Background: Breast augmentation is one of the most frequently performed aesthetic procedures in the United States. Online information is often used by patients to make decisions when undergoing cosmetic procedures. It is vital that online medical information includes relevant decision-making factors and uses language that is understandable to broad patient audiences. Ideally, online resources should aid patient decisions in aesthetic surgical planning, especially implant size selection for breast augmentation. We describe patient decision-making factors and readability of breast implant size selection recommended by private practice plastic surgery webpages. Methods: Using a depersonalized, anonymous query to Google search engine, the terms "breast implant size factors" and "breast implant size decision" were searched, and 52 plastic surgery private practice webpages were identified. Webpages were analyzed for reported decision-making factors of implant size selection. Readability analyses of webpages were performed with Readability Studio and Hemingway Editor. Results:The two major decision-making factors for implant size selection reported by webpages were body/tissue-based measurements and surgeon input. Ten factors related to patient lifestyle, surgical goals, and procedural options were also identified. Average webpage scores for five readability measures exceeded recommended levels for medical information. Conclusions: Reported decision-making factors for implant size selection emphasize a plastic surgeon's expertise but may enhance the patient's role in preoperative planning. Webpages describing breast implant size selection exceed the sixth and eighth grade reading levels recommended by the AMA and NIH, respectively. Improving the readability of webpages will refine the role of online medical information in preoperative planning of breast augmentation.
Background: Rhinoplasty is one of the most common cosmetic procedures performed by plastic surgeons and otolaryngologists. Previous studies have concluded that the readability of rhinoplasty information does not meet the recommended guidelines for the 8th grade reading level. In this study, we performed an updated readability analysis and a comprehensive online review of decision-making factors for patients considering rhinoplasty. Additionally, the differences between plastic surgery and otolaryngology-specific web pages were also analyzed in this study. Methods: This study analyzed 30 websites from universities and private practice webpages for decision-making factors, readability, and tone. These sites were identified by performing a depersonalized Google search using the search terms “nose job decision factors” and “rhinoplasty decision factors.” An independent t-test was performed to assess the differences between webpages. Results: A total of 30 websites were comprehensively reviewed for a comparative analysis of readability for potential rhinoplasty patients. Decision-making factors were divided into 3 categories: individual factors, goals of the procedure, and technical considerations. These categories were then further divided into subcategories. The most common decision-making factor discussed was procedural considerations (83.3%), the least common being lifestyle (10%). Additionally, only 26.7% of web pages mentioned ethnic background and skin type as potential considerations before surgery. Less than half (40%) discussed the importance of setting realistic expectations for the procedure. Of the total sites analyzed in the study, 65.5% were ENT-based, 24.1% were plastic surgery-based, 3.4% were dental/oral maxillofacial surgeons, and 6.9% were combined plastic surgeons and ENT. Statistically significant differences between ENT- and plastic surgeon-based webpages were observed. Risks and complications were more frequently discussed on ENT web pages ( P = .02). ENT sites also had more adverbs ( P = .024) and more uses of passive voice ( P = .006). Additionally, plastic surgery web pages appeared to elicit more of the emotion “disgust” after analysis utilizing IBM Watson Natural Language Understanding ( P < .001). Conclusions: This study highlights the necessity for continued improvement in the readability of webpages designed for patients considering rhinoplasty. Additionally, there were statistically significant differences between decision-making factors presented on ENT-based webpages and plastic-surgery-based webpages. This study may aid surgeons in developing websites that are more accessible, equitable to patients, and contain a more comprehensive discussion regarding key patient decision-making factors and preoperative considerations.
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