Public Interest in Breast Augmentation: Analysis and Implications of Google Trends Data

Navigating Aesthetic Pursuits: A Google Trends Insight into Cosmetic Tourism

BACKGROUND

The popularity of cosmetic tourism may increase unnecessary risks for patients as postoperative care is variable. However, little is known about the current trends and public perception of this growing phenomenon. This study compares interest in cosmetic tourism in popular medical tourism destinations relative to the US.

METHODS

Google Trends was queried from October 2017 to September 2023, examining trends over the full period and dissecting changes between 2017-2020 and 2020-2023. Search volume data were retrieved for the top international countries and the US for each of the top five cosmetic procedures, according to the ISAPS 2022 Global Survey. A p value < 0.05 was used for statistical significance.

RESULTS

Searches for liposuction, blepharoplasty, breast augmentation, mastopexy, and abdominoplasty were compared between the US, Mexico, Turkey, Thailand, and Colombia. Google Trends data mirrored the prevalence of the two most common procedures, liposuction, and breast augmentation. Differences in interest regarding liposuction were greatest in Mexico, Thailand, and Turkey compared to the US (p < 0.05). Medical tourism for blepharoplasty had the highest search interest scores for Turkey and Thailand from 2017 to 2023 (p < 0.05). Significant differences were also consistent across all time intervals for breast augmentation, mastopexy, and abdominoplasty, with higher interest in Mexico and Turkey (p < 0.05).

CONCLUSIONS

Google Trends analysis serves as an insightful tool for understanding cosmetic tourism. Changing trends bring the potential to assess worldwide versus country-specific procedure interest. These observed trends may foreshadow future international aesthetic procedure trends.

NO LEVEL ASSIGNED

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Google Trends Analysis of Peripheral Nerve Disease and Surgery

BACKGROUND

Despite advances in the surgical management of peripheral nerve pathologies over the past several decades, it is unknown how public awareness of these procedures has changed. We hypothesize that Google searches for peripheral nerve surgery have increased over time.

METHODS

Google Trends was queried for search volumes of a list of 40 keywords related to the following topics in peripheral nerve surgery: spasticity, nerve injury, prosthetics, and nerve pain. Monthly relative search volume over the first 5 years of the study period (2010-2014) was compared with that of the last 5 years (2018-2022) of the study period.

RESULTS

Search volumes for keywords "nerve injury," "nerve laceration," "peripheral nerve injury," "nerve repair," "nerve transfer", "neuroma," "neuroma pain," "nerve pain," "nerve pain surgery," and "neuroma pain surgery" all increased more than 10% points in relative search volume over the study period (P < 0.0001 for each keyword). In contrast, searches for "rhizotomy," "spasticity surgery," "targeted muscle reinnervation," "bionic arm," and "myoelectric prosthesis" either decreased or remained stable. Technical terms such as "selective neurectomy," "hyperselective neurectomy," "regenerative peripheral nerve interface," and "regenerative peripheral nerve interface surgery" did not have adequate search volume to be reported by Google Trends.

CONCLUSIONS

The increase in Google searches related to nerve injury and pain between 2010 and 2022 may reflect increasing public recognition of these clinical entities and surgical techniques addressing them. Technical terms relating to nerve pain are infrequently searched, surgeons should use plain English terms for online discovery. Interest in spasticity and myoelectric prosthetics remains stable, indicating an opportunity for better public outreach.

Using Google Trends for Evaluation of Public Interest in Female Genital Aesthetic Procedures

BACKGROUND

Genital aesthetics is a treatment that is increasing in popularity.

OBJECTIVE

To clarify public interest in genital aesthetic procedures among women between 2004 and 2022.

