#PlasticSurgery: A Comparative Deep Dive Analysis into Social Media and Plastic Surgery

A Systematic Review on the Reinforcement Loop in Aesthetic Medicine and Surgery: The Interplay of Social Media, Self-Perception, and Repeat Procedures

INTRODUCTION

This systematic review delves into the impact of social media on self-perception and the escalating interest in clinical aesthetic procedures, proposing that social media significantly influences beauty standards and increases demand for aesthetic enhancements.

METHOD

Following PRISMA guidelines, a mixed-method analysis of 34 articles was conducted, sourced from various databases, focusing on social media's psychological effects on clinical aesthetics decisions. The studies encompassed a broad spectrum, including qualitative, quantitative, and mixed methodologies, reflecting diverse geographical and cultural perspectives.

RESULTS

The quantitative analysis demonstrated a strong positive correlation between social media usage and the consideration of aesthetic procedures (r=0.45, p<0.001), indicating a significant impact. Specific findings included a large effect size (Cohen's d=0.8) for the relationship between time spent on social media and the desire for aesthetic enhancements. Individuals spending more than 3 hours per day on social media platforms were twice as likely to consider aesthetic procedures compared to those with less usage, with a 95% confidence interval indicating robustness in these findings.

CONCLUSION

Confirming the reinforcing effect of social media on aesthetic decision-making, this study highlights the complex interplay between digital media exposure, altered self-perception, and the increased inclination towards aesthetic procedures. It suggests a critical need for practitioners to carefully navigate the digital influence on patient's desires, reinforcing the significance of understanding psychological motivations and societal pressures in clinical aesthetics. This comprehensive analysis offers pivotal insights for clinical practice and ongoing research into social media's role in contemporary beauty standards.

LEVEL OF EVIDENCE III

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 .

Social Media Influence on Body Image and Cosmetic Surgery Considerations: A Systematic Review

Social media platforms like Instagram (Meta Platforms, Inc., Menlo Park, California, United States) and Snapchat (Snap Inc., California, United States) significantly influence motivations for aesthetic surgery by promoting idealized and digitally enhanced images. Understanding their impact on body image dissatisfaction and acceptance of cosmetic procedures is crucial. A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines explored the link between social media, body image dissatisfaction, and cosmetic surgery. The review included 25 studies with 13,731 participants. Specific findings revealed that 70% of young adult women and 60% of young adult men report dissatisfaction with their bodies, leading to increased surgical considerations. The search process utilized databases such as PubMed, ScienceDirect, and Google Scholar, employing keywords like "cosmetic surgery," "social media," and "body image dissatisfaction" for articles published between January 2013 and December 2023. Both men and women show increased dissatisfaction with body parts, leading to surgical considerations. Social media's emphasis on visual aesthetics fosters body dissatisfaction and social appearance anxiety, especially through selfies. Cultural norms and celebrity influence further shape beauty perceptions. While social media promotes cosmetic surgery acceptance, ethical concerns about misleading advertisements, unrealistic beauty standards, and patient privacy persist. This underscores the need for strategies to promote healthy body image and informed choices in the digital age.

The Reel Health Care Professionals of Instagram: A Systematic Review

Social media and health research have covered the benefits for the public and patients as users. Specifically, this has focused on searching for health information, connecting with others experiencing similar health issues, and communicating with their health professionals. Recently, there has been a shift in research to focus on health care professionals as users as they participate in professional development, improve communication with patients, and contribute to health research and service. However, such research has predominantly focused on text-based platforms, namely Facebook and Twitter. The scope of this article is a systematic review of publications on health care professionals' use of the image-based platform Instagram, according to the preferred reporting items for systematic reviews and meta-analyses guidelines. This study, drawing from 51 articles, shows how health care professionals use Instagram, and reveals that these professionals utilize the platform to address health concerns that may not necessarily align with their specific expertise. Images were the common format of posts created by health care professionals, with six content types identified: (a) educational, (b) promotional, (c) patient experience, (d) personal, (e) emotion based, and (f) other. Three measures of post engagement were used by researchers, including (a) likes and comments, (b) use of hashtags, and (c) number of followers. This study also identified the dangers of misleading users, including (a) lack of credentials reported, (b) edited images, (c) quality of content, and (d) patient and client confidentiality issues. In conclusion, insights into the advantages of health care professionals' use of Instagram and ways in which they can maximize its use to reach and engage with their target audience are provided.

