The Racial Representation of Cosmetic Surgery Patients and Physicians on Social Media

Abstract

Abstract Background Aggregated data show that Black patients undergo disproportionately lower rates of cosmetic surgery than their Caucasian counterparts. Similarly, laboratory findings indicate that social media representation is lower among Black patients for breast reconstruction surgery, and it is expected that this could be the case in cosmetic surgery as well. Objectives The aim of this study was to explore the social media representation of Black patients and physicians in the 5 most common cosmetic surgery procedures: rhinoplasty, blepharoplasty, abdominoplasty, breast augmentation, and liposuction. Methods Data were collected from RealSelf (Seattle, WA), the most popular social media site for sharing cosmetic surgery outcomes. The skin tone of 1000 images of patients in each of the top 5 cosmetic surgeries was assessed according to the Fitzpatrick scale, a commonly utilized skin tone range. Additionally, the Fitzpatrick scores of 72 providers who posted photographs within each surgical category were collected. Results Black patients and providers are underrepresented in rhinoplasty, blepharoplasty, breast augmentation, and liposuction compared with the general population (defined by the US Census Bureau), but were proportionately represented in abdominoplasty. Additionally, it was found that patients most often matched Fitzpatrick scores when both had scores of 2, whereas patients with a score of 5 and 6 rarely matched their provider’s score. Conclusions The underrepresentation of Black patients and providers in social media for cosmetic surgery may well discourage Black patients from pursuing cosmetic surgeries. Therefore, it is essential to properly represent patients to encourage patients interested in considering cosmetic surgery.