A growing number of men are taking cosmetic procedures into their own hands, injecting themselves with neuromodulators, fillers, fat dissolving products, and peptides, and some even taking mallets to their faces to reshape their bone structure.
The products are often unregulated and easily purchased online, said Zakia Rahman, MD, a clinical professor of dermatology at Stanford University, Redwood City, California. Rahman has been seeing and treating a rising number of complications because of the trend, known as looksmaxxing, which promotes a narrow and idealized version of masculinity.
Men of varying ages are taking greater interest in improving their appearance, Rahman said. But boys and young men, whose brains are still developing, are potentially more vulnerable to looksmaxxing influencers. Many family doctors may be unaware of the trend, given its relative novelty, but they can play a role in counteracting its messaging.
Looksmaxxing is “centered on the belief that real men must have specific physical traits like a square jawline, tall stature, muscular build, perfect hair, and clear skin,” said Jason Nagata, MD, MSc, an associate professor of pediatrics and eating disorders specialist at the University of California, San Francisco. Along with injections, followers are encouraged to use techniques like mewing (pressing the tongue to the roof of the mouth) and bonesmashing (repeatedly hitting the face with a blunt object) to reshape their face.
The practices are mainly promoted through TikTok but also appear across different social media platforms and in online forums, such as Looksmax.org. Influencers like Clavicular and Oscar Patel are racking up hundreds of thousands of followers by promising to help them become more attractive.
It is important for physicians and healthcare providers to understand that patients and the public, including now men, are dealing with the very reasonable desire to optimize their external appearance and take care of themselves, with the unrealistic expectations often set through distorted images seen through social media,” Rahman said.
She frequently visits the Reddit group DIYaesthetics to find out what products and practices people are recommending and buying. There she sees posts by people who’ve had bad reactions to products purchased online who are wondering whether to tell a dermatologist the truth. Some patients develop infections that lead to permanent “crater-like” facial scarring if not addressed quickly, she said. Studies have linked serious health effects — including kidney failure and skin cancer— to injections of black market melanotan, a synthetic hormone used to darken the skin.
“They’re often quite embarrassed,” Rahman said. “But we don’t want them to be embarrassed because time is of the essence oftentimes.”
‘Grounded in Pseudoscience’
High costs put clinical interventions out of reach for many who populate looksmaxxing forums. Before becoming a celebrity looksmaxxer, Clavicular, whose real name is Braden Peters, discussed the challenge of saving up enough money to afford cosmetic surgery. Many are turning to cheaper, often dangerous DIY methods of changing their bodies and faces instead.
Bonesmashing, for example, “can lead to some pretty significant disfigurements and harm to the body,” said Edward S. Kwak, MD, a facial plastic surgeon in New York City. This year, Kwak posted on Instagram to discourage using the practice. It puts pressure on soft tissue, which may cause temporary swelling that initially mimics “contouring effects,” Kwak said. But repeated force over time can damage fragile nerves and bones of the cheek region where, “there’s not a lot of buffer,” Kwak said. “It’s just like having a blow to the face. If you’re assaulted or injured, then that could lead to a fracture injury.”
Mewing, a looksmaxxing practice aimed at achieving a more defined jawline, was developed by orthodontist John Mew. He encouraged up to 8 hours of mewing daily and lost his license in 2017 due to unproven claims. The American Association of Orthodontists (AAO) advised against the practice in 2024, warning it carries risks for loosened teeth, misaligned bite, and speech impediments, all of which may require “complicated treatment” to resolve.
“There is no scientific evidence that mewing changes jawlines, enhances cheekbones, straightens noses, or aligns the teeth,” said Michael G. Durbin, DDS, MS, president-elect of the AAO. And despite what influencers say, when the body stops growing, the jaw is unlikely to undergo significant changes without surgical intervention, he added.