MATERIALS AND METHODS

In total, 12 terms including labiaplasty, vaginoplasty, perineoplasty, laser vaginal rejuvenation, labia cosmetic surgery, vaginal cosmetic surgery, vaginal tightening, genital bleaching, hymenoplasty, clitoroplasty, labiaplasty cost, and vaginal laser were reviewed. To evaluate public attention to female genital aesthetic procedures between January 1, 2004, and January 1, 2022, three 6-year periods were compared about the abovementioned 12 terms.

RESULTS

Public attention to labiaplasty and hymenoplasty was significantly higher in 2010 to 2016 than in 2004 to 2010 and 2016 to 2022. Vaginoplasty, laser vaginal rejuvenation, and labia cosmetic surgery terms were researched significantly less in 2010 to 2016 and 2016 to 2022 than in 2004 to 2010 (p = .001). Public interest in vaginal tightening and labiaplasty cost significantly increased from 2004 to 2022. Finally, the term vaginal laser was researched most between 2016 and 2022 (p = .001).

CONCLUSION

This study found that public attention to labiaplasty cost and vaginal tightening continuously increased between 2004 and 2022. In addition, public interest in the term vaginal laser significantly increased after 2016. By contrast, vaginoplasty, laser vaginal rejuvenation, and labia cosmetic surgery terms were researched significantly less after 2010.

Effect of the COVID-19 Pandemic on Global Interest in Plastic Surgery

Introduction

Due to the SARS-CoV-2 (COVID-19) pandemic, many elective surgeries were canceled, including most aesthetic plastic surgery procedures. Although studies have shown COVID-19's effect on plastic surgery in the United States, no study to date has examined the international interest in plastic surgery procedures after the start of the COVID-19 pandemic. Thus, we sought to find this effect using the Google Trends tool.

Material and Methods

The most common cosmetic procedures and top countries with the highest plastic surgery volume were selected from the International Society of Plastic Surgeons report and used as the search terms for Google Trends. Weekly search data from each procedure and country were collected from March 18, 2018 to March 13, 2022, split into 2 periods according to the start of the US COVID-19 lockdown, and compared.

Results

Among the countries, the United States had the most plastic surgery interest after the COVID-19 pandemic, with India and Mexico closely following. On the other hand, Russia and Japan had the fewest changes in procedure interest. Regarding specific procedures, interest in breast augmentation, forehead lift, injectable filler, laser hair removal, liposuction, microdermabrasion, and rhytidectomy increased in all countries after the COVID-19 pandemic.

Conclusions

After COVID-19, there has been increasing interest in almost all plastic surgery procedures globally, especially nonsurgical procedures and facial plastic surgery, with the greatest increases in the United States, India, and Mexico. These results can help inform plastic surgeons which procedures to focus on and which devices or technologies to invest in that are specific to their country.

The Readability and Accountability of Online Patient Education Materials Related to Common Oculoplastics Diagnoses and Treatments

PURPOSE

To assess the readability and accountability of online patient education materials related to oculoplastic diagnoses and treatments, and to determine the source of information encountered by patients searches.

METHODS

We conducted a Google search for 20 search terms related to common oculoplastic diagnoses and treatments and analyzed the first 10 patient education websites populated for each term. Readability was assessed using four validated measures: Gunning Fog Index, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, and New Dale-Chall Readability. Accountability was assessed using 4 JAMA benchmarks on a scale of 0-4, with one point awarded for each of the following accountability criteria provided on the website: (1) including all authors and their relevant credentials (2) listing references (3) providing disclosures and (4) providing date of last update.

RESULTS

The average grade level of 200 websites analyzed was 10.89, with 29% written at less than the 6^th grade reading level recommended by the American Medical Association. The source of online information was most frequently educational institutions (36%) and private practices (34%), with fewer online patient education materials from national organizations (18%) and crowdsourced websites (12%). There were no significant differences in readability when comparing searches related to oculoplastics diagnoses versus treatments. Websites averaged 0.91 out of a maximum of 4 recommended accountability criteria, reflecting low overall accountability.

