YouTube for Cosmetic Plastic Surgery: An Effective Patient Resource?
Brittany Ward, BS, Haripriya S. Ayyala, MD, Kathy Zhang, BA, Priya A. Mansukhani, BS, Boris Paskhover, MD, Edward S. Lee, MD.
Rutgers New Jersey Medical School, Newark, NJ, USA.
Background
As the second most visited website in the world, YouTube is increasingly being utilized as a major educational resource by patients. Patients encounter videos by trusted medical professionals and are recommended videos posted by former patients discussing their personal experience with the procedure. The authors aim to evaluate the quality of the most likely videos that patients will encounter when searching YouTube for some of the most common cosmetic plastic surgery procedures and compare the quality of videos based on the search term entered.
Methods
Using Google Trends, the most common medical and colloquial terms were identified for common cosmetic surgery procedures: “abdominoplasty”, “tummy tuck,” “breast augmentation,” “boob job,” “liposuction,” “lipo,” “mastopexy,” “breast lift,” “reduction mammoplasty,” and “breast reduction.” Videos were searched by relevance (default) and view count; the top 10 results were collected in each group and rated using the DISCERN criteria. Each video was assigned an overall and bias DISCERN score (DS). A score of 1 indicates high bias and low overall quality and a score of 5 indicates low bias and high overall quality. Additionally, the video publication date, number of views, and presence of a US board certified plastic surgeon were recorded. Videos appearing in multiple search term results were classified as duplicate videos and were rated once.
Results
143 unique videos were identified, which resulted in a mean bias DS of 2.29 and mean overall DS of 2.44. 72 videos included US board certified plastic surgeons and 58 were classified as patient experience. Videos had 667,373,209 total views and were an average of 4.27 years old. Videos including US board certified plastic surgeons were of significantly higher quality and showed lower bias than videos without (P<.05). Searching for the medical term opposed to the colloquial term for a procedure did not lead to higher quality results. Overall, videos showed high bias and low overall quality. All search terms with a mean overall DS under 2.00 (boob job, breast reduction, and lipo) had a high proportion of results include personal experiences and a low proportion include US board certified plastic surgeons.
Conclusion
Plastic surgeons should be aware of this popular resource and counsel patients, as YouTube videos can often present biased information. Board-certified plastic surgeons or academic plastic surgery organizations should strive to upload high quality, unbiased videos with both medical and colloquial terms to increase visibility to patients as a more appropriate resource.
| Search Term & Type | # of Videos | # of Videos Including US Board Certified Plastic Surgeons | # of Personal Experience Videos | Mean Video Age | Total # of Views | Mean # of Views | Mean DISCERN Bias | Mean DISCERN Overall |
| Abdominoplasty | 20 | 15 | 1 | 5.65 | 13,621,116 | 681,055.80 | 2.25 | 2.65 |
| Relevance | 10 | 9 | 3.21 | 1,525,884 | 152,588.40 | 2.90 | 2.90 | |
| View Count | 10 | 6 | 1 | 8.09 | 12,095,232 | 1,209,523.20 | 1.60 | 2.40 |
| Boob job | 20 | 2 | 12 | 2.44 | 102,298,707 | 5,114,935.35 | 1.15 | 1.85 |
| Relevance | 10 | 1 | 6 | 1.29 | 33,807,262 | 3,380,726.20 | 1.10 | 2.00 |
| View Count | 10 | 1 | 6 | 3.59 | 68,491,445 | 6,849,144.50 | 1.20 | 1.70 |
| Breast Augmentation | 20 | 12 | 4 | 4.71 | 132,285,338 | 6,614,266.90 | 2.45 | 2.95 |
| Relevance | 10 | 5 | 4 | 2.48 | 1,192,438 | 119,243.80 | 3.90 | 3.30 |
| View Count | 10 | 7 | 6.94 | 131,092,900 | 13,109,290.00 | 1.00 | 2.60 | |
| Breast Lift | 20 | 9 | 6 | 3.14 | 14,409,255 | 720,462.75 | 3.80 | 3.25 |
| Relevance | 10 | 4 | 3 | 1.50 | 404,463 | 40,446.30 | 4.00 | 3.40 |
| View Count | 10 | 5 | 3 | 4.79 | 14,004,792 | 1,400,479.20 | 3.60 | 3.10 |
| Breast Reduction | 20 | 6 | 10 | 3.35 | 25,731,978 | 1,286,598.90 | 2.05 | 1.95 |
| Relevance | 10 | 4 | 6 | 1.42 | 803,677 | 80,367.70 | 1.30 | 1.80 |
| View Count | 10 | 2 | 4 | 5.27 | 24,928,301 | 2,492,830.10 | 2.80 | 2.10 |
| Lipo | 20 | 2 | 8 | 3.82 | 157,968,844 | 7,898,442.20 | 1.40 | 1.40 |
| Relevance | 10 | 2 | 4 | 1.90 | 3,491,300 | 349,130.00 | 1.40 | 1.30 |
| View Count | 10 | 4 | 5.74 | 154,477,544 | 15,447,754.40 | 1.40 | 1.50 | |
| Liposuction | 20 | 5 | 4 | 4.49 | 187,943,469 | 9,397,173.45 | 2.35 | 2.15 |
| Relevance | 10 | 2 | 4 | 2.20 | 3,370,632 | 337,063.20 | 2.30 | 2.40 |
| View Count | 10 | 3 | 6.78 | 184,572,837 | 18,457,283.70 | 2.40 | 1.90 | |
| Mastopexy | 20 | 6 | 5 | 4.28 | 7,104,812 | 355,240.60 | 2.10 | 2.70 |
| Relevance | 10 | 2 | 4 | 1.29 | 108,056 | 10,805.60 | 2.00 | 2.80 |
| View Count | 10 | 4 | 1 | 7.28 | 6,996,756 | 699,675.60 | 2.20 | 2.60 |
| Reduction Mammoplasty | 20 | 7 | 5.45 | 2,397,251 | 119,862.55 | 2.60 | 2.70 | |
| Relevance | 10 | 5 | 2.93 | 156,525 | 15,652.50 | 2.70 | 2.80 | |
| View Count | 10 | 2 | 7.97 | 2,240,726 | 224,072.60 | 2.50 | 2.60 | |
| Tummy Tuck | 20 | 8 | 8 | 5.35 | 23,612,439 | 1,180,621.95 | 2.75 | 2.80 |
| Relevance | 10 | 3 | 4 | 3.81 | 3,760,959 | 376,095.90 | 2.80 | 2.90 |
| View Count | 10 | 5 | 4 | 6.89 | 19,851,480 | 1,985,148.00 | 2.70 | 2.70 |
| TOTAL | 200 | 72 | 58 | 4.27 | 667,373,209 | 3,336,866.05 | 2.29 | 2.44 |
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