Some young men are mewing “to a compulsive, almost nonstop degree,” said Michael Halpin, PhD, an associate professor in the Department of Sociology and Social Anthropology at Dalhousie University in Halifax, Halifax, Nova Scotia, Canada. Halpin analyzed about 8000 comments from the forum Looksmax.org, focusing on 6 months worth of the most popular posts, for a 2025 study in Sociology of Health and Illness.
One poster on the forum claimed to have inclined his bed and slept wearing a backpack to attempt mewing in his sleep. Middle and high school teachers told Halpin that some boys “don’t speak because they’re too busy mewing” or get all their calories from liquids “because they can mew and drink at the same time.”
Forum advice “can be grounded in pseudoscience,” Halpin said. “They use scientific, medical language to justify what they’re doing, but the things that they’re doing are extremely risky and dangerous. And they’re recommending that others follow their path and giving instructions for how they can do so.”
For example, Looksmax.org users discussed where to buy anabolic steroids and various hormones. One argued that injections of relaxin — a hormone released during pregnancy to relax ligaments and ease delivery — “should make you taller,” Halpin said. The user claimed to have purchased relaxin from a Chinese black market website. Leg lengthening surgery is often touted, as “the vast majority believe that if you are under 6 ft tall as a man, you will never have romantic or sexual success,” Halpin said.
A Role for Family Physicians
Teenage boys were already highly image-conscious and prone to comparing themselves to others before the advent of social media. Now, “there’s this additional pressure to not just consume content and see the influencers but also to produce content and put your own body or face on display,” Nagata said. Boys who engage with social media are more likely to be dissatisfied with their bodies. If they view muscular bodies and content about muscle-building drugs, they’re more likely to develop muscle dysmorphia, an obsession with becoming muscular also known as bigorexia or reverse anorexia.
“They may view themselves as puny even if they are objectively muscular,” Nagata said.
His 2022 prospective cohort study of 1535 young adult men found 53.5% reported changing their eating habits to increase muscle or tone during the previous year, with 2.2% using steroids and 10.1% using other muscle-building substances, including growth hormone. While not all young men trying to build muscle are looksmaxxing, Nagata said, those engaged with the looksmaxxing community may be more likely to develop an unhealthy relationship with exercise and nutrition.
“Looksmaxxing is certainly likely to be a risk factor for the development of an eating disorder or muscle dysmorphia,” Nagata said.
Recommended screening for eating disorders many family doctors use focuses on weight loss, he said, but “especially with boys, you might capture more variation if you are more open-ended about that question.” For example, providers can ask if boys are trying to change their weight. If a patient says they’re trying to gain muscle, providers can ask about use of supplements, high-protein diets, and other muscle-building behaviors.
Across specialties, clinicians should familiarize themselves with looksmaxxing, said George S. Corpuz, MD, a plastic and reconstructive resident physician at Indiana University School of Medicine, Indianapolis. Corpuz was a co-author of a December 2025 article in Facial Plastic Surgery & Aesthetic Medicine on looksmaxxing and a January 2026 letter to the editor in the International Journal of Dermatology on unregulated use of melanotan promoted by social media, both of which sought to encourage the development of public health strategies to combat dangerous looksmaxxing practices.
“We don’t have the skills to keep up with the evolving landscape of social media, especially the misinformation being heavily distributed amongst really impressionable audiences,” Corpuz said. “I don’t know how we become better at that, but certainly there has to be a push, not just within plastic surgery, but primary care.”
Halpin recommends doctors pay closer attention to self-esteem and self-image among young men and boys and provide body positivity resources. Validating that people are treated differently based on their appearance — a form of bias known as “looksism” — can also be a starting point for discussions about looksmaxxing, he said. Another tip: push back or provide counterfactuals against looksmaxxing’s “really limited notions of what it means to be a man” and “derogatory opinions” of both women and other men.
“They may not trust you. They may not believe you,” Halpin said. “But I think hearing information that challenges what they’re getting in this echo chamber is useful. It might not lead to a change in how they think, but at least it’s a data point for them.”
The sources in this story reported having no relevant financial conflicts of interest.
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