The Ethics and Responsibilities of Social Media Usage by Plastic Surgeons: A Literature Review

BACKGROUND AND OBJECTIVES

Social media has revolutionised how plastic surgeons advertise their work and promote their services, but concerns have been raised regarding the ethics of these practices. This review aims to identify said concerns and develop measures to address them.

METHODS

PubMed, Cochrane and Medline were searched for studies assessing the ethics of social media use by plastic surgeons. Five search terms were used and 23 studies identified. Results were catalogued according to which principle of medical ethics was infringed.

RESULTS

Autonomy: Patients must not be coerced into allowing their operative media to be shared and content anonymised by removing identifiable features and scrubbing metadata. Beneficence: It is difficult to balance the benefit to patients of posting photographs for educational purposes with the risk of identifiable features being present, particularly within craniofacial surgery. Non-maleficence: Taking operative media could be a distraction from the patient and lengthen the procedure which could lead to harm. Any content posted on social media should be adapted to avoid trivialisation or sexualisation. Justice: Surgeons should not entertain their audience to increase their following at the expense of patients.

CONCLUSIONS

Greater oversight of social media use by plastic surgeons is required to avoid patient harm and tarnishing of the specialty's professional standing. Professional bodies should be tasked with devising a course dedicated to the responsible use of these platforms. This should ensure the public's trust in the specialty does not become eroded and patients are not harmed by unethical social media use. This review highlights the relevant shortfalls of SoMe use by plastic surgery Several proposals are made to reduce the incidence of these shortfalls and to ensure SoMe is used in a professional and responsible manner It also lists areas of the specialty where SoMe is underused and could be of help, such as academia LEVEL OF EVIDENCE IV: 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 http://www.springer.com/00266 .

Social Media Popularity and Academic Productivity in Academic Plastic Surgery: A Positive Correlation

BACKGROUND

Social media is a powerful tool that has empowered plastic surgeons to easily collaborate with one another and rapidly publicize research progression. The present study investigates the relationship between academic productivity and social media presence among both integrated and independent plastic surgery programs and their faculty.

METHODS

Plastic surgery programs on the American Council of Academic Plastic Surgeons website were included. Faculty were identified via review of each program's website. Following metrics of academic productivity were collected for each faculty member: h-index, i10-index, number of publications, and number of citations. Online review was then conducted to identify faculty and program Instagram and Twitter accounts, and the number of associated followers and posts.

RESULTS

Integrated plastic surgery programs were more likely to have an Instagram account (p < 0.001), have higher average faculty h-index (p = 0.027), i10-index (p = 0.027), and number of publications (p = 0.042). A number of Instagram followers were significantly associated with average faculty h-index (p < 0.001), i10-index (p < 0.001), and number of publications (p < 0.001). The number of posts on a program's Instagram significantly predicted average faculty h-index (p < 0.001), i10-index (p < 0.001), and number of publications (p < 0.001). Twitter followers were significantly associated with average faculty h-index (p = 0.0397), i10-index (p = 0.0432), and number of citations (p = 0.00737).

CONCLUSIONS

The present study reveals a correlation between metrics of social media popularity and academic productivity of plastic surgeons. We propose that Instagram and Twitter are effective tools with which plastic surgeons may not only publicize their clinical practice, but also rapidly disseminate important innovations among the medical community. Integrated plastic surgery programs and their faculty have significantly higher utilization of social media platforms. The number of followers and posts on a program's Instagram have a significantly positive correlation with average faculty's academic productivity. Social media platforms may empower academic plastic surgeons to disseminate their innovations on a larger scale.

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 .

Capitalizing on social media: An evaluation of the public's preferences for plastic surgery social media content

BACKGROUND

The effectiveness of utilizing social media platforms to promote clinical practices and attract patients has been well established. This study aimed to assess what plastic surgery social media content and educational material the public is most responsive to.

