Forget those vacation pictures. Sharing graphic social media posts is one new way to gain followers.
Everything from botox to tummy tucks and breast augmentation are now being posted and live-streamed online by doctors and medical practitioners. While tactics like these are becoming increasingly popular to advertise surgery, there has been no regulation or direction regarding what is appropriate or allowed in the medical field — until now.
“It’s kind of like the Wild West out there, with no guidelines or rules,” Robert Dorfman, a third-year medical student at Northwestern University Feinberg School of Medicine who co-authored a new code of ethical behavior for sharing plastic surgery videos on social media said. The suggested guidelines, published last week in the Plastic and Reconstructive Surgery Journal, are meant to address the “circus atmosphere” of plastic surgery social media and drew on inspiration from founding principles of medical ethics that date back to Hippocrates.
Examples of the “circus”-like behavior cited in the paper included a plastic surgeon cradling fat removed from a tummy-tuck in his arms like a baby and then putting a baby face on it using a Snapchat filter. Other doctors dressed in costumes, danced before surgery, and otherwise flaunted removed body tissues on camera.
Examples of the ‘circus’-like behavior cited in the paper included a plastic surgeon cradling fat removed from a tummy-tuck in his arms like a baby and then putting a baby face on it using a Snapchat filter.
Dorman calls this the “Dr. Miami effect,” referring to Miami-based plastic surgeon Michael Salzhauer who began posting procedures online several years ago and gained 661,000 followers on Instagram FB, +0.29% Dorman said many are seeking to replicate this social-media-fueled success. “This is a trend we are seeing throughout the U.S. and the world,” he said.
“Dr. Miami” also posts his price list on Instagram: It costs $9,945 for a “Brazilian Buttlift.”
Salzhauer said he agrees with the suggested guidelines, calling them “reasonable.” Sharing surgery on social media may help reduce fear potential patients may have about going under the knife, he added; in fact, half of his patients now request their procedures be shared online. In the majority of cases, Salzhauer protects the patient’s anonymity by covering his or her face, and any identifying tattoos. “The benefits of Snapchatting surgery far outweigh any risks,” he said. “It allows patients to see how surgery is actually done.”
Proposed guidelines include obtaining written consent from patients before posting their operations on social media channels and informing patients that they have the right to refuse or change their mind regarding online posts. Surgeons are already required to obtain consent before posting identifying videos and photos of patients, but Dorfman and other authors question the validity of the consent due to the power dynamics in patient-doctor relationships.
They say it is important to warn patients that even if they change their minds about a post and opt to have it deleted, it can live on through other social media posts or manipulated and shared. Another recommendation put forth by the author: Hire assistants to document surgeries to ensure photographing and video taping does not interrupt the procedures, something Salzhauer says he has already done.
“There is increasingly vulgar content by a growing number of plastic surgeons that is not in the best interest of the patient,” senior author Dr. Clark Schierle, a plastic surgeon and faculty member of Northwestern University Feinberg School of Medicine said. “We want to create guidelines that balance the need for plastic surgeons to post on social media, but we also want to maintain some element of professionalism.”
Exacerbating the problem: Many practitioners using social media to advertise procedures are not board-certified plastic surgeons, said Heather Furnas, a member of the American Society of Plastic Surgeons. This means they have not completed the six-or-more years of additional training required to be approved by the American Board of Plastic Surgery.
In fact, a recent study found only 18% of more than 1.7 million posts under the “plastic surgery” hashtag on Instagram were posted by board-certified plastic surgeons. Others were posted by barbers, salons, dentists, and other physicians not certified by the board. Because of this, board-certified surgeons have to place additional importance on following the rules — and recognizing the serious nature of surgery, she said.
“When surgeons are dancing in the operating room, people may misperceive surgery as this lighthearted event,” Dorfman said. “Yet there are risks associated with going under the knife, such as infection, excessive bleeding or possibly blood clots. The videos may be giving some people false illusions of what surgery is actually like.”
The latest proposals are still a long way from becoming industry requirements. They were published in the Plastic and Reconstructive Surgery Journal on Sept. 28 and will be presented Oct. 6 at the American Society of Plastic Surgeons (ASPS) annual meeting in Orlando. The recommendations will be considered and voted on at the ASPS meeting and, if passed, will apply to all members of the society.