CONCLUSIONS

Online education resources encountered by patients are often written at inappropriate reading levels and demonstrate low accountability. Online patient education materials are most frequently maintained by educational institutions and private practices, with fewer articles from national organizations. Revision of online materials may be necessary to improve health literacy among oculoplastic patients.

#PlasticsTwitter: The Use of Twitter Data as a Tool for Evaluating Public Interest in Cosmetic Surgery Procedures

BACKGROUND

Plastic surgeons are increasingly turning to social media to market their services. The newly released Twitter Academic Research Product Track (TARPT) database provides free, customizable analysis of keywords that are included in tweets on the Twitter platform. The TARPT tool may provide valuable insight into public interest in cosmetic surgery procedures.

OBJECTIVES

The aim of this study was to determine TARPT's utility in tracking and predicting public interest in cosmetic surgery procedures and to examine temporal trends in tweets related to cosmetic facial and body procedures.

METHODS

The TARPT tool was used to calculate the total number of tweets containing keywords related to 10 facial cosmetic procedures and 7 cosmetic body procedures from 2010 to 2020. Annual volumes for respective procedures were obtained from annual statistics reports of The Aesthetic Society from 2010 to 2020. Tweet volumes and procedure volumes were compared by univariate linear regression, taking P < 0.05 as the cutoff for significance.

RESULTS

Variations in tweet volume were observed. Univariate linear regression analysis demonstrated statistically significant positive correlations between tweet volumes and procedure volumes for 7 search terms: "eyelid lift," "facelift," "lip injections," "mastopexy," "butt lift," "butt implants," and "liposuction." Many procedure-related keywords were not significant, demonstrating the importance of careful selection of Twitter search terms.

CONCLUSIONS

The TARPT database represents a promising novel source of information for plastic surgeons, with the potential to inform marketing and advertising decisions for emerging trends in plastic surgery interest before these patterns become apparent in surgical or clinical volumes.

Use of Three-Dimensional Imaging to Assess the Effectiveness of Volume as a Critical Variable in Breast Implant Selection

BACKGROUND

In breast augmentation, breast base diameter has been recognized as an important variable in implant selection. However, breast implant volume also has a tremendous impact on the final result. Previous methods of preoperative volume determination have been limited to external devices in a bra. Computer-based three-dimensional simulation technology now allows the physician to effectively communicate with the patient preoperatively regarding volume.

METHODS

A cohort of 40 consecutive patients underwent routine breast augmentation with either anatomically shaped or round implants. Five methods of preoperative volume determination including the Crisalix three-dimensional computer imaging system (Crisalix Virtual Aesthetics, Lausanne, Switzerland), along with an associated virtual reality tool, were used to assess the preoperative desires of the patients. A postoperative questionnaire was used to assess patient satisfaction with each volume determination method.

RESULTS

Of the 40 patients, 100 percent were satisfied with their result; however, given the opportunity, 12 percent would have chosen a larger implant. The virtual reality tool and external sizers were shown to be the most effective in choosing an implant. The virtual reality tool was judged to be very helpful (62 percent), very accurate (78 percent), and important (88 percent) in helping patients choose their desired implant size.

CONCLUSION

Prioritizing volume as an implant selection variable in breast augmentation results in a very high rate of patient satisfaction.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Therapeutic, IV.

Going Viral: A Systematic Review of Google Trends in Plastic Surgery and a Recommended Framework for Its Use