METHODS

An anonymous 25-question survey was distributed using REDCap and Amazon's Mechanical Turk to ascertain demographic information, patterns of social media use, levels of interest in plastic surgery, and preferences for plastic surgery content.

RESULTS

Of 401 participants, the typical respondent was between 25 and 34 years old and on social media daily. Almost half of the respondents (46.1%) have intentionally viewed plastic surgery content on social media, of which most used Instagram (71.1%) and Facebook (55.4%). Participants grouped as either younger or older than 35 years old were equally likely to have viewed plastic surgery content (p = 0.33). Content categories with the highest interest were before and after results (mean Likert weight 4.00 ± 1.10), patient testimonials (3.73 ± 1.15), and recovery process (3.67 ± 1.14). Content on celebrities (2.89 ± 1.17), comedic videos (2.79 ± 1.19), and surgeons' private lives (2.51 ± 1.08) received negative interest. Photo posts (51.4%) were preferred more than video posts (27.2%). Before and after results on social media were the most influential factor in the selection of a plastic surgeon (45.9%).

CONCLUSIONS

The importance of social media for plastic surgeons to be able to interact with patients is at unprecedented heights. Understanding patterns of the public's social media content preferences will help plastic surgeons optimize their social media reach and influence their target audience.

Promoting Publications Through Plastic Surgery Journal Instagram Accounts: Is It Worth It?

PURPOSE

Journals are increasingly using social media to increase article engagement. We aim to determine the impact of Instagram promotion on, and identify social media tools that effectively enhance, plastic surgery article engagement and impact.

METHODS

Instagram accounts for Plastic and Reconstructive Surgery, Annals of Plastic Surgery, Aesthetic Surgery Journal, and Aesthetic Plastic Surgery were reviewed for posts published by February 8, 2022. Open access journal articles were excluded. Post caption word count and number of likes, tagged accounts, and hashtags were recorded. Inclusion of videos, article links, or author introductions was noted. All articles from journal issues published between the dates of the first and last posts promoting articles were reviewed. Altmetric data approximated article engagement. Citation numbers from the National Institutes of Health iCite tool approximated impact. Differences in engagement and impact of articles with and without Instagram promotion were compared by Mann-Whitney U tests. Univariate and multivariable regressions identified factors predictive of more engagement (Altmetric Attention Score, ≥5) and citations (≥7).

RESULTS

A total of 5037 articles were included, with 675 (13.4%) promoted on Instagram. Of posts featuring articles, 274 (40.6%) included videos, 469 (69.5%) included article links, and 123 included (18.2%) author introductions. Promoted articles had higher median Altmetric Attention Scores and citations (P < 0.001). On multivariable analysis, using more hashtags predicted higher article Altmetric Attention Scores (odds ratio [OR], 1.85; P = 0.002) and more citations (OR, 1.90; P < 0.001). Including article links (OR, 3.52; P < 0.001) and tagging more accounts (OR, 1.64; P = 0.022) predicted higher Altmetric Attention Scores. Including author introductions negatively predicted Altmetric Attention Scores (OR, 0.46; P < 0.001) and citations (OR, 0.65; P = 0.047). Caption word count had no significant impact on article engagement or impact.

CONCLUSIONS

Instagram promotion increases plastic surgery article engagement and impact. Journals should use more hashtags, tag more accounts, and include manuscript links to increase article metrics. We recommend that authors promote on journal social media to maximize article reach, engagement, and citations, which positively impacts research productivity with minimal additional effort in designing Instagram content.

Research Promotion is Associated with Broader Influence and Higher Impact of Plastic Surgery Publications

BACKGROUND

Social media has altered the mechanisms by which published research is disseminated and accessed. The objective of this study was to measure the effect of promotion on research article dissemination, influence, and impact in Plastic and Reconstructive Surgery.

