Why Fixing Your Face Doesn’t Always Fix How You Feel With Dr. Evan Rieder

Mirror Mirror with Amy Chang

Host Amy Chang interviews dual-board-certified dermatologist and psychiatrist Dr. Evan Rieder about 'perception drift,' a psychological phenomenon where repeated exposure to certain aesthetic trends or environments

Key takeaways

• Dr. Evan Rieder explains that perception drift occurs when repeated exposure to specific looks (e.g., large lips or overfilled cheeks) retracts the brain's aesthetic baseline, making extreme features feel normal over time.
• Social media algorithms accelerate this shift by rapidly feeding users content they linger on, with studies showing preference for exaggerated features can change within minutes of rapid-fire imagery exposure.

Main topics

• Perception drift and shifting beauty baselines
• Social media algorithms and repeated exposure effects

Notable quotes

"If you linger on a pair of large lips, you will see more and more large lips. And in the beginning, you may be like, well, these are too big. But if you see more and more of them, you will retrain your brain to find those to be more attractive."

Conclusion

The episode provides a clinically grounded framework for navigating aesthetic treatments by prioritizing

Transcript preview

Speaker 1 (0:00) If you linger on a pair of large lips, you will see more and more large lips. And in the beginning, you may be like, well, these are too big. But if you see more and more of them, you will retrain your brain to find those to be more attractive. Speaker 2 (0:12) So it sounds like perception drift is not a problem with the product. It's not because of Botox. It's not because of filler. It's a problem with perception. You Speaker 1 (0:21) know, perception drift sets a new... sort of mental baseline for you. Like you don't realize that actually like you're not the same person in terms of the way you look than you were before. Speaker 2 (0:32) We've all seen it. Someone starts with a little bit of Botox, a little bit of filler, and then as the years go by, they begin to look overfilled, frozen, and unnatural. How does this happen? This is the question that we are going to be exploring on today's podcast episode with... guest who is uniquely positioned to talk about this phenomenon. He is one of only three physicians in all of the United States to hold a dual board certification in both dermatology and psychiatry. He trained at Dartmouth, University of Pennsylvania and NYU and sat on faculty at NYU's Department of Dermatology for years before going off to start his own private practice. 36. north moore street and he's become one of the leading voices to discuss this intersection of beauty psychology and aesthetics today we're going to explore how someone's view of themselves can become distorted and how you can partake in the world of aesthetics while still being able to accurately see yourself today's guest is dr evan reader evan thank you so much for being here thanks Speaker 1 (1:36) amy thank you for having me Speaker 2 (1:37) How do people slowly lose the ability to see themselves? So Speaker 1 (1:42) in my practice, it happens infrequently, but I think people can lose their sense of selves when they sort of push it too far. And we see that one of my colleagues coined a term called perception drift, which is not really, it's not a psychological term, but it describes a phenomenon that we all have seen. Those of us who are embedded in the aesthetic world, we've all seen it. And you may have seen it as well if you've ever gone to like any sort of beauty conference or an aesthetic conference or if you've walked into an aesthetic practitioner's office who has a specific look. And so for me, that experience is, okay, so when you come to my office, you look around, I think it looks nice. I think it's very tastefully done. And people look normal. They conform to general standards of beauty and society. The United States is great because we have a melting pot. We have people of all races. We have all ethnicities. And so there is no one stereotypical idea of beauty in the States, right? But there are people who have ideas that deviate from what we think is traditionally beautiful in society. And sometimes this is the overfilled face. This is the cheeks that are too big. This is the lips that are not proportional to the face. And if you find yourself in that sort of society and that sort of group socially or in your family, then you can actually retrain your brain consciously or unconsciously to find that to be beautiful. So for the person who is in that environment, they can actually change their perception of what they find is beautiful. And then they can be taken down this road of transformation of their facial features or of their body. so much to a point where they no longer look like themselves. And my clinic, we don't see that too much, but I have seen that in lots of other people. And I think there's a lot of reasons that that can happen. Could Speaker 2 (3:33) you share some of those reasons why perception drift happens? Again, Speaker 1 (3:37) I think the biggest reason is that our ideas of beauty are not static and they can change depending on the situation that we find ourselves in. The most immediate is our... our environment before the time of social media when people were just living their own lives and not in communication with the outside world as much it would have to do with their environment look like if you were a young person you grew up in a house where like your parents both had plastic surgery and they radically transformed their faces you may find that to be aesthetically beautiful and maybe they had a great outcome but maybe they pushed a little too far they looked a little too tight they were a little too frozen and you may say that's normal that's what beauty is in this environment and then you will be striving for that and we do see that for people who are coming in young people are coming in and their teens and their early 20s who have parents who have pushed it too far they're already looking for aesthetic intervention Now, I also think that social media has played a huge role in that. You know, you're scrolling and if you linger for just a fraction of a second on something, then social media will show you more of that. And it can rapidly change according to the day. Like, you know, last week my content was beauty. This week I lingered on an image of like a soccer player scoring a goal and I'm getting more of that. So social media, and I think that... they