What Does the Public Think? Examining Plastic Surgery Perceptions through the Twitterverse

Background: Twitter is a recognized social media platform for communication of health information. Rime reported that emotion is the main motive for social sharing. This study is a content analysis of Twitter that was performed to identify the public's perceptions and attitudes toward plastic surgery and the emotional triggers that drive social sharing of plastic surgery information. Methods: Tweets containing "#PlasticSurgery" or "Plastic Surgery" were archived randomly from August 1, 2014, to December 30, 2016 (n = 4548). Tweets were categorized according to tweet author, specialty, topic, content, multimedia included, emotion, tone, accuracy of information, source, and retweet rate. Statistical analysis was performed to detect significant patterns. Results: Tweets on cosmetic surgery (74 percent) were shared mostly on Twitter, predominantly posted by the public [n = 1611 (48 percent)]. More than 13 percent of posts contained "celebrity news" and 42.8 percent contained professional information and resources. The most frequent emotions shared and retweeted were "relaxed/content" (51.5 percent) and "excited/interested" (18.4 percent). Most tweets posted by the public contained inaccurate information [n = 1486 (80 percent)]. Only 154 (11.2 percent) of board-certified plastic surgeons' tweets were rated as "most accurate." Conclusions: The majority of tweets posted on Twitter contained inaccurate information that can lead to misperception among the public. Understanding emotional triggers for social sharing provides insight into what is most appealing. To enhance public uptake and sharing of tweets, plastic surgeons can use these findings to promote the specialty using relaxed/content emotions or excitement in their social media posts.