Presence of Cosmetic and Aesthetic Surgery on TikTok.

In the past decade, social media has had an important role in shaping the public perception of health care. Social media offers an avenue for health care education and for physicians to promote their practice. Despite its rising popularity since 2019, TikTok has received limited evaluation.[1] A previous study suggested that plastic surgeons are increasingly using TikTok as influencers, but little is known about the content and purpose behind their posts.[2] In this study, plastic surgery-related content on TikTok was examined, including who posts and how the platform is being used.

In January 2022, 21 hashtags were queried for medical and layperson terminology relevant to plastic surgery (Table 1). Content analysis was used to evaluate each of the 20 “most liked” posts associated for each hashtag. Data extracted for each post included the number of likes, the number of comments, the type of poster (individual health professional, individual nonhealth professional, or business), and the primary purpose (promotional, educational, or personal). For health professionals, specialty and training were included. Non-English-speaking posts were excluded.

Table 1.

List of Hashtags

Hashtag	Total No. Views
#plasticsurgery	11.4 billion
#bbl	4.6 billion
#nosejob	3.8 billion
#rhinoplasty	2.2 billion
#plasticsurgeon	1.8 billion
#tummytuck	1.3 billion
#liposuction	814.3 million
#facelift	669.5 million
#breastaugmentation	663.0 million
#cosmeticsurgery	440.5 million
#breastimplant	319.8 million
#abdominoplasty	313.5 million
#bodycontouring	296 million
#breastlift	219.7 million
#liquidrhinoplasty	65.9 million
#mastopexy	56.9 million
#necklift	56.6 million
#eyebrowlift	35.4 million
#aestheticsurgery	10.9 million
#cosmeticsurgeon	4.8 million
#aestheticsurgeon	2.2 million
Total	29,069,000,000

Analysis of the 420 videos yielded a total of 433 million likes and 3.87 million comments. Compared with the 38% of plastic surgery Instagram posts by surgeons, the majority of plastic surgery-related content (51.2%) on TikTok is by physicians.[3] The remaining were by nonphysician private accounts (47.6%) and private clinics (1.2%). (See Supplemental Digital Content 1, which displays a pie chart that shows poster distribution by uploader, http://links.lww.com/PRSGO/C152.) The male-to-female distribution was 49.5% and 49%, respectively; the remaining 1.4% were uploaded by either transgender users or users of unknown gender (Table 2). Among physicians, 79.1% of the posts were uploaded by the American Board of Plastic Surgery certified plastic surgeons, 17.3% by cosmetic surgeons/aestheticians, 2.2% by dermatologists, 0.9% by otolaryngologists, and 0.5% by gynecologists (Table 2). The majority (60.2%) of the posts were self-promotional. (Supplemental Digital Content 2, which displays a pie chart that shows video categories for all posts, http://links.lww.com/PRSGO/C153.)

Table 2.

Characteristic of TikTok Posts

Variable	No. (%)
Gender of poster
Male	208 (49.5)
Female	206 (49.1)
Transgender	1 (0.2)
Unclear	5 (1.2)
Total	420
Uploader
Individual physician	215 (51.2)
Individual—nonphysician	200 (47.6)
Private practice or business	5 (1.2)
Total	420
Post based on physician specialties
Plastic surgeon (including five plastic surgery clinics)	174 (79.1)
“Cosmetic surgeon” or aesthetician (not board-certified plastic surgeons)	38 (17.3)
Dermatology	5 (2.2)
ENT	2 (0.9)
Gynecologist	1 (0.5)
Total	220
Video categories for all post
Promotional	253 (60.2)
Educational	105 (25)
Personal	62 (14.8)
Total	420
Video categories for physicians
Promotional	147 (66.8)
Educational	73 (33.2)
Personal	0 (0)
Total	220

Compared with a 2018 study analyzing Plastic Surgery Instagram content (83%), there is less self-promotional content on TikTok. However, TikTok is growing among plastic surgeons to maximize exposure to the public eye and potential patient base.[4] While only 16% of Instagram posts had an educational purpose, 25% of posts on TikTok were educational (See Supplemental Digital Content 2, which displays a pie chart that shows video categories for all posts, http://links.lww.com/PRSGO/C153.)[5] According to the insider, cosmetic surgery advertisement videos can bypass TikTok regulations to reach a younger audience. For this reason, it is of utmost importance for users to distinguish between the types of posts as well as the identity of the content uploaders before pursuing plastic surgery procedures.[5] Our study highlights the increased use of TikTok among plastic surgeons over the last 3 years, as well as its potential to become a more dominant tool for patient education and promotion.

DISCLOSURE

The authors have no financial interest to declare in relation to the content of this article.