As the leading global search engine with billions of daily queries, Google and its open-source Google Trends (Google, Mountain View, CA) represent an emerging and powerful tool for epidemiological and medical research. Within the field of plastic surgery, Google Trends has yielded insights into online interest for facial feminization surgery, gender-affirmation surgery, cosmetic body procedures, and breast reconstruction, among other common procedures. The existing literature of Google Trends in plastic surgery was systematically reviewed following established Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Google Trends' 4 input variables-keyword, region, period, and category-were assessed. Seventeen plastic surgery studies employing Google Trends were reviewed. There was strong inter-rater reliability (Cohen's kappa = 0.68). Analyzing keyword syntax, only 3 of 17 studies (17.6%) used the "+" function to combine terms, which can significantly improve sensitivity. For the region variable, 12 of 16 studies (75%) conducted worldwide searches; yet, none of the studies used any non-English keywords, introducing significant bias. For the period, 88.2% of studies utilized a timespan of greater than 5 years, resulting in monthly intervals between data points in Google Trends. For the "category" variable, none of the studies appear to have employed the "surgery," "cosmetic surgery" or "health" categories to improve specificity. Google Trends is presented as an emerging methodology in plastic surgery research. The strengths and limitations of Google Trends as a resource for plastic surgeons and medical professionals are discussed, and a recommended step-by-step guide for conducting and interpreting Google Trends research is outlined.

Thinking Outside the Black Box: Current Perceptions on Breast Implant Safety and Utility

BACKGROUND

There is growing public concern surrounding breast implant safety. In fact, the U.S. Food and Drug Administration recently proposed changes to breast implant labeling, which include a boxed warning. Given such efforts to increase transparency on breast implant safety, this study assessed laywomen's perceptions of breast implant safety, and the impact of proposed changes to breast implant labeling on laywomen's decision-making regarding breast implants.

METHODS

This was a cross-sectional investigation of women recruited through Amazon Mechanical Turk. Discrete choice modeling was used to query opinions on breast implants after viewing proposed labeling changes. Chi-square and analysis of variance were used for subgroup analyses, and McNemar analyses were used to assess changes in participants' responses.

RESULTS

The authors received 500 survey responses. At baseline, 353 participants (70.6 percent) considered breast implants to be at least somewhat safe. After viewing the proposed boxed warning, 252 participants (50.4 percent) responded that they would be less likely to receive implants. In fact, a significantly greater proportion of participants considered breast implants to be either unsafe or very unsafe after viewing suggested changes to implant labeling than at baseline (58.4 percent versus 28.8 percent; p = 0.001). By the end of the survey, willingness to consider alternative options for breast augmentation/reconstruction increased significantly from baseline.

CONCLUSIONS

Improved labeling can enhance laywomen's understanding of breast implant safety and can impact decision-making. However, greater scrutiny of breast implants should not prevent women who need implants from receiving them. Transparency and objectivity in the surgeon-patient dialogue can ensure the appropriate use of medical devices such as breast implants.

Social Media and Plastic Surgery Practice Building: A Thin Line Between Efficient Marketing, Professionalism, and Ethics

Social media sites and platforms have grown in numbers with an enormous potential to reach and disseminate information in real time. They are impacting tremendously for better or for worse on the current practice of plastic surgery. As the demand for elective plastic surgery, in particular for aesthetic procedures, continues to rise, there is a need to determine the influence of social media advertisements and how it motivates the public to undergo cosmetic procedures. Most importantly, there is an urgent need to determine how the social media are impacting plastic surgery practice building and what is proper and efficient marketing while upholding ethics of the medical profession? A thorough PICO tool-based comprehensive literature search was conducted. Fifty-one peer-reviewed publications, 15 patient-centered, 33 provider-centered, and three combined patient/provider were identified to be relevant to the use of social media in plastic surgery and were selected for this review. Evidence on how social media influences the medical practice and helps in practice building remains scarce; nevertheless, reliance of plastic surgeons on social media to improve their practice has been increasing steadily. Social media may be a powerful tool to promote one's career. It presents, however, serious professional, legal, and ethical challenges including maintenance of professionalism and protecting patient confidentiality. If misused, it may be a quick way to end a plastic surgery practice.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Public Interest in Cataract Surgery: Analysis and Implications of Google Trends Data from 14 European Countries