METHODS

All articles published in Plastic and Reconstructive Surgery from January 1, 2016-December 31, 2018 were obtained and reviewed to determine inclusion/exclusion and for the Altmetric Attention Score (AAS), citations, relative citation rate (RCR), and 16 unique promotional tags (journal club, editor's pick, press release, patient safety, etc.) as indexed on the Plastic and Reconstructive Surgery website. 1,502 articles were included in the analysis. Statistical analysis was completed using descriptive statistics, Pearson's correlations, and Student t-tests where appropriate with a predetermined level of significance of p≤0.05.

RESULTS

A total of 637 articles (42.4%) had a promotional tag, while 252 (16.8%) had multiple tags. Articles with promotional tags had higher AAS (30.35 vs 8.22; p<0.001), more citations (11.96 vs 8.47; p<0.001), and a higher RCR (2.97 vs 2.06; p<0.001) compared to articles without a tag. Articles with multiple tags had higher AAS (50.17 vs 17.39; p<0.001), more citations (15.78 vs 9.47; p<0.001), and a higher RCR (3.67 vs 2.51; p<0.001) compared to articles with only one tag. As the number of tags increased for an article, AAS (p<0.001), citation count (p<0.001), and RCR (p<0.001) likewise increased.

CONCLUSIONS

This analysis strongly suggests that promotion of research articles is associated with significantly wider dissemination, broader visibility, and more subsequent citations in the literature.

#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.

The Evolving Role of Social Media in Pediatric Orthopaedics

BACKGROUND

Social media has grown significantly and its application in health care has been dramatically accentuated by the COVID-19 pandemic. It is often considered as a "new dimension" of health care, particularly in its ability to provide health information. In 2017, the top social media sites utilized by pediatric orthopaedic surgeons included Facebook, LinkedIn, and Twitter. In our study, we analyze the current social media usage, trends in Instagram and TikTok content, and the perceptions on social media usage among pediatric orthopaedic surgeons.

METHODS

The Pediatric Orthopaedic Society of North America (POSNA) membership directory was searched for the presence of social media. A review of all Instagram and TikTok posts made by the POSNA members were reviewed. A survey regarding the perception of social media networks and content was distributed to all POSNA members.

RESULTS

A total of 1231 POSNA members actively practicing in the United States were included in our study. In all, 327 (26.6%) had a LinkedIn profile, 34 (2.8%) had a professional Facebook profile, 15 (1.2%) had a public Instagram account, 0 (0%) had TikTok, and 72 (5.8%) had a professional Twitter account. Fifteen POSNA members with public Instagram accounts had 10,878 followers. A total of 907 Instagram posts were made, 134 (14.8%) of which were education and 462 (50.9%) of which were personal or political. The perception of various social media networks such as Instagram (3.02), Facebook (3.16), and LinkedIn (3.51) were positive on a 5-point Likert scale, while perceptions of TikTok (2.36) and Twitter (2.99) were negative. Educational posts on Instagram (3.19) and Facebook (3.37) were positive.

CONCLUSIONS

We provide an update to the utilization of social media by pediatric orthopaedists. Use of Instagram and TikTok accounts remain rare. Educational posts, when hosted on an appropriate social media platform, are perceived positively among pediatric orthopaedists.

LEVEL OF EVIDENCE

Level IV.

Ophthalmology and Social Media: An In-Depth Investigation of Ophthalmologic Content on Instagram

Purpose

Social media has become a popular source of health information for patients. This study aimed to characterize the top-performing ophthalmologic posts on a large social media platform to better understand the spread of ophthalmic information via social media.

Materials and Methods

This was a web-based study that searched for ophthalmology-related posts on Instagram, with subjects being users who posted ophthalmic content. A list of 36 ophthalmology-related hashtags, including the most common diagnoses and procedures identified from the IRIS Registry, was queried. For each hashtag, data were collected for “Top 9 posts” (as ranked by Instagram’s engagement-based algorithm) at three different time points. Posts were analyzed for the poster’s background, credentials, post format, content, caption length, and engagement level.