know exactly what's going on. They're showing you more of what you want to see. And if you linger on a pair of large lips, you will see more and more large lips. And in the beginning, you may be like, well, these are too big. But if you see more and more of them, you will retrain your brain to find those to be more attractive. There was an interesting study that came out in the plastic surgery literature that kind of was like a pilot study looking at that. They showed a group of people, rapid fire imagery. lips okay all did different sizes and they were asked to show their preferences okay and they rated them and then after that they showed them lips that were much larger okay Speaker 2 (5:37) just a couple minutes after rapid Speaker 1 (5:38) -fire imagery showing them the images what they found was that after looking at these huge lips that were out of proportion to the faces and people were asked to rate their preferences their preferences were then 30 % larger than they had originally been So it doesn't take that long to change your ideals of beauty. So I think the combination of the environment in which you find yourself and the effects of social media can really do a lot to change your your ideas of beauty. Speaker 2 (6:04) I had Dr. Sarah Benet Weiser on the podcast, who's the dean of the School of Communications at the University of Pennsylvania. And we were talking about how media and this idea of repetition cultivates within us, like what we see is beautiful. She was talking about how even with It's not just what we see, it's what we hear, it's what we're exposed to repeatedly that shapes what feels familiar and feels beautiful and resets that new baseline of normal. She gave me this example of when you first hear a song and you may not like it, and then it's constantly on repeat, and two weeks later, suddenly that's all you want to listen to because it becomes familiar. And so it sounds like what you're describing is that repetition of certain images reset. a person's baseline so it touches on ai face or instagram face you Speaker 1 (6:51) can call it whatever you want to call it but what she was referring to is a marketing concept and social psychology concept called the mere repeated exposure phenomenon it's Speaker 2 (7:03) used everywhere Speaker 1 (7:04) that experience when you walk down the street and you see the billboards or like the flyers for the political candidate or someone's handing them out to you they want you to talk to them, but like just you seeing the face on the card is actually enough to change your decision making. So you may not know who that person is, but you may see the name and it may register as familiar to you. So when you go to that ballot box and you're sitting there and you're like, okay, I know who I want to vote for for president, but I don't know who these other people are. I kind of recognize that name there. You've sort of been like detailed, right? And you will choose that person's name because they're more familiar to you. the mere repeated exposure effect. I talk about that with songs too. I think that's a great analogy. It works to a certain extent, except for when you're talking about something that's like super poppy because, you know, you'll like it immediately and then it'll fizzle out. But some of the more interesting songs, the mere repeated exposure effect works. Or when you go in an art gallery and you're like, that's ugly or like that's not moving me at all. And you keep going back and you keep going back and then you like it more and more and more. Things that are familiar to us, we tend to like more. And that has been proven. over and over again and that happens all spheres of aesthetics that happens in politics and that's i think the most nefarious way but marketers have been using this phenomenon that's very well known you know in those circles but not known in the general population for many many years so Speaker 2 (8:28) it sounds like perception drift is not a problem with the product it's not because of botox it's not because of filler it's this perception it's a a problem with perception and we've seen you know the past like five years ten years or so there's been demonizing around certain products like oh that person looks frozen or overfilled botox is bad filler is bad but do you feel like the general population is moving away from that and understands that it's not that the product itself is bad it's that perception drift happens perhaps it's who you go to for your work it's Speaker 1 (9:03) a really good question you know perception drift sets a new sort of mental baseline for you. You get a little high from getting your procedure, you go back down and you're at your, you're sort of like your, your perception of your new baseline is kind of warped. Like you don't realize that actually like you're not the same person in terms of the way you look than you were before. So it changes the way you perceive something, your changes, your cognition. And then because, you know, we want that little hit again, that little dopamine rush of like, fixing something else, people move on to the next thing. Oh, we've now fixed my wrinkles. Now let's move to my skin quality. Now we fix my skin quality. And now actually my cheeks aren't big and big enough. And so the pattern repeats itself and keeps going until someone intervenes or someone has pushed it so far that they realize that they have lost themselves. Right. And so an astute practitioner will intervene. family member might intervene or that person may take a step back and say oh my god what's happened but in general when you are sort of in this this ladder of increasing more and more aesthetic procedures you have difficulty getting yourself out of it and then looking back in time because it can be pretty painful to do so in response to your question about demonizing those procedures i think i still think that happens and i think that There's an outside effect that certain influential people have on what happens in society in terms of our aesthetic ideals. And there's certain people who have huge media presences, TV, print media, and now on social media. And so a young woman in a family in Los Angeles can post something and then millions of people will see it and they look. ethnically ambiguous enough that they can, someone in Latin America can identify them, someone in the Middle East can identify with them, someone in Asia can identify with them and see themselves in that person. And if they want bigger cheeks, then like all these other people are