The problem: what is portrayed on Instagram isn’t always feasible. He says that his competitors, the most prominent of whom have followings in the hundreds of thousands or millions, might Photoshop out a scar from a breast implant, though it’s impossible to perform the procedure without making an incision. Their patients may post a before-and-after photo, where the after photo is filtered and edited and the patient’s skin looks more tan and smooth than it was previously.