Results

Of the top-performing posts analyzed (n = 972), the most frequent post format was a photo (82.2%), followed by video (8.8%) and graphic (8.4%). Ophthalmologists (35.8%) authored the highest number of posts, followed by patients (27.1%), optometrists (20.1%), and organizations (12.7%). The highest average engagement level ratios (ELRs) belonged to ophthalmologists-in-training (0.096), followed by patients (0.084), optometrists (0.070), all ophthalmologists (0.067) and organizations (0.051); p < 0.001. The most engaging type of content was self-promotional (0.118) and personal experience-related (0.091); educational content was the least engaging (0.059) even though it comprised the majority of posts (56%); (p < 0.001). Characteristics that predicted the highest ELRs (reaching 80th percentile) were captions and/or images that featured personal experiences (3.335 OR), whitecoats (3.259), and those authored by ophthalmologist trainees (3.172); (p < 0.01). The least engaging were those featuring fundus photos (0.281), educational content (0.359), and authored by organizations (0.428); (p < 0.05).

Conclusion

The majority of ophthalmologic content on Instagram is authored by non-ophthalmologists, with educational content being the least engaging. Practicing ophthalmologists have an opportunity to reach more patients through social media by incorporating specific features known to drive post engagement and reach.

Precis

Social media has become a popular source of health information for patients. Our study demonstrates that the majority of ophthalmology content on Instagram is authored by non- ophthalmologists, with educational content being the least engaging. Practicing ophthalmologists have an opportunity to reach a wider audience through social media by incorporating specific features known to drive post engagement and reach.

A retrospective analysis of social media posts pertaining to COVID-19 vaccination side effects

OBJECTIVES

With an uprising influence of social media platforms like Twitter and Instagram a multitude of worldwide accessible information is available. Since the beginning of COVID-19 pandemic the exchange of medical information about several topics related to this infectious disease and its vaccination has increased rapidly. The purpose of this investigation was to assess the content associated with COVID-19 vaccination and its side effects and evaluate its educational quality.

METHODS

We conducted this retrospective study to investigate 600 Twitter and Instagram posts by #covidvaccinesideeffects due to number of 'likes', comments, type of post, language, its purpose and source. In addition, posts were evaluated due to educational quality by three examiners of different educational levels.

RESULTS

The majority of posts showed 0 to 50 "likes" and 0 to 5 comments in English language. A comparison between Twitter and Instagram by the influence of application showed significant differences in number of posts and "likes" or comments (p < 0.05). The major post type were texts for Twitter (251; 83.7%) and videos for Instagram (104; 34.7%). While a majority of posts by #covidvaccinesideeffects report about the occurrence of side effects, the majority of them were mild and general COVID-19 vaccination feedback during the first 4 months was positive. But, only 3 to 7% were rated by "excellent" educational and validatable content. Interrater reliability between all three examiners presented a high concordance with 89% (p = 0.001).

CONCLUSIONS

This study presents an analysis of quantity and quality of social media content according to COVID-19 vaccinations and its side effects. It supports the deduction that most of the content on Twitter and Instagram is shared by patients and unclear sources and thus is limited informative. Nevertheless, influence of social media on medical information especially during COVID-19 pandemic is increasing and practitioners have to face its effect on their patients.

Who is talking about #Facelift on Instagram?

Background

The internet has become a powerful tool for disseminating medical information. Social media platforms have gained popularity among medical professionals to connect with patients and promote their work and practices. We aimed to understand who is posting about facelift procedure on Instagram.

Methods

Sprinklr, a social listening platform, was used to compile conversations that were posted on Instagram between January 1, 2021, and February 28, 2021, and contained hashtags #facelift, #necklift, #plasticsurgery, #plasticsurgerybeforeandafter, and #platysmabands. English and Spanish language posts were analyzed for positive sentiment. Based on the number of likes, the top 100 English and Spanish posts were selected. Posts were categorized based on primary specialty of the poster as plastic surgeon, non-plastic surgeon, country of active clinical practice, board certification, and members of international plastic surgery societies.

Results

A total of 5099 posts with a total of 11,918 mentions were collected. Of the top 100 English posts, the countries most represented were the USA (59%), followed by Turkey (6%). Physicians made up 48% of the top English posts, of whom 42% were US board-certified plastic surgeons. By contrast, of the top 100 Spanish posts, the countries most represented were Mexico (29%) and Colombia (25%). Physician posters constituted 78%, of whom 38.5% were plastic surgeons certified by their country of practice.

