Social Media in Plastic Surgery Practices: Emerging Trends in North America (2023)

Abstract

Background:Social media is a common term for web-based applications that offer a way to disseminate information to a targeted audience in real time. In the current market, many businesses are utilizing it to communicate with clients. Although the field of plastic surgery is constantly changing in response to innovative technologies introduced into the specialty, the utilization of social media in plastic surgery practices is currently unclear.

Objectives: The authors evaluate the current attitudes and practices of aesthetic surgeons to emerging social media technology and compare these to attitudes about more traditional modes of communication.

Methods: A 19-question web-based survey was disseminated by e-mail to all board-certified or board-eligible American plastic surgeons (n = 4817). Respondents were asked to answer questions on three topics: (1) their use of social media in their personal and professional lives, (2) their various forms of practice marketing, and (3) their demographic information.

Results: There were 1000 responses (20.8%). Results showed that 28.2% of respondents used social media in their practice, while 46.7% used it in their personal life. Most plastic surgeons managed their social media themselves or through a staff member. The majority of respondents who used social media in their practice claimed that their efforts were directed toward patient referrals. The typical plastic surgery practice that used social media was a solo practice in a large city with a focus on cosmetic surgery. Local competition of plastic surgeons did not correlate with social media use. Most plastic surgeons (88%) advertised, but the form of marketing varied. The most common forms included websites, print, and search engine optimization, but other modalities, such as television, radio, and billboards, were still utilized.

Conclusions: Social media represents a new avenue that many plastic surgeons are utilizing, although with trepidation. As social media becomes commonplace in society, its role in plastic surgery practice development and communication will become more prominent and defined.

cosmetic medicine, practice management, social media

The field of plastic and reconstructive surgery is constantly changing as new and innovative procedures and technologies are introduced into the specialty. By definition, plastic surgeons are some of the earliest adopters of new technologies (particularly those that are treatment related) because the specialty relies so heavily on these advances. The successful plastic and reconstructive surgeon must be able to embrace innovation and adapt to changes that can improve patient care, patient education, and patient outcomes.

This “early adopter” philosophy is not limited to clinical technology, however; many aspects of the digital revolution and its application to health care have been adopted by plastic surgeons. For example, plastic surgeons were some of the first to transition from film photography to digital photography. They were also among the first to utilize the Internet by creating websites for their practices. Today, the Internet plays a vital role in practice development; almost all practices, even academic ones, have websites. Many offices now employ computer programs (such as electronic medical records) for patient and office management. Furthermore, surgeons frequently use e-mail instead of standard mail as way of communicating with patients, colleagues, and acquaintances. The Internet has clearly become an important part of modern plastic surgery practice and a major source of information for surgeons and patients alike.

The static nature of the standard website and the passive presentation of information on the Internet is increasingly out-of-date. Modern users have grown to expect a high degree of interactivity, which is clearly demonstrated with the overwhelming popularity of social networking through applications such as Facebook, Myspace, Twitter, Flickr, and YouTube. There are also more individual forms of communication, such as blogging. Social media is the common term for this group of applications, all of which offer a way to disseminate information to a targeted audience in real time. Through these venues, users can make information instantly available to a selected group of readers, or subscribers.

Use of social media is not limited to individuals; it has already been embraced by many organizations in plastic surgery. The American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS) have Twitter, Facebook, and YouTube applications built into both their national meetings and their websites. Aesthetic Surgery News and Plastic Surgery News, distributed respectively by ASAPS and ASPS, have both featured several articles on social media and its possible role in the plastic surgery marketplace.1,2 Both societies have partnered with a website (realself.com) that uses social media to inform the public about cosmetic surgery.3 Additionally, ASAPS has developed a video-on-demand product called Project Beauty (www.projectbeauty.com) as a resource for patients who may be considering plastic surgery, including an on-demand “Ask a Surgeon” function that allows the public to solicit answers to plastic surgery questions in real time. In terms of individual use, Facebook has more than 500 pages devoted to private “plastic surgery” practices. Social media is clearly an emerging technology in the arena of plastic and reconstructive surgery.

In this article, we examine, via results from a web-based survey, the current attitudes toward and practices with this emerging technology in the plastic surgery community. Our study examined not only the use of social media by surgeons but also how their application of it compared to other, more traditional forms of public communication.

