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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 amount of data has made social media difficult to study.


OBJECTIVES
This study seeks to provide a comprehensive assessment of Plastic Surgery content throughout the world using techniques for analyzing large-scale data.


METHODS
'#PlasticSurgery' was used to search public Instagram posts. Metadata was collected from posts between December 2018 and August 2020. In addition to descriptive analysis, we created two instruments to characterize textual data: a multi-lingual 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). Our 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 Physician (28%), Plastic Surgery (9%), Advanced-Practice-Practitioners and Nurses (1.6%), Facial Plastics (1.3%), and Oculoplastics (0.2%). Content between Plastics and non-Plastics 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.