The President of the United States likes commenting on the physical appearance of his colleagues. His observant eye focuses most frequently on his opponents, and even more frequently on women.

Perhaps the most egregious part of Trump’s explosion against Brzezinski isn’t that his observation was flatly inaccurate or inappropriate or mean—it was just a bit passé. It’s pretty rare for anyone in Washington to have a big, bloody surgery. It’s all about the subtle refresh in this town. In fact, interest in minimally-invasive procedures has grown 18% since last year specifically around D.C. area, according to RealSelf, a Yelp-like review site for the plastic surgery world. On a national level, the American Society of Plastic Surgeons reported a 3% increase in minimally-invasive treatments—more than 15.4 million people had them done in 2016, compared to 15 million the year prior.

Lots of wealthy people—celebrities, socialites, Silicon Valley ballers—get routine touch-ups, but politicians in Washington, D.C. have particular needs. It begins with their arrivals.

When it comes to their facial features, the goal for politicians is to seem engaged and friendly, according to experts. It’s a personality type that can be accomplished or signaled with their skin.

Aside from high-definition televisions and the the frantic randomness of President Trump, the newest factor in politicians clamoring for cosmetic enhancement is the front-facing camera phone and the selfie.

Unfortunately for pols, every day is a crazy day where they have to look their best, just in case.