They call themselves dolls. These are cosmetic surgery patients who document their desires and results on Instagram, but only, most say, for other patients or prospective clients. They use names and hashtags that connect the work to their provider. So, for example, KathySmithDoll would be a woman who underwent surgery with a Dr. Kathy Smith.

In an era of patient empowerment, these pages — they’re called “Sx pages,” with “Sx” mimicking the prescriptive “Rx” — form a just-out-of-sight Instagram community. They serve as a cosmetic surgery shopping guide, a best-practices education system, and can also sound the alarm about bad experiences with practitioners. Some presurgery doll pages are more like inspiration pages or mood boards, collecting images of desired shapes.