Dangerous trends on social media related to facial esthetics: Analysis of looksmaxxing and its softmaxxing and hardmaxxing practices.

OBJECTIVES: This study aimed to systematically analyze the online discourse surrounding dangerous facial aesthetic trends, with particular focus on the "looksmaxxing" phenomenon and its associated practices. METHODS: This study employed a cross-sectional design. Quantitative data were collected using Brand24 social listening tools, Google Trends analysis, and Instagram engagement metrics. Search strategies combined keywords including "DIY cosmetic procedures," "self-injection," "bonesmashing," "mewing," "DIY chemical peels," and "looksmaxxing." Inclusion criteria comprised non-medically supervised facial aesthetic procedures inspired by social media and popular content promoting specific facial aesthetic trends. Engagement metrics (likes, shares, comments, views) were compared using Mann-Whitney and Kruskal-Wallis tests with Dunn's post-hoc tests and Bonferroni correction. Following quantitative analysis, a qualitative thematic analysis was conducted on a purposive sample of the 100 most-engaged posts promoting looksmaxxing practices. RESULTS: Over the 12-month period, the term "bonesmashing" generated 2,518 total mentions, with social media reach estimated at 32 million and total interactions reaching 2,477,227 over three months. YouTube dominated the discourse (43.7%), followed by TikTok (17.4%). Sentiment analysis revealed 65% neutral mentions, 18% negative, and 17% positive, with joy (33%) as the predominant emotion. Tutorial content received higher engagement than non-tutorial posts (W=9, p=0.0978). Gender analysis demonstrated an overwhelming male predominance in #bonesmashing content (approximately 98% male), compared to #mewing (74% male; χ²=8.31, p<0.01). Google Trends showed a 5,000% increase in searches for "bonesmashing" compared to the previous year. Qualitative thematic analysis of the 100 most-engaged posts identified four dominant narratives: (1) self-improvement as empowerment; (2) pseudoscientific legitimacy; (3) community belonging and mutual validation; and (4) risk minimization and normalization. CONCLUSIONS: The data demonstrate that looksmaxxing practices constitute a significant online phenomenon with substantial reach and engagement, particularly among young men. The prevalence of positive and neutral sentiment, combined with high engagement with tutorial content, suggests that dangerous practices are being normalized within online communities through sophisticated discursive strategies that employ pseudoscientific language and community validation.