Conclusions

Plastic surgeons have become more active in creating popular content related to facelift on Instagram over the past few years. However, a significant percentage of IG content on #facelift, a surgical procedure, was made by non-physicians and non-plastic surgeons in 2021.

Level of evidence:  Not gradable.

US Public's Perceptions of Online Transformation Photos

BACKGROUND

Although many plastic surgeons seek to optimize their online presence and reach a broader patient base, no studies to our knowledge have evaluated the general public's perceptions of one of the most valued informational tools: transformation photos.

OBJECTIVES

The aim of this study was to evaluate the general public's preferences for viewing transformation photos online.

METHODS

Respondents representative of the US public, crowdsourced through Amazon Mechanical Turk, answered a survey assessing perceptions of the posting of before-and-after photos.

RESULTS

One thousand respondents completed the questionnaire. Ninety percent (905/1000) of respondents are willing to view online before-and-after photos. Sixty-three percent (634/1000) would consent to online posting of before-and-after photos of at least 1 body area, with comfort levels highest for facelift (36.4%), nonoperative facial rejuvenation (31.9%), liposuction (24.9%), and abdominoplasty (23.2%). Breast reduction (12.4%), breast reconstruction (10.9%), gluteal augmentation (14.0%), and vaginal rejuvenation (4.4%) are considered least acceptable for public posting. Respondents are significantly more opposed to online viewing of genitals than any other body area (P < 0.0001). Of those willing to have their own transformation photos posted online, 74.0% would allow posting on professional practice websites, 35.1% on Instagram, 26.6% on Facebook, 17.2% on Twitter, and 10.7% on Snapchat. Significantly more respondents prefer their transformation photos reside only on professional practice websites rather than on a social media platform (P < 0.0001).

CONCLUSIONS

The public considers aesthetic facial procedures and body contouring most acceptable for showcasing transformation photos online. Although most respondents prefer viewing these photos on professional practice websites, Instagram is the favored social media platform. The majority of the public seek transformation photos when choosing a plastic surgeon for a cosmetic procedure.

Evaluation of Social Media Utilization by Academic Plastic Surgery Programs during the COVID-19 Pandemic

Background:

In response to the cancellation of away rotations and the shift to virtual interviews due to the coronavirus disease of 2019 (COVID-19) pandemic, residency programs have pursued other methods of sharing program details, most notably with the use of social media. This study aimed to evaluate the extent of social media utilization in the setting of the COVID-19 pandemic by plastic surgery residency programs.

Methods:

Instagram, Twitter, and Facebook accounts of plastic surgery programs, program directors, and chiefs were identified. Number of followers, total posts, and posts since March 1, 2020, were extracted. Account content was categorized as informational, social, operative, research, self-promotional, guest lecture, education, or other. Spearman’s coefficient was used to determine correlations among account data. Differences among regions and program pathways were evaluated using the Kruskal-Wallis test.

Results:

Since March 1, 2020, 17 Instagram, five Twitter, and three Facebook accounts have been created. Instagram was most widely used and followed (1720 posts, 1235.7 ± 735.9 followers) compared with Twitter (722 tweets, 325.6 ± 451.0 followers) and Facebook (430 posts, 338.3 ± 363.3 followers). Although the majority of content was informational (45.1 percent), Instagram contained more social content (21 percent), Twitter contained more research (21 percent), and Facebook contained more self-promotional content (25 percent). Integrated-only programs on average posted more on Instagram (21.5 ± 15.1 posts) than did independent-only programs (9.4 ± 8.5 posts), and post volume moderately correlated with number of followers. There were no statistically significant differences among regional means.

Conclusion:

Plastic surgery residency programs have incorporated social media into their recruitment strategies and will likely continue to increase and diversify their posts to effectively engage with future applicants.

