It is likely true that before early 2020, Zoom was not a well known remote conferencing system, and if we'd bought shares in it, we'd like be very very wealthy now.

That aside, most of us have used teleconferencing extensively, for meetings and even for patient consultations that we would in days prior, have conducted face to face, in real life.

Teleconferencing has been such a boon to most of us, we do not wish to see it go away entirely, especially if it obviates the need, especially in Medicine, for face to face when no procedures are planned with ongoing risks due to the novel Coronavirus. 

It can only be all good right? Not so.

Since the pandemic and the more recent Sydney lockdown, we are seeing more people book in for the first time, because they "hate the way I look." and a lot of the time, this is contributed to, or added to, by necessary meetings on tele platforms where you get to see your own face, in unflattering light and angles.

Equally, we see ourselves animated, wrinkles and all, in a way that never previously bothered us because we did not see our own faces while interacting with others, but do now! I have seen several new patients for video consults as well as face to face consults who were finally ready to take the step towards non surgical treatments BECAUSE they were repeatedly seeing their own dark undereye circles, or wrinkles and sag while on video calls for work.

So what is Zoom face?

Zoom face is a form of disconnect between the brain and the eyes; how we perceive ourselves as presenting to others based on looking at ourselves in 3D, eg in the mirror, and how we appear in selfies (2D) with distortion of lighting as well as camera angles.

Video conferencing adds to this by adding in the element of our being able to see ourselves animated with other people, and watching that animation in the form of lines, wrinkles, hollows (under eyes) and sag (lower face) we did not realise exist (to quite THAT EXTENT) when we are merely speaking in the mirror. When we are genuinely animated, we tend to use far more facial muscle movement than when we are going through the motions in front of the mirror due to a feedback loop between our eyes and our brains, to help us keep looking “good’ to our own eyes. 

The combination of these factors can lead to a jarring sense for most of us of looking "wrong". Many of us have realised, during seemingly endless calls during these past 20 months, that this is how others likely see us, and for many of this, where we have been slightly bothered by aspects of our appearance before, this may become a more persistent discontent, leading to seeking out help and cosmetic opinions , including surgery.

So what can we do about it from a realistic angle?

I am first and foremost, a doctor. As such, I have an ethical obligation to "first do no harm".

For most new patients, I spend a significant amount of time not only taking photos in good standardised light, but also in discussing what bothers someone and why it has led to them presenting now. We spend a lot of time discussing their concerns, what they are, how realistic they are in their expectations, within the limitations of their unique anatomy and whether they have the means and willingness to budget for it and the time to be patient.

Equally, I discuss with patients what the phenomenon of "zoom dysmorphia" or "zoom face" is:
- a distortion of facial proportions if using a handheld phone such that aspects of the face appear bigger, such as the nose.

• a conversion of a 3D image that we would see in a mirror for example, into a 2D image, that loses some of its depth, leading to a flatter look
• often, reversal/ flipping of the image that our brain cannot quite comprehend as being "normal".
• the jarring sensation of watching ourselves animate and seeing unexpectedly, hollows, sagging skin and wrinkles where we would not usually see them when taking stills or even talking to ourselves in the mirror
• poor lighting or shadows in videos that may highlight or exaggerate this appearnce, leading to a more marked distortion than we are used to seeing.

What can be done about it?

As always, start with a conversation with a trusted clinician you can speak to about your concerns, who will take the time to understand your point of view, if they are amenable to being "fixed" or improved, and what can be done about them, over what timeframe and at what cost.

These are conversations that take upwards of 20+ minutes, with clinical photographs and standardised lighting and rely on time taken to understand your expectations. 

Unlike Beauty, we are not simply covering up worrying problems with makeup and filters. It is important to understand that we are working with your underlying genetics and anatomy, as well as age and cumulative factors such as sun damage and other lifestyle choices such as smoking, which may limit outcomes, even if money was no object.

Lastly, once you have had this discussion, and understand realistically what is feasible, and what is not, via committing to  skin improvements, injectables, minimally invasive surgery or referral to a Plastic Surgeon, and associated costs and timeframes, you can decide if it is an avenue worth pursuing.

Equally, some patients, once they understand how zoom face works, and the time and costs associated with making longterm changes involved, will decide to do nothing, which is as it should be, without any pressure or salesy tactics. 

Have you struggled with Zoom Face during the pandemic and have you done anything about it if so?

Images courtesy of Daniel Boschung of his photography project.