Methods

We obtained the e-mail addresses of all active plastic surgeons in the United States who are American Board of Plastic Surgery certified or eligible. After excluding retired members, a total of 4817 e-mails were sent, containing a blinded web-based survey administered via Catalyst. The surveys were sent out in April 2010 and were available to members for two months. Our survey consisted of 19 multiple-choice questions and one open-ended question. The survey allowed for multiple answers to many of the questions. (A copy of the survey can be seen in the appendix following this article and online at www.aestheticsurgeryjournal.com)

The initial portion of the survey focused on social media. These questions explored the extent of social media use in each respondent’s professional practice, as well as his or her personal life. Respondents were queried about their attitudes toward social media in general, as well as its perceived effectiveness in their practice.

The second section focused on forms of practice marketing, including a website presence and the perceived effectiveness of Internet marketing. Respondents were queried about the forms of advertising in their practice. These questions allowed for multiple answers and included all forms of marketing.

In the final section, respondents were asked to provide demographic information, including answers about the metropolitan size of their practice location, local plastic surgeon density, years in practice, type of practice, number of partners, and overall clinical case mix. This demographic information allowed for subset analysis, which helped us to identify trends based on various parameters.

Results

Of the 4817 e-mails sent, approximately 300 were returned as a result of nonfunctional e-mail addresses or e-mail filters that blocked the receipt of the survey. In total, we received 1000 responses, for a response rate of 20.8%.

Demographics

The respondents were evenly distributed in years of practice and practice location. Many (46.6%) practiced in an area with moderate competition (between four and 15 surrounding plastic surgeons). Most were in private practice (77.7%), and many of those were single practitioner (54.5%). Very few respondents were hospital employees (5.9%) outside of academic centers. Almost all respondents practiced a mix of cosmetic and reconstructive surgery, but about 40% had a mostly cosmetic practice. Only 6.3% of respondents did not take insurance. The vast majority (91.7%) had a website for their practice. Approximately half the respondents (46.7%) used social media in their personal life, and 28.2% used it in their practice.

The Value of Social Media and Practice Websites

Respondents who utilized social media in their practices (28.2%) predominantly relied on Facebook (about 96%) and Twitter (about 47%). Most believed that it accounted for only a small percentage (1%-10%) their practice volume, as listed in Figure 1. It did not appear to be as successful at generating business as a practice website (Figure 2), but about 89% of respondents who used social media did believe that it played a role in practice development. Of those who used it, the majority of practitioners (about 88%) managed their own social media, either directly (about 52%) or in cooperation with a staff member (about 50%). Outside management of social media occurred in only 12% of respondents’ practices. For those respondents who did not utilize social media, about 50% reported that they felt they had no time, approximately 34% felt it had no value, and about 11% felt it was too complicated.

Figure 1.

Social Media in Plastic Surgery Practices: Emerging Trends in North America (1)

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Volume of practice generated by social media referral.

Figure 2.

Social Media in Plastic Surgery Practices: Emerging Trends in North America (2)

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Volume of practice generated by website referral.

Characteristics of a Practice That Utilizes Social Media

Those practitioners who tended to utilize social media also used other forms of digitally-based marketing. Almost all had a website (about 98%) that was linked to their social media (about 78%); individuals in these practices tended to use social media more frequently in their personal lives as well. The surgeons who used social media were likely to be in their first 20 years of practice. If surgeons used social media in their practice, we found that, when compared to their colleagues who did not use social media, they were more likely to (1) perform mostly cosmetic surgery, (2) be in private practice, (3) be in a large urban center, and (4) have fewer partners. There was no difference between the groups in the amount of local competition (Table 1).

Table 1.

Characteristics of Plastic Surgeons Who Use Social Media, %

UsersNonusers
Less than 20 years of experience7063
Solo practice6153
Mostly cosmetic practice5932
Private practice9473
Use social media in personal life7037
Have a practice website9890
Live in a large metropolitan area5344
More than 16 plastic surgeons nearby3535
UsersNonusers
Less than 20 years of experience7063
Solo practice6153
Mostly cosmetic practice5932
Private practice9473
Use social media in personal life7037
Have a practice website9890
Live in a large metropolitan area5344
More than 16 plastic surgeons nearby3535

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Table 1.

