Today’s airbrushing could be tomorrow’s Botox.

Doctors say the pressure to look good comes from seeing your own face popping up on social media: Over 40% of surgeons in a recent American Academy of Facial Plastic and Reconstructive Surgery survey said patients said looking better in selfies on Instagram, Snapchat and Facebook was an incentive for getting surgery. “People see pictures of themselves fairly routinely on Facebook,” said Fred Fedok, a Foley, Ala.-based plastic surgeon and president of the academy. Constantly seeing yourself from unflattering angles can take its toll on your self-esteem, he said.

Americans are finding inspiration through celebrities and celebrity plastic surgeons online. In fact, half of plastic surgeons say social media is a cheap way of advertising their services, an American Society of Plastic Surgeons survey found, and one renowned Miami-based plastic surgeon, Michael Salzhauer, has accrued hundreds of thousands of followers by detailing his surgeries on Instagram and broadcasting real-time Snapchats of his surgeries. He has over 500,000 followers on Instagram and started his Snapchat account on advice from his teenage daughter.

Although the overall number of procedures has increased 115% in the U.S. since 2000, the kinds of procedures are shifting, influenced by the people they follow on social media. The majority of facial plastic surgeons (66%) said that nonsurgical procedures such as lip fillers used by social media and reality TV stars like Kylie Jenner and Lisa Rinna were the most common in their practice, according to a 2016 survey from the American Academy of Facial Plastic and Reconstructive Surgery, a professional association representing more than 2,500 surgeons.