Barbers and hair salons market cosmetic surgery on Instagram

Social media has become the leading destination for consumers seeking information about plastic surgery. 

But in the States, a new study shows the majority of providers advertising aesthetic surgery services on Instagram are not board certified-plastic surgeons, so patients who respond to the ads are putting themselves at risk.

The ads particularly affect young people, who increasingly want to improve their appearance for Instagram, Snapchat and other social media channels, but often do not understand who is qualified to perform procedures, the researchers said.

'This is a very scary finding,' said Robert Dorfman, the first author of the study and a third-year medical student at Northwestern University Feinberg School of Medicine. 'Providers, ranging from physicians who are not licensed in plastic surgery to dentists, hair salon employees and barbers, are doing procedures for which they do not have formal or extensive training. That's extremely dangerous for the patient.'

The paper will be published August 30 in the Aesthetic Surgery Journal.

Physicians, such as gynaecologists and emergency medicine doctors, advertise cosmetic surgery procedures services for which they are not board certified, the study found.

'A cosmetic surgeon is not necessarily the same thing as a board certified plastic surgeon, and patients need to be made aware of this,' Dorfman said.

Even more concerning: the hair salons, dentists, barbers and spas with no associated physician marketing plastic surgery procedures on Instagram, he said.

'The confusing marketing on social media is putting people at risk,' said senior study author Dr Clark Schierle, a health system clinician of surgery at Feinberg and a Northwestern Medicine plastic surgeon. 'There have been many recent reports of patient harm and deaths resulting from inexperienced providers offering services outside of their area of expertise.'

A previous study by Dr. John Kim, a Northwestern Medicine plastic surgeon, reported a nearly 300%  increase in the number of complications for panniculectomies (removal of a hanging flap of loose skin and fat from the abdomen) performed by non-plastic surgeons compared with board-certified plastic surgeons.

Schierle has operated on numerous patients to correct botched surgeries by non-certified plastic surgeons. One patient had complications from a botched tummy tuck by the general surgeon who performed her weight loss or bariatric surgery.

'Although a tummy tuck may seem like a straightforward removal of skin and fat, there are several variations in the technique that allow us to optimise the results for individual patients that can only be learned in the setting of the full spectrum of plastic surgery residency training,' Schierle said.

He's also cared for several patients who travelled overseas for cheaper plastic surgery and required revision surgery for infections, poor stitching, delayed wound healing and poor scar placement, among other problems.

'It can be harder to understand proper credentialing and licensing of providers overseas, and you often get what you pay for,' Schierle said.

The new Northwestern study examined the types of providers marketing body-contouring procedures, including breast augmentation, facial surgery, gluteal buttocks augmentation and liposuction. The study also identified what plastic surgery content is being posted and what hashtags are being used.

'All these procedures had a mix of people marketing them who were not licensed plastic surgeons,' Dorfman said.

'Someone uninformed might think why do I need to pay higher fees for a board-certified physician to do injections or fillers?' Dorfman said. 'It seems so simple – can't just anyone do it? Definitely not. The blood vessel supply in the body is very intricate. If you accidentally inject something into a vein and it then goes into your lungs, it can kill you. There are numerous reports of this.'