Background Subjective online physician evaluation is an important component of patient decision-making. Understanding reviews may improve satisfaction and build positive online reputation. Objectives Our objective was to analyze and compare the top predictive factors driving patient satisfaction across the most popular plastic surgery procedures. Methods Online reviews were analyzed from RealSelf, Yelp, and Google for the five highest-rated plastic surgeons of the six metropolitan areas. Blank, non-English, consultation, duplicate, and unrelated reviews were excluded. Data from free-text reviews included physician rating, patient-reported reasons for rating, procedure, and complications. Univariate analysis was performed to compare predictive factors of online ratings. Results 11,078 reviews were included. RealSelf the highest average rating (4.77), while Yelp had the lowest (4.66). Reviews in Miami, Philadelphia, New York City, and Chicago were mostly published on RealSelf, while Houston and Los Angeles most used Google and Yelp, respectively. Reconstructive procedures were rated significantly higher than cosmetic procedures (p = 0.035). Aesthetic appearance was the strongest predictor of rating across all procedures. Buccal fat removal (98.8%) and abdominoplasty (98.1%) had highest satisfaction, while Brazilian butt lift had the lowest (88.2%) (p < 0.001). Additional significant contributors included staff interaction, bedside manner, health outcomes, complications, and postoperative care (p < 0.001). Conclusions While aesthetic outcome is an important predictor of satisfaction, other aspects of care, such as bedside manner and staff interaction, provide an important foundation of support. Excellent patient-surgeon communication and postoperative care may mitigate patient dissatisfaction and elicit high-satisfaction online patient reviews.
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