Purpose: Cataract surgery is the most common surgery performed in the European Union (EU) annually. Analysis of Google Trends (GT) data could give European eye care providers useful information regarding interest in cataract surgery and potential barriers making patients unwilling to undergo surgery.Methods: Data were collected using GT for cataract surgery and the two most related queries, for each of 14 included countries from January 2004 to December 2018. Case volumes were extracted from the Eurostat report for the calendar years 2004-2018.Results: The most related queries analysis demonstrated surgery outcomes, founding issues and understanding of the disease as potential factors for patients considering cataract surgery. Trend analysis showed that the total search volumes for "cataract surgery" gradually increased over the study period. Also, for "cataract", "after cataract surgery", "cataract surgery NHF" rising trends were revealed. Trends found for "cataract surgery price" and "cataract surgery complications" were inconclusive. Univariate linear regression analysis demonstrated statistically significant correlations between average annual search volumes of "cataract surgery" and the annual volume of cataract surgeries performed in included countries, according to Eurostat data (R² = 0.889, p = <.001). In addition, univariate linear regression analyses revealed similar, statistically significant correlation for each the most related queries.Conclusions: To the knowledge of the authors, this is the first and the only analysis of GT data in the ophthalmology literature to date. This study highlights this potentially powerful data set for European eye care providers.

Data-Driven Insights on the Effects of COVID-19 on Aesthetics: Part I (Passive Analysis)

Background

Since COVID-19 was declared to be a worldwide pandemic and US national emergency in March (week 11), it has significantly changed aesthetic plastic surgery. As plastic surgeons now move towards reopening practices, understanding public interest in medical aesthetics will be critical to maximize efforts and resource allocation in procedures and treatments that patients want.

Objective

This study passively queries public interest in aesthetics using Google Trends search data.

Methods

Google Trends was used to quantify relative search volumes over the past four years for a variety of categories: patient-related, surgery-related, injectables, breast procedures, face procedures, and body procedures. Data were deseasonalized and represented graphically. Z-scores of each time-point differing from the expected values was determined using least squares regression.

Results

Of the 204 significantly anomalous search term data points in 2020, 172 (84.0%) occurred after week 11 (pandemic/national emergency declaration). 60% of searches in all time-points after week 11 were significantly different, and 25/26 (96.0%) of search terms experienced significant changes after week 11. Eighteen terms saw decreased interest with variable recovery. Procedural nadirs for decreased search volume troughs occurred between weeks 11-14. Six patient-related chief complaints saw increased search interest after COVID-19, with peak interest between weeks 11-17.

Conclusions

This is the first study to assess real-time, national data about the impact of COVID-19 on public interest in aesthetics.

What is the UK Public Searching for? A Correlation Analysis of Google Trends Search Terms and Cosmetic Surgery in the UK

Introduction

Search engine optimisation (SEO) in plastic surgery practice is crucial for increasing web traffic. Knowing what patients are searching for online can help plastic surgeons understand public interest, enhance patient engagement, and improve service provision. This study analyses the correlation between Google Trends (GT) search activity and the number of cosmetic procedures carried out in the UK.

Methods

GT search term data were analysed for popularity of use and geographical variation in the UK. Pearson’s correlation coefficient was used to analyse GT data against the number of cosmetic surgery procedures undertaken in the UK in the corresponding year and with 1-year time lag.

Results

GT score was higher for most colloquial search terms, such as “tummy tuck” compared to “abdominoplasty” (GT score 59 vs 6), but “otoplasty” was higher than “ear correction” (GT score 55 vs 19). Geographical variation showed that London ranked first in proportional search term activity for “brow lift” and Birmingham for “tummy tuck”. There was statistically significant positive correlation for three search terms and the number of corresponding surgeries undertaken. This increased to nine search terms when analysed with a 1-year time lag.

