.” (Kanvas did land their Love Island-er eventually: Cane’s castmate Charlie Williams appeared in a video promo at the start of the year.)

Those honest reviews, however, are hard to find. Scrolling #lipfillers, for example, it is difficult to tell which images are from satisfied clients, and which should be marked #sponsored. The two may not even be mutually exclusive.

Marla says she carefully researches clinics using RealSelf, Google, Yelp, and Better Business Bureau — but sometimes she pays for their services, and sometimes she doesn’t. Usually, she says, she will pay for the first treatment, then propose “a give-and-take business exchange” for subsequent visits. “I’ve never had a cosmetic surgeon, or anybody in the beauty industry that I’ve pitched tell me ‘no.’”

The Federal Trade Commission (FTC) has been trying to rein in this sort of marketing since 2017, reminding influencers and brands that any “material connection […] must be clearly and conspicuously disclosed” — for example, by using the hashtags ad or sponsored. (#spon, it said, was not clear enough.) The Competition and Markets Authority (CMA) has had a similar drive in the U.K.

But with both bodies dependent on the public, consumer watchdogs, or frustrated competitors to notify them of potential violations, their scope is limited and enforcement is low. Many influencers say that they are either confused about their obligation or confident that they won’t be pursued. “For all of us littler guys, the FTC is not a threat,” says Marla. She recently paid for lip fillers at a clinic in Harlem, then brokered a deal that the next time she visits, she’ll get a free microdermabrasion facial in exchange for posting footage and a review. Though she would always give her honest opinion, “I’m not going to put #ad or #sponsored.” Some companies even specify that there be no such disclosure as a condition of partnering, she says. “They want it to seem more organic.”

“There’s so much of this activity out there, I think the likelihood of the FTC even knowing about a violation is slim, unless it’s on a major scale.”

Ellie Altshuler, an entertainment lawyer and partner at the firm Nixon Peabody in Los Angeles, says the FTC’s rules are clear: If there is a connection between an influencer and a service provider that their followers would not expect — such as free services, even if they have paid the provider in the past — then that should be made explicit.

Altshuler notes that the disclosure requirements do not seem to have negatively impacted influencer marketing, though she wonders if it may be becoming less potent. “Does it lose its effectiveness, if the consumer becomes so used to seeing it that they ignore it?” says Altshuler. “There’s so much of this activity out there, I think the likelihood of the FTC even knowing about a violation is slim, unless it’s on a major scale.” She says there is likely “heightened sensitivity” in the case of medical procedures.

Though fillers are widely accessible, they are not without risk. Administered incorrectly, they can lead to infection, scarring, and even (in exceptional cases) blindness. “If I ask how the majority of my clients how they came to be treated at a particular clinic or by a particular doctor […] social media is always where the questions seem to lead,” says Elena Manukyan, a lawyer with Graham Coffey in the British city of Manchester, who specializes in personal injury claims arising from cosmetic procedures.

It is unlikely that an influencer would ever be held liable in the case of injury, she says. “It’s almost like saying, if the advert was on a bus, ‘Can we pursue the bus?’ It’s just a platform.” They would, however, risk negative publicity and a backlash from their followers.

For Marla, the threat of having “someone blast my page and my face on ‘Page Six’” if an endorsement goes wrong seems to be a greater curb on her activity than the FTC — as well as her own sense of responsibility to her followers. If she didn’t care about her reputation and “being super-authentic,” she says, somewhat ruefully, “I wouldn’t have to bartend to supplement my rent, let’s just say that.”

In the meantime, the visit to the Harlem clinic has already had an effect. “I didn’t really need my lips done again, but I noticed that people are already asking me about them. And that’s what propels my career.”

I’m a freelance journalist based in London.

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