Characteristics of Plastic Surgeons Who Use Social Media, %

UsersNonusers
Less than 20 years of experience7063
Solo practice6153
Mostly cosmetic practice5932
Private practice9473
Use social media in personal life7037
Have a practice website9890
Live in a large metropolitan area5344
More than 16 plastic surgeons nearby3535
UsersNonusers
Less than 20 years of experience7063
Solo practice6153
Mostly cosmetic practice5932
Private practice9473
Use social media in personal life7037
Have a practice website9890
Live in a large metropolitan area5344
More than 16 plastic surgeons nearby3535

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We found that when compared to less experienced practitioners, surgeons who had been in practice more than 20 years were less likely to use social media in their practice (approximately 26% vs 33%) and less likely to feel that it could play a role in practice development (approximately 51% vs 69%). However, they were just as likely to have a website (both about 93%).

Current Trends in Practice Marketing

Advertising in a plastic surgery practice has become commonplace, with only 12% of respondents claiming either “no advertisement” or “word of mouth” as their only form of marketing. The utilization of different marketing strategies in plastic surgery varied widely (Figure 3).

Figure 3.

Social Media in Plastic Surgery Practices: Emerging Trends in North America (3)

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Advertising utilization in plastic surgery practices.

Practitioners in large metropolitan areas (3 million or more residents) were just as likely to advertise as those in less populated areas (populations of fewer than 100,000; both 85%). Practitioners in large metropolitan areas were more likely than those in smaller markets to use more digital forms of advertising (social media, websites, search engine optimization, paid web-based advertising, bulk e-mail). Practitioners in smaller markets relied more heavily on print, radio, television, and billboards.

Discussion

Previous studies have shown that in direct proportion to its popularity in the general public, the Internet has become a dominant source of information for plastic surgery patients.4 Aesthetic surgeons have historically been early adopters of technological trends, including Internet-based marketing, and individual websites remain a highly-utilized method for disseminating information about a practice. Today, several new social media applications are available that are poised to effect a paradigm shift similar to the one created with the advent of the Internet. Smart phones and Wi-Fi have given us instantly-available networks with which to communicate; coupled with those, the advances in social media technology are altering the personal communication landscape. They have revolutionized—and will continue to revolutionize—not only how we communicate but also how information is distributed to our patients.

Our survey results show that plastic and reconstructive surgeons have begun to recognize the value of active participation in social media networks such as Facebook and Twitter. These services are increasingly being utilized at our national meetings, and professional societies such as ASAPS and ASPS are linking their websites to its networks. Based on answers to this survey, it also appears that individual practitioners are beginning to use it alongside more traditional media outlets.

In this survey, our response rate was limited to 20.8%. Previous survey studies have reported higher percentages (28.7% to 45%), but the actual numbers of respondents varied from 280 to 591 surgeons.5-9 These studies focused on subgroups of plastic surgeons and may have enjoyed a higher response rate as a result of a more focused survey population. However, our survey had a higher number of overall respondents. Historically, authors who have reported survey data targeting the entire specialty have had similar response rates (11.4%-24%).10-12 Also, many surveys are e-mailed multiple times to nonresponders; because our survey was anonymous, we had no way of contacting nonresponders without also distributing the survey to those who had already replied, which we chose not to do.

One limitation of the present study is the possibility of nonresponder bias. For example, surgeons who did not have e-mail addresses never received this survey; as such, they are probably less likely to use social media. On the other side of the coin, surgeons who are technologically savvy may have had e-mail filters in place to block unwanted survey e-mail. These surgeons are possibly more likely to use social media but also less likely to respond to a survey. Surgeons with e-mail addresses screened by staff members may also have been less likely to take the survey. However, given the large number respondents as well as the variability in their answers and demographic data, we concluded that the data did not appear to be compromised by the presence of these potential biases.

Social media use was more prevalent in plastic surgery practices (28.2%) than we originally hypothesized. In fact, the majority of plastic surgeons (62.4%) agreed that the use of social media could benefit their practice. Those who currently used social media in their practices also believed that they were generating a portion of their referrals (albeit a small one) through social media. Not surprisingly, however, the established practice website still appears more powerful in generating patient interest. Social media, with its ability to target individual patients with information tailored to their unique interests, may eventually surpass the standard website (which is far more static) as the preferred method of marketing. This seems likely in much the same way that practice websites were not as powerful or prevalent 10 years ago as they are today.