Conclusion

These results highlight the trends in online search activity in the UK and their correlation with cosmetic procedures. The higher number of significant correlations with 1-year time lag may reflect the patient’s decision-making journey to undergo cosmetic surgery. These results can be utilised for SEO, thus leading to a better-informed public and more robust practice building.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Predicting Public Interest in Nonsurgical Cosmetic Procedures Using Google Trends

BACKGROUND

Google Trends (GT) provides cost-free, customizable analyses of search traffic for specified terms entered into Google's search engine. GT may inform plastic surgery marketing decisions and resource allocation.

OBJECTIVES

The aim of this study was to determine GT's utility in tracking and predicting public interest in nonsurgical cosmetic procedures and to examine trends over time of public interest in nonsurgical procedures.

METHODS

GT search volume for terms in 6 ASPS and ASAPS nonsurgical procedure categories (Botox injections, chemical peel, laser hair removal, laser skin resurfacing, microdermabrasion and soft tissue fillers [subcategories: collagen, fat, and hyaluronic acid]) were compared with ASPS and ASAPS case volumes for available dates between January 2004 and March 2019 with the use of univariate linear regression, taking P < 0.01 as the cutoff for significance.

RESULTS

Total search volume varied by search term within the United States and internationally. Significant positive correlations were demonstrated for 17 GT terms in all 6 ASPS and ASAPS categories: "Botox®," "collagen injections," "collagen lip injections" with both databases; and "chemical skin peel," "skin peel," "acne scar treatment," "CO2 laser treatment," "dermabrasion," "collagen injections," "collagen lip injections," "fat transfer," "hyaluronic acid fillers," "hyaluronic acid injection," "hyaluronic acid injections," "Juvederm®," and "fat transfer" with just 1 database. Many search terms were not significant, emphasizing the need for careful selection of search terms.

CONCLUSIONS

Our analysis further elaborates on recent characterization of GT as a powerful and intuitive data set for plastic surgeons, with the potential to accurately gauge global and national interest in topics and procedures related to nonsurgical cosmetic procedures.

Public Interest in Textured Breast Implants Recall: A Google Trends Analysis

BACKGROUND

Large-scale media coverage of health care outcomes can have a profound influence on health care utilization by the general population. Google trends (GT), an online resource, allows for tracking of global search volumes as a proxy for determining public interest.

OBJECTIVE

To utilize GT to characterize measurable effects on public interest in breast implant removal procedures and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) following March 2019 FDA Advisory Committee Meeting and July 2019 public statements by the FDA and Allergan announcing the voluntary recall of BIOCELL^® textured breast implants.

METHODS

GT databases of search volumes were collected for terms related to 3 categories including Allergan BIOCELL^® textured breast implants, BIA-ALCL, and breast implant removal from January 2004 to October 2019. The short-term and long-term interests were determined by the percent change in monthly search volumes with respect to the announcements from Allergan and FDA Advisory Committee Meeting.

RESULTS

Following Allergan's recall announcement, public interest in "textured breast implants" and "allergan breast implant" peaked in July 2019 and rose 456% and 669%, respectively. Public interest in "anaplastic large cell lymphoma breast implant" and "ALCL cancer" rose 200 and 175%, respectively. Long-term interest in all implant removal terms was found to be higher after March 2019 FDA Advisory Committee Meeting than beforehand (p < 0.05).

CONCLUSIONS

GT data correlate with shifts in real-world health care utilization and public interest caused by high-profile media coverage, making it a useful tool for providers for real-time prediction of trends in public health in response to observable influences.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Global Interest in Oral and Maxillofacial Surgery: Analysis of Google Trends Data

PURPOSE

Oral and maxillofacial surgery (OMS) has an expansive scope, with myriad diagnoses treated by practicing surgeons. Patients and referring providers are increasingly turning to Web-based sources to find information about clinical conditions before consultations or in conjunction with ongoing care. The purpose of this study was to examine the current trends of public interest of OMS procedures as assessed by online search trends.

