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Crowdsourcing and Comparing the General US Public's Perceptions of Online Before-And-After Transformation Photos

Joshua T. Henderson, MD Cody L. Mullens, MPH Kerri M. Woodberry, MD MBA
West Virginia University
2020-02-15

Presenter: Josh Henderson, PGY-2

Affidavit:
I certify the above statement is true. This material has not been published and represents the original work of the resident and the medical student.

Director Name: Kerri M Woodberry

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics

Ethical practice of plastic surgeons utilizing patient identifying media to advertise clinical outcomes has emerged as a hot button issue in the plastic surgery community. No studies have assessed the US public's perception of this practice. The aim of this study was to assess public perceptions of plastic surgeons' utilization of transformation photos.

A crowdsourcing platform, Amazon MTurk, was utilized to obtain perspectives of the US public on Plastic Surgeons' postings of before-and-after photos.

There were 999 respondents. 624 (62.4%) would consent to online before-and-after posting of at least one body area, with comfort levels highest for facelift (36.4%), nonoperative facial rejuvenation (31.8%), liposuction (24.7%), abdominoplasty (23.0%) and head and neck reconstruction (23.0%). Gluteal augmentation (13.9%), breast reduction (12.3%), breast reconstruction (11.0%) and vaginal rejuvenation (4.4%) were considered least acceptable for public posting. Respondents were significantly more comfortable with their own and others' before-and-after photos viewable on professional practice websites than on social media (p<0.0001), and this preference was stronger in respondents above age 50. Instagram was the most favored social media platform for viewing before-and-after photos. Respondents were significantly more opposed to online viewing of patients' genitals than any other body area (p<0.0001). 36.5% of respondents felt that before-and-after photos should be reserved only for patients in surgeons' offices, and 128 (12.8%) felt that before-and-after photos should be withheld altogether from future patients.

The US public's perceptions of online before-and-after photos vary significantly. The posting of these photos should be done cautiously with particular consideration of the ideal platform.

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