“Oh my god, I need a nose job so badly!” I heard a high-pitched voice yell from a nearby table during a recent breakfast in New York City. I turned around to see three young women huddled around an iPhone, scrolling through photos. Another asked, “Have you guys seen that new filter on Insta that makes your lips huge and your face, like, perfect?” She pulled up the app to demonstrate. “This is exactly how I want my lips done!” the third girl said after trying it out for herself.

These sorts of self-deprecations are nothing new, of course. We’ve all looked in the mirror and thought, I really need to lose five pounds or If only my cheekbones were more defined. The difference is that now, in the age of selfie filters that smooth our skin and slim our faces, we’re able to better imagine what we might look like with a few tweaks. As a result, plastic surgeons around the world have noticed not only an increase in the number of patients seeking cosmetic procedures, especially those that will photograph well on Instagram, but they’re also noticing that patients’ expectations are alarmingly unrealistic.