MATERIALS AND METHODS

A cross-sectional study of Internet search data obtained via Google Trends (GT; Alphabet, Mountain View, CA) was conducted. Data were collected using GT for OMS-related search terms between January 2004 and May 2019. The search terms used in the analysis were "wisdom teeth," "TMJ," "dental implants," "jaw surgery," "jaw fracture," "facial trauma," and "facial cosmetic surgery," defined to be the core surgical aspects of OMS based on public awareness campaigns sponsored by the American Association of Oral and Maxillofacial Surgeons. Relative search volumes, trends over time, geographic trends, and seasonal trends were analyzed. For all analyses, P ≤ .05 was considered significant.

RESULTS

Overall search volume trends for OMS procedures showed an increase over time, with seasonal and geographic trends. "Wisdom teeth" was the most searched term and had the greatest increase in search volume over time. "Facial trauma" was the least searched term, with no appreciable trend over time. Geographic search volume was greatest in the United States. Seasonal changes were most apparent with searches for "wisdom teeth" and "jaw surgery."

CONCLUSIONS

Analysis of GT data shows substantial interest in core OMS procedures, with seasonal variations noted for certain areas of practice (third molars and jaw surgery) and consistent interest in other areas (facial cosmetic surgery, dental implant reconstruction, and temporomandibular disorders). The use of GT data may be a powerful tool for predicting demand for OMS services and for public education campaigns.

Analysis and Interpretation of Google Trends Data on Public Interest in Cosmetic Body Procedures

BACKGROUND

Several online resources such as Google Trends (GT) enable plastic surgeons to track search volume trends for cosmetic procedures. Understanding these data may allow surgeons to better anticipate patients' interests and meet their needs.

OBJECTIVES

The authors sought to evaluate the correlation between GT search volumes and annual surgery volumes.

METHODS

Search terms were generated using the "related queries" feature of GT. Data were obtained for the terms breast augmentation, buttock augmentation, buttock implants, buttock lift, calf augmentation, liposuction, lower body lift, thighplasty, abdominoplasty, and brachioplasty from January 2004 to November 2017. Annual volumes for respective procedures were obtained from statistics reports of the American Society of Plastic Surgeons (ASPS) from 2006 to 2017 and American Society of Aesthetic Plastic Surgery (ASAPS) from 2004 to 2017. Correlations were evaluated applying univariate linear regression of GT data to both ASPS and ASAPS data.

RESULTS

Geographical and temporal variations in search volume were detected during the study. Search volume trends that correlated significantly with both ASPS and ASAPS surgery volume trends were: "butt implants surgery" (ASPS: R2 = 0.366, P = 0.049; ASAPS: R2 = 0.380, P = 0.019); "liposuction" (ASPS: R2 = 0.690, P = 0.002; ASAPS: R2 = 0.578, P = 0.002); and "liposuction surgery" (ASPS: R2 = 0.672, P = 0.002; ASAPS: R2 = 0.476, P = 0.006). Several search terms demonstrated no significant relationships, negative correlations, or were significant with only one database.

CONCLUSIONS

This study characterizes GT as a convenient and informative data set for plastic surgeons to analyze patient interest in cosmetic body-sculpting procedures. GT represents a useful instrument for tailoring marketing strategies and addressing the needs of our patient population.

Celebrity Influence Affecting Public Interest in Plastic Surgery Procedures: Google Trends Analysis

BACKGROUND

Medical decisions made by celebrities have a profound influence on medical decisions made by the general population. Google Trends (GT) is a free, online resource with virtually no barriers to use that allows for tracking of global search volumes as a proxy for determining public interest. In this study, we utilize GT to characterize the significant and measurable effects that the May 2013 announcement of Angelina Jolie's BRCA-influenced prophylactic mastectomy, May 2015 announcement of Kylie Jenner's lip augmentation, April 2017 announcement of Caitlyn Jenner's gender affirming surgery and February 2014 media attention given to Kim Kardashian's rumored buttock augmentation had on corresponding surgical procedure volumes.

