Ten years ago, a typical patient at my plasti...

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Ten years ago, a typical patient at my plastic surgery clinic in McLean, Va., was 47 or 48. They generally wanted to look like a younger version of themselves. This might mean a face or neck lift, eyelid lifts, a skin-resurfacing procedure or Botox (肉毒杆菌) injections. ''What do you recommend? '' they'd ask. This is the kind of work I am expecting to do, and these are the consultations I am expecting to give.

Today, my average patient, according to my office records, is 38 or 39. They'll come in with a specific ''flaw'' on their faces and often know exactly what procedure they want. They are pretty sure that their noses are too big, their chins are too large, or their eyebrows appear dull. And these patients are much less realistic about what I can achieve. They will ask for Kim Kardashian's nose, even if their facial structure looks nothing like hers.

There’s a reason for this rapid and radical change: selfies. The self-taken photograph is greatly attacking the confidence of many younger people. They come to my offices, show me their selfies and point to a defect on their faces, which is a totally normal shape to me. Often they will have already searched online till they’ve found someone with a similar “issue” who fixed it with surgery. Once, a 20-year-old, having studied countless images of herself and searched hundreds of pictures of the ideal looks she wanted, said she needed a facelift. But to me, no 20-year-old needs a facelift.

Selfies also mislead people about how they look. Smartphone cameras get better each year, but photos taken at arm’s length or closer often produce a ''fish eye'' effect: whatever's at the center of the photo is bigger, and things on the edge are smaller. A study published in JAMA Facial Plastic Surgery last year found that selfies make noses look 30 percent larger than they are.

A survey done by the American Society of Plastic Surgeons last year found that social media was driving more plastic surgery requests than any other social influence: more than TV, movies or magazines. People are spending more time looking at themselves, in an online environment where comparisons with others seem inevitable. Academic psychologist Brian Feinstein, who studied a sample of 268 college-age adults, has found that the more people use social media, the more they reflect on their own supposed drawbacks, and therefore causes self-confidence to drop.

1.Why did the author's typical patients want plastic surgery ten years ago?

A.They were recommended to do so.

B.They were unsatisfied with the faces they were born with.

C.They’d like to look younger than they really were.

D.The author expected them to do so.

2.What can we know about Kim Kardashian?

A.She is a patient of the author's.

B.She is a model who has a beautiful nose.

C.She is a doctor of plastic surgery.

D.She is a fan of plastic surgery.

3.What can we learn from Paragraph four?

A.Smartphone cameras can help people take better selfies.

B.Smartphone cameras make people look at their selfies through a fish eye.

C.People usually take photos at arm's length or closer.

D.Smartphone cameras make people's faces in a selfie unreal.

4.Which of the following would be the best title of the passage?

A.Selfies Are Weakening Self-confidence.

B.Young People Like to Take Selfies.

C.More People Are Getting Plastic Surgery.

D.People Like to Look Better in Selfies.

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