#facialtraumasurgery: Educational Content of Instagram as a Social Media Source for Facial Trauma Surgery

ABSTRACT

With an uprising influence of social media platforms like Instagram during the last decade, medical and healthcare related posts have accumulated majorly. In particular the head and face characterizes and signifies each individual's human character, which may be the reason why numerous posts are shared on social media platforms. The purpose of this investigation was to assess the content associated with facial trauma surgery and evaluate its educational quality.The authors performed a retrospective investigation on 550 Instagram posts by #facialtraumasurgery due to number of "likes," comments, type of post, language, its purpose, and source. Furthermore, posts were evaluated due to their educational quality by 3 examiners of different educational levels.The majority of posts showed 0 to 50 "likes" and 0 to 5 comments in English language. The major post type were single photographs (289; 52.5%), multiple photographs (188; 34.2%), videos (73; 13.3%) and predominantly case reports (233; 42.4%). The source was 322 (58.5%) posts by surgeons, followed by 185 (33.6%) clinic posts. Only 10% to 18% of the posts were rated "excellent." Interrater reliability between all 3 examiners presented a high concordance with 89% (P = 0.000).Our study presents an analysis of quantity and quality of social media content according to facial trauma surgery. It supports the deduction that most of the content on Instagram is shared by patients and unclear sources and thus is limited informative. Nevertheless, influence of social media on medical information is increasing and practitioners have to face its effect on their patients.

Global Trends in Plastic Surgery on Social Media: Analysis of 2 Million Posts

BACKGROUND

Plastic surgeons and patients increasingly use social media. Despite evidence implicating its importance in plastic surgery, the large volume of data has made social media difficult to study.

OBJECTIVES

The aim of this study was to provide a comprehensive assessment of plastic surgery social media content worldwide by utilizing techniques for analyzing large-scale data.

METHODS

The hashtag "#PlasticSurgery" was used to search public Instagram posts. Metadata were collected from posts between December 2018 and August 2020. In addition to descriptive analysis, 2 instruments were created to characterize textual data: a multilingual dictionary of procedural hashtags and a rule-based text classification model to categorize the source of the post.

RESULTS

Plastic surgery content yielded more than 2 million posts, 369 million likes, and 6 billion views globally over the 21-month study. The United States had the most posts of 182 countries studied (26.8%, 566,206). Various other regions had substantial presence including Istanbul, Turkey, which led all cities (4.8%, 102,208). The classification model achieved high accuracy (94.9%) and strong agreement with independent raters (κ = 0.88). Providers accounted for 40% of all posts (847,356) and included the categories physician (28%), plastic surgery (9%), advanced practice practitioners and nurses (1.6%), facial plastics (1.3%), and oculoplastics (0.2%). Content between plastic surgery and non-plastic surgery groups demonstrated high textual similarity, and only 1.4% of posts had a verified source.

CONCLUSIONS

Plastic surgery content has immense global reach in social media. Textual similarity between groups coupled with the lack of an effective verification mechanism presents challenges in discerning the source and veracity of information.

Social Media for the Hepato-Pancreato-Biliary community (#SoMe4HPB): connecting a specialized online group for scientific and clinical knowledge dissemination

BACKGROUND

Social media has an increasingly important role in scientific communication, clinical discussions and knowledge distribution. While several surgical disciplines have taken to internet for increased connectivity, there is currently little knowledge about the social media activity in the field of hepatopancreatobiliary surgery. We aimed to evaluate the implementation and use of a specific HPB hashtag and Twitter handle.

METHODS

The hashtag and Twitter handle (#SoMe4HPB; @hpb_so) were initiated on February 2019. We evaluated the response during the initial 15 months by applying NodeXL to trace activity.

RESULTS

The Twitter handle had 1388 followers (by May 7, 2020) and had generated 855 tweets and retweets. A total of 1120 mentions of 182 accounts were recorded in original tweets by @hpb_so. The largest global reach was recorded in December 2019 (254.000 people). Pancreatic cancer was the subject of 15% of all posts, liver malignancies of 12% of all posts and minimally invasive surgery of 8%.

CONCLUSION

The Social Media for the Hepato-Pancreato-Biliary community (#SoMe4HPB) and its associated Twitter handle @hpb_so had a well-built inception followed by a progressive development connecting individuals interested in HPB Surgery internationally. The involvement of more actors is required in order to fully attain its scientific dissemination role.