METHODS

GT databases of search volumes were collected for terms related to prophylactic mastectomy, lip augmentation, gender affirming surgery and buttock augmentation categories from January 2004 to March 2019 using the "related queries" feature. Mean search volumes prior to respective announcements were compared to that of the period starting 6 months after. Additionally, the percent change from the month preceding respective celebrity announcements was compared to the month of the announcement for each search term.

RESULTS

For mastectomy, all terms demonstrated peak interest during May 2013. Following Jolie's announcement, interest in "mastectomy" rose 1328%, "prophylactic mastectomy" rose 324%, "BRCA1" rose 316%, "BRCA2" rose 138% and "BRCA gene" rose 354%. Long-term interest was higher after May 2013 than beforehand for all terms except "prophylactic mastectomy" (each, p < 0.001). Following Kylie Jenner's announcement, interest in "lip augmentation" rose 43%, "lip enhancement" rose 37%, "lip fillers" rose 3233%, "lip implants" rose 8% and "lip injections" rose 13%. Long-term interest was higher after May 2015 than beforehand for all terms except "lip augmentation" and "lip enhancement" (each, p < 0.001). Following Caitlyn Jenner's announcement, "gender affirming surgery" rose 119%, "gender reassignment" rose 186%, "gender reassignment surgery" rose 203% and "transgender surgery" rose 35%. Long-term interest was higher after April 2017 than beforehand for all terms except "sex change" (each, p < 0.001). Following Kardashian's rumored injections, interest in "butt enhancement" rose 34% and "butt implants" rose 100%. Long-term interest was higher after February 2014 than beforehand for all terms (each, p < 0.001).

CONCLUSIONS

GT data trends correlate with shifts in real-world healthcare utilization and healthcare-related public interest caused by high-profile public events, making it a useful tool for real-time prediction of trends in public health in response to a variety of observable influences.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Google Trends as a Tool for Evaluating Public Interest in Facial Cosmetic Procedures

BACKGROUND

The utility of Google Trends (GT) in analyzing worldwide and regional patient interest for plastic surgery procedures is becoming invaluable to plastic surgery practices. GT data may offer practical information to plastic surgeons pertaining to seasonal and geographic trends in interest in facial cosmetic procedures.

OBJECTIVES

The authors sought to analyze geographic and temporal trends between GT search volumes and US surgery volumes using univariate analysis.

METHODS

The "related queries" feature of GT generated potential search terms. GT data were compiled for cheek implants, mentoplasty, otoplasty, blepharoplasty, rhytidectomy, forehead lift, hair transplantation, lip augmentation, lip reduction, platysmaplasty, and rhinoplasty from January 2004 to December 2017. Annual volumes for respective procedures were obtained from annual statistics reports of the American Society of Plastic Surgeons (ASPS) from 2006 to 2017 and American Society of Aesthetic Plastic Surgery (ASAPS) from 2004 to 2017.

RESULTS

Geographical and temporal variations in search volume were detected during the study. Search volume trends that correlated significantly with both ASPS and ASAPS surgery volume trends were: "eyelid plastic surgery" (ASPS R2 = 0.336, P = 0.048; ASAPS R2 = 0.661, P = 0.001); "facelift" (ASPS R2 = 0.767, P ≤ 0.001; ASAPS R2 = 0.767, P = 0.001); "lip injections" (ASPS R2 = 0.539, P = 0.007; ASAPS R2 = 0.461, P = 0.044); and "rhinoplasty surgery" (ASPS R2 = 0.797, P ≤ 0.001; ASAPS R2 = 0.441, P = 0.01). Several search terms demonstrated no significant relationships or were significant with only one database.

CONCLUSIONS

GT may provide a high utility for informing plastic surgeons about the interest expressed by our patient population regarding certain cosmetic search terms and procedures. GT may represent a convenient tool for optimizing marketing and advertising decisions.