Consumers might want to look beneath the surface of Instagram posts about smaller noses, bigger breasts and flatter tummies, based on the results of a new study.
Most of those advertising plastic surgery services on the social media platform are not board-certified plastic surgeons, according to a study from Northwestern Medicine being published Wednesday in the Aesthetic Surgery Journal.
In fact, the study found some of the top posts on Instagram came from dentists, spas and even a hair salon.
"I see examples of patients who've been botched by providers who were inadequately credentialed, and patients who were misled by false advertising or social media," said Dr. Clark Schierle, senior author of the study and a Northwestern Medicine plastic surgeon.
"Sometimes, if things seem too good to be true, they just might be," said Schierle, a faculty member at Northwestern University's Feinberg School of Medicine.
The study looked at results for 21 hashtags related to plastic surgery, including #plasticsurgery, #facelift, #breastimplant, #boobjob, #liposuction and #brazilianbuttlift. In all, those 21 hashtags had nearly 1.8 million posts, but the study's authors whittled those down to the top nine posts for each of the hashtags for their research.
They found the largest number of posts came from foreign surgeons. The next largest number — more than 26 percent — came from doctors such as dermatologists, gynecologists and general surgeons who were not certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada. Any licensed medical doctor can legally perform cosmetic surgeries, though the doctors' levels of training may vary.
Meanwhile, board-certified plastic surgeons accounted for only 17.8 percent of the top posts. Four of the posts were from dentists, four were from spas with no associated physicians and one came from a hair salon.
Schierle said the study should serve as a "wake-up call" for board-certified plastic surgeons. "We're losing the information war, and (we're) being drowned out by these other players," Schierle said.
Dr. Peter Revenaugh, director of facial, plastic and reconstructive surgery at Rush University Medical Center, said the study highlights something not often examined in medical literature — though he said the results don't surprise him.
"It's a reasonable take, in that consumers need to be aware that there are people out there that may not be super trained in something they're doing," said Revenaugh, who was not involved in the study. "It is something with a little more risk than buying a car."
Some, however, say consumers shouldn't necessarily worry about going under the knife with providers who aren't board-certified plastic surgeons. Doctors who aren't plastic surgeons may get additional training to perform cosmetic surgery and can be certified by other organizations.
The American Board of Cosmetic Surgery, for example, says doctors it certifies must first complete a one-year fellowship training program in cosmetic surgery, in addition to a residency in a related discipline. Cosmetic surgeons focus on enhancing people's appearances, while plastic surgeons often focus on repairing problems, though they may also perform cosmetic procedures.
"There are a lot of great surgeons in the world, and they're not all plastic surgeons," said Dr. Joe Niamtu, a board member for the American Academy of Cosmetic Surgery, a separate organization.
Niamtu said some cosmetic surgeons have more experience with certain procedures than some plastic surgeons. He said he's done about 20,000 cosmetic surgeries over his career. He attended dental school, did a hospital internship and then spent four years doing a hospital residency in oral and maxillofacial surgery.
"It boils down to your training, your experience and your outcomes," he said.
The American Board of Cosmetic Surgery cautions that patients should do their homework when it comes to choosing someone to do a procedure.