American Council of Academic Plastic Surgeons

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#BreastReconstruction: A Qualitative Analysis of Aesthetic and Reconstructive Breast Surgery Photographs on Instagram
Rose S. Maisner, BS; Kailash Kapadia, MD; David Cohen, BA; Haripriya S. Ayyala, MD; Edward S. Lee, MD
Division of Plastic and Reconstructive Surgery, Rutgers-New Jersey Medical School, Newark, NJ

Background: Patients are increasingly searching the Internet for information on both aesthetic and reconstructive breast procedures. Social media sites, such as Instagram, have become platforms for patients to learn about desired procedures and view before-and-after photographs. Such information can guide expectations of the healing process and aesthetic results. This study aims to assess the quality, comprehensiveness, and adherence to Plastic Surgery Foundation (PSF) and American Society of Plastic Surgeons (ASPS) photographical standards, of Instagram posts on breast reconstruction surgery
Methods: On August 8, 2020, the authors queried 20 breast reconstruction surgery-related hashtags. The top 30 posts by US plastic surgery practices comprising patient photographs were included. Post content and captions were analyzed. Each image within a post was compared with the photographical standards for Breast Images established by the PSF and ASPS
Results: A total of 280 posts containing 1-10 individual images and 1-5 different views were identified. 83.9% of posts were made by individual plastic surgeons, while 16.1% were made by group practices. 88.2% of posts did not disclose patient age, 81.1% did not state the time that post-operative images were taken relative to the procedure, 96.1% did not include the recovery time, and none mentioned complications. 73.6% of posts failed to frame photographs according to national guidelines, 41.4 and 35.4% of posts are not positioning and disrobing patients appropriately, respectively. 54.3% of posts had a visible scar. Additionally, 8.6% of posts were about procedures inconsistent with the queried hashtag. On average, posts are utilizing 17.2 8.4 hashtags
Conclusion: The photographs of aesthetic and reconstructive breast surgery on Instagram are not standardized and show poor adherence to established photographic guidelines by PSF and ASPS. Plastic surgeons should take this into consideration as Instagram remains a widely used patient resource.


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