Quality and Consistency of Rhinoplasty Photos on Social Media: Prevalence of Potentially Misleading Before-and-After Images

Overview

How rhinoplasty results are presented on social media varies widely, and inconsistencies between the before and after photograph can make a result look better than it is. The authors searched Instagram on 4 April 2024 using the hashtag rhinoplastybeforeandafter and analyzed posts meeting their criteria for differences in background, makeup, use of a personal photo, and variation in face size between the two images.

Sections of note

• Design: cross sectional analysis of social media images, single search date.
• 888 sets of before and after photos were included; nearly all, 882, came from surgeon accounts.
• 23.7 percent had a face size discrepancy of 10 percent or more between the two images.
• 5.1 percent had a face rotation discrepancy of 10 percent or more.
• Only 35.7 percent were considered high quality, meaning no significant photo discrepancies plus a reported time since surgery.
• Account demographics and time since surgery were also recorded.
• Inconsistencies were found in background, image source, face size, face rotation and brightness.

What it means for a patient

• Nearly a quarter of these posts showed the after photo at a noticeably different size from the before photo, which alone changes how a nose appears.
• Fewer than four in ten posts stated how long after surgery the photograph was taken, which matters because swelling takes many months to resolve.
• Almost all the posts came from surgeon accounts rather than patients, so the inconsistencies originate with practices rather than individuals.
• Limits: one platform, one search date, one hashtag, and quality judged on photographic consistency rather than on whether the surgical result was genuine.

Why this paper matters

Before and after photographs are the main evidence prospective patients see, and they are unregulated. Quantifying how often the two images differ in ways that flatter the result puts numbers on a widely suspected problem. Whether these inconsistencies actually change what viewers believe was not tested.

Terms

• Before-and-after photograph: paired images used to show a surgical result.
• Face size discrepancy: the face appearing larger or smaller in one image than the other.
• Face rotation: the head being turned at a different angle between two photographs.
• Standardized photography: taking images with fixed distance, lighting, angle and background.
• Cross-sectional analysis: examining a sample at one point in time.