The Internet along with social media sites have become an integral part of modern society including the medical profession, prominent in the field of plastic surgery.[4,5] Social media has become an important source of information for patients who expect personal medicine with an ongoing patient-physician relationship and instant online availability.[3,13,14] As such, plastic surgeons have begun to adapt and are beginning to operate in this virtual world; however, most of the information on the Internet is far from being dominated by health care providers. For example, only 6% of the posts about plastic surgery on Twitter were published by plastic surgeons.
In this study, 300 posts in English on Facebook, Instagram, and YouTube containing the key phrase "plastic surgery" were analyzed to elucidate the factors that attract attention to content about plastic surgery on social media.
Plastic surgeons lag behind in the growing competition for attention.[16,17] Only a third of the posts analyzed in this study were written by plastic surgeons, with resembling findings in other studies.[4,7,16] Most of the posts from plastic surgeons were published on Instagram, which is an excellent platform for reaching patients, perhaps because it is perceived as offering a more personal experience with less negative behavior like shaming compared with other social media sites. Instagram may also be less convenient for commercial use because companies tend to operate with a more business-minded approach and advertise (Figure 1).
Unfortunately, educational posts and those about studies, accounted for only a small percentage of the total posts (16% and 2%, respectively) and generated only a little interest from the users. In contrast, using photographs of attractive women is still widely used, accounting for 68% of posts, and attracted much more attention than educational content (Figure 6). Sadly, this controversial advertising is pervasive because it is still effective.[17,18] As shown in Figure 8, attractive female plastic surgeons who post personal photographs on Instagram attract an incredible amount of attention. On the other hand, attractive male plastic surgeons generate less interest than their female counterparts (Table 1).
The phenomenon of shaming using the Internet and social media to publicly embarrass and insult others has become a major problem, particularly for plastic surgeons, that operate in a private, competitive market. Shaming is seen in 21% of the posts, mostly on Facebook (39%), and mainly relating to a public figure (25%; Figure 2). However, it does not mean that plastic surgeons are exempt from ridicule. We noticed shaming of board-certified plastic surgeons when reviewing the posts, but it mainly occurred in the comments section and hence was not recorded. There is no need to elaborate on the hazards this tool entails.[16,19–21]
Some of the posts used reality television stars (7%) and were mainly on Facebook (17%). Reality television stars attracted a lot of attention, measured by "likes," but this attention may not be as effective (measured also by comments and shares) as that of other public figures (Figs. 3, 4). Educational content using videos or pictures of surgeries may be worthy alternatives to using public figures (Figure 8, Table 1 and Table 2). Notably, posts that include videos or aim to educate patients are rewarded by a substantially higher number of shares, perhaps because they resonant more with the target audience. Shares are a good way to pass information, as it is loyal to the original massage, posts with videos, in particular, draw more attention than posts without them (Figure 7).
Interestingly, uniqueness in the form of humor or quirkiness was more likely to attract attention compared with the traditional advertising methods of using attractive women and/or celebrities in posts (Figure 8).
Our study found that, per post, there were an average of 5,433 "likes," 530 comments, 556 shares, and 875,943 views. Hence, social media is undoubtedly the future and a ground worth pursuing.
Whether a surgeon is a novice or an experienced user in the social media (networks), the main challenges of attracting the right public attention and picking the right media for each post still remain. Today's plastic surgeons must understand their future patients to create social medial content that caters to their interests and attracts positive attention. Our study results may aid in this quest. For example, following our findings, the novice social media user can use Instagram as a tool for self-promotion, and YouTube as a convenient stage for educational content. The veteran user can add new strategies to their repertoire by adding jokes, personal stories of patients (upon consent), videos, or photographs of surgeries to attract more attention and educate the public.
Apart from the traditional ways to measure the success of a physician, tomorrow's success, potential, and public influence of a surgeon might be measured by "social media currency" ("Likes", comments, shares, and views). The potential of celebrities to attract attention (Figure 5) can be harnessed to reach a larger audience. Notably, very few doctors were able to use social media effectively to attract large audiences by themselves. It may be wise to enlist the help of "social media celebrities," which were shown in the study to attract as much attention as commercial companies.
A deep understanding of the power of media, both traditional and new, is vital for all those engaged in the competitive plastic surgery market to self-promote and connect with potential patients. In our opinion, it may be wise to establish a set of rules that will outline the proper way to act in this field,[15,21,22] a place where negative influences, misinformation, and destructive phenomena such as shaming are a common occurrence.[9,15,20–22] Uncoordinated activity may allow negative influences to take root. In summary, we can use these tools to our advantage to increase the board-certified plastic surgeon's accessibility to the general public, according to established ethical rules, and to educate the public through evidence-based medicine.[23,24]
Plast Reconstr Surg Glob Open. 2018;6(12):e1958 © 2018 Lippincott Williams & Wilkins