Plastic surgery on Instagram: where do we stand on racial diversity and inclusion?

Plastic surgeons use Instagram to expand their practices to accommodate growing interest in plastic surgery. Thus, it is important to assess whether the depiction of plastic surgery on Instagram is inclusive. This study aimed to analyze the racial representation of posts by United States (US) board-certified plastic surgeons and its impact on engagement with the content. Instagram accounts of US board-certified plastic surgeons active from February 1, 2023 – April 12, 2023, were randomly chosen. For procedural posts, the engagement and race of both the patient depicted and the surgeon were collected. ANCOVA was performed to explore whether patient race influenced engagement. Additionally, patient-surgeon racial concordance was investigated. 2,157 posts from 120 accounts were analyzed. White patients were overrepresented compared to the reported demographics of plastic surgery patients. Asian and Hispanic patients were underrepresented. Posts featuring Black patients in our sample had significantly more views, likes, and comments than White patients in the Southeast when controlling for other covariates. However, race was not a significant predictor of engagement per follower. Hispanic plastic surgeons were underrepresented compared to the demographics of practicing plastic surgeons. 88 of 120 accounts had > 50% patient-surgeon racial concordance. 23 had 100% concordance, all featuring White patients/surgeons. The depiction of plastic surgery on Instagram of patients and surgeons can become more racially inclusive. This will likely bring more engagement to this content, resulting in the growth of plastic surgery as a field and increased perceived accessibility to plastic surgery.