As expected, practices that focus heavily on cosmetic surgery reported using social media more frequently than did the more mixed surgical practices. However, even academic practices are utilizing social media tools. Surprisingly, the degree of local competition (defined as the number of plastic surgeons within a five-mile radius) did not seem to influence the use of social media. There was also no difference in social media usage with regard to years of practice, except when the number reached 20 years or more. It is difficult to know if those practices were too busy to invest time in social media or if surgeons beyond a certain age were personally uncomfortable with the idea or application of social media.

Some of the most revealing data from the survey came from the open-ended questions. While many of the respondents’ comments suggested a clear interest in this technology, many of the negative comments seemed to underscore a general lack of understanding about what social media is and how it works. For example, those who commented that plastic surgeons need to “skip the social media and concentrate on patient interaction” seemed to believe that this technology would replace the doctor-patient relationship rather than offer an adjunct forum for patient interaction. Plastic surgeons face competition from a myriad of providers offering surgical services, and this technology could provide a forum for targeted education on topics such as patient safety, outcomes, and surgical techniques. In addition, younger patients are just as likely to access information about plastic surgeons from social media as they are from the more traditional websites.

Legal and ethical concerns regarding control of content provoked several comments from plastic surgeons who have not adopted this technology to their practice. The central issue appeared be a perceived lack of control over postings on their social media network. While this is a legitimate concern, the moderator of a social media site such as Facebook has control over any comments posted on their specific profile page. The administrator can limit the ability to post comments to only those patients who have been accepted to their network. A moderator can also simply delete incorrect or damaging information, or they can even block someone’s access altogether. The most common response cited a desire to keep personal and business information separate or nonpublic. In these cases, the creation of a business account could very easily separate personal information from business relationships. Furthermore, social media sends information to a specifically preselected target group, which is actually more private than the unrestricted dissemination on a practice website.

Marketing was once considered taboo in plastic surgery. It is now not only acceptable but the norm for most practicing plastic surgeons (about 88%, according to our survey). ASPS even recently commissioned a book to help guide its members on effective advertising and brand recognition. In our study, most respondents reported using multiple forms of advertising for their practices (about 77%). Location or population size did not directly correlate with the use of advertising, but it did influence the method, with a trend toward less technologically-dependent advertising in smaller markets. Advertising has become a necessity in the current market; non–plastic surgeons are offering (and advertising for) cosmetic procedures, and competition has drastically increased as a result.

Of note, we (the authors) have not yet integrated social media into our practices, but we have been intrigued by its potential applications. To determine the current influence in our specialty, we sought to characterize and quantify the feelings toward and use of social media/marketing by our colleagues. Given the benefits, reasonable price, and current upward trends in other plastic surgery practices, we expect to incorporate social media into our future marketing efforts. As with the majority of our colleagues, our efforts will most likely consist of separate business and personal accounts that are comanaged with the involvement of a more technologically savvy office staff member.

Conclusions

Social media, which is fast becoming an integral part of society at large, is playing a quickly-expanding role in plastic surgery practices. These technologies allow for peer interaction in the younger generations and will likely continue to grow in use as an important method of communication. Based on survey results from 1000 board-certified or board-eligible plastic surgeons, it seems that our specialty has begun to embrace social media but remains cautious regarding its application and consequences.

Appendix

Survey Sent to Participants (Response Rates in Parentheses)

Social Media in Plastic Surgery Practices: Emerging Trends in North America (4)

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Appendix

Survey Sent to Participants (Response Rates in Parentheses)

Social Media in Plastic Surgery Practices: Emerging Trends in North America (5)

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Disclosures

The authors declared no potential conflicts of interest with respect to the authorship and publication of this article.

Funding

The authors received no financial support for the research and authorship of this article.

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FAQs

How does social media influence plastic surgery? ›

Our findings revealed that viewing cosmetic surgery–related material on social media, spending longer hours on social media platforms, and having negative self-views when viewing social media are associated with an increased likelihood of considering undergoing cosmetic procedures in the future.

Has there been an increase in plastic surgery due to social media? ›

A poll conducted by the American Academy of Facial and Reconstructive Surgery shows surgeons are seeing more than a 30 percent increase in the number of patients interested in plastic surgery to improve their image on social media.

Is the plastic surgery industry growing? ›

KEY MARKET INSIGHTS

The global cosmetic surgery market size was USD 44.55 billion in 2020. The market is projected to grow from USD 46.02 billion in 2021 to USD 58.78 billion in 2028 at a CAGR of 3.6% in the 2021-2028 period.

Which country is leading in plastic surgery? ›

South Korea

The country boasts the highest number of cosmetic procedures per capita globally, with many top-ranking plastic surgeons specializing in face and body transformations.

How does the media encourage plastic surgery? ›

The researchers found that the more social media applications a person used, the more likely they were to consider cosmetic surgery. Those who used Tinder and Snapchat were more likely to have a positive attitude to surgery, compared with other apps.

How does social media influence beauty standards? ›

The finding of the study revealed that even 30 minutes on the social media app can “make women fixate negatively on their weight and appearance,” according to The New York Post. Additionally, the participants displayed dissatisfaction about their own bodies after looking at “fitspo” images and idolized celebrities.

Do influencers get plastic surgery? ›

In exchange for social media promotion, influencers are offered free and discounted filler, Botox and more. Some say it can become an addiction. Over the past two years, Awnuh, 19, has undergone a variety of cosmetic procedures: cheek filler, lip filler, breast augmentation and rhinoplasty. They are pricey procedures.

How does social media affect mental health? ›

When people look online and see they're excluded from an activity, it can affect thoughts and feelings, and can affect them physically. A 2018 British study tied social media use to decreased, disrupted, and delayed sleep, which is associated with depression, memory loss, and poor academic performance.

What is the connection between body image and cosmetic surgery? ›

Undergoing Cosmetic Surgery Enhances Self-Confidence and Body Image. One of the most obvious benefits of cosmetic surgery is perceived improvement in appearance. People with a pleasing appearance tend to have high self-confidence and a more positive body image.

How big is the plastic surgery industry in the US? ›

Plastic Surgeons in the US - Market Size 2002–2027
$20.1bnPlastic Surgeons in the US Market Size in 2022
1.4%Plastic Surgeons in the US Market Size Growth in 2022
2.3%Plastic Surgeons in the US Annualized Market Size Growth 2017–2022
1 more row
Jun 8, 2021

How common is plastic surgery in America? ›

Cosmetic surgery is very common. Every year, providers do more than 15 million cosmetic surgery procedures in the United States. More than 13 million of those are minimally invasive procedures. People of all genders and ages get cosmetic surgery.

Who is the #1 plastic surgeon in the world? ›

David Lickstein has been named a 2021 Best Plastic Surgeon by Newsweek. This is a tremendous honor, as his rankings are a result of surveys conducted amongst 5,000 Dr. Lickstein's peers, who were asked to recommend the best plastic surgeons in their states as well as across the United States.

What's the plastic surgery capital of the world? ›

SEOUL —With the highest rate of cosmetic surgeries in the world and nearly 1 million procedures a year, South Korea is often called the world's plastic surgery capital.

Which country has free plastic surgery? ›

Many people dream of free plastic surgery, and if you live in Brazil, this dream has the potential to become a reality. Performing more than 11.5 million procedures annually, Brazil represents one of the largest plastic surgery consumer markets in the world.

Which state has the most plastic surgery? ›

Descriptive data and main results
Rank, Surgical Demand IndexState NameSurgical Density (Surgeons per 10,000 people)
1Wyoming0.051
2Oklahoma0.083
3Arkansas0.071
4New Mexico0.091
46 more rows

Do influencers get plastic surgery? ›

In exchange for social media promotion, influencers are offered free and discounted filler, Botox and more. Some say it can become an addiction. Over the past two years, Awnuh, 19, has undergone a variety of cosmetic procedures: cheek filler, lip filler, breast augmentation and rhinoplasty. They are pricey procedures.

How does social media affect mental health? ›

When people look online and see they're excluded from an activity, it can affect thoughts and feelings, and can affect them physically. A 2018 British study tied social media use to decreased, disrupted, and delayed sleep, which is associated with depression, memory loss, and poor academic performance.

What do cosmetic surgeons do? ›

Plastic surgeons do not only perform cosmetic procedures. They perform reconstructive procedures on almost all parts of the body, and help children born with deformities, patients recovering from cancer, and patients who have suffered burns and other trauma.

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