Background Increased video-chatting, stimulated by the COVID-19 pandemic, has been correlated with increased appearance concerns. Initial lockdown restrictions correlated with a decrease in aesthetic/cosmetic plastic surgery case volumes. Objectives We aim to delineate public interest in aesthetic procedures surrounding the COVID-19 pandemic via Google Trends (GT). We hypothesize that because of the pandemic, public interest in plastic surgery procedures increased, especially localized above the shoulder. Methods Trends in the US for given search terms and volumes were gathered via Google Trends between January 2015 to March 2021. The search volumes were normalized, and a bivariate regression analysis of panel data was then applied to the aggregate trendlines to determine if a statistically significant change in search volume occurred following the stay-at-home orders. Results The following search terms had statistically significant (p < 0.000) increases in search volumes after February 2020: blepharoplasty, Botox, brachioplasty, breast implant removal, breast reduction, brow lift, buccal fat removal, hair transplantation, lip augmentation, mentoplasty, otoplasty, platysmaplasty, rhinoplasty, and thighplasty. Chi-squared analysis demonstrated a statistically significant association (Chi-squared = 4.812, p = 0.028) between increases in search volume and above the shoulder procedures. Conclusions Public interest in above the shoulder surgical procedures showed a statistically significant increase following February 2020 compared to below the shoulder procedures. Continued examination of specific procedure trends, as well as determining correlations with more accurate procedural datasets, will provide increased insight into consumers’ mindsets and to what extent video conferencing plays on the public’s interest in pursuing aesthetic surgery.

Background Physician attire has been shown to impact patients’ perceptions of their provider with regards to professionalism, competency, and trustworthiness in various surgical subspecialties, except in plastic and reconstructive surgery. Objectives This study aims to address this knowledge gap and obtain objective information regarding patients’ preferences. Methods A survey was distributed to adult, English-speaking participants in the U.S. using Amazon MTurk platform from February 2020 to December 2020. Participants were asked to evaluate six attires (scrubs, scrubs w/ white coat, formal attire, formal attire w/ white coat, casual, casual w/ white coat) in terms of professionalism, competency, and trustworthiness for male and female plastic surgeons during their first encounter in clinic using a 5-point Likert scale. Results A total of 316 responses were obtained, which consists of 43.4% men and 56.6% women. Mean age of participants was 53.2 years. The highest scores across all metrics of professionalism, competency, trustworthiness, willingness to share information, confidence in the provider, and confidence in surgical outcomes were given to the formal attire with white coat group with average scores of 4.85, 4.71, 4.69, 4.73, 4.79, 4.72, respectively. The lowest scores across all metrics belonged to the casual attire group with scores of 3.36, 3.29, 3.31, 3.39, 3.29, 3.20, respectively. Patients preferred formal attires for young plastic surgeons (p=0.039). Conclusions Our study suggests that physician attire impacts patients’ perception of plastic surgeons with regards to their professionalism, competency, and trustworthiness. White coats continue to remain a powerful entity in clinical settings given that attires with white coats were consistently ranked higher.

Background Instagram (Menlo Park, CA) has become a popular means of advertisement for aesthetic surgery procedures, influencing patients’ likelihood of undergoing a procedure. This study aims to explore public interest in aesthetic procedures before and after the Instagram platform began to obtain popularity via Google Trends (Google, Mountain View, CA), a platform with previously demonstrated utility for tracking interest in surgical procedures. Objectives We hypothesize that as a result of increased medical marketing on Instagram, there is an increase in public interest in plastic surgery elective procedures. Methods Trends in the United States for given search terms and volumes were gathered via Google Trends between April 2004 to January 2022. Search terms included popular aesthetic procedures based on the 2020 Aesthetic Plastic Surgery National Data Bank Statistics. The search volumes were normalized, and a bivariate regression analysis of panel data was then applied to the aggregate trendlines to determine if a statistically significant change in search volume occurred following the increase in user traffic of the Instagram platform. Results We found significant variations in search volume for plastic surgery procedures before and after April 2012. Blepharoplasty, Botox, brachioplasty, breast implant removal, breast reduction, brow lift, butt lift, hair transplantation, lip augmentation, male breast surgery, mastopexy, mentoplasty, otoplasty, platysmaplasty, rhinoplasty, and thighplasty (p<0.000) had statistically significant increases in search volume while buccal fat removal (p = 0.003) had a statistically significant decrease in search volume after April 2012. Conclusions We observed a significant increase in public interest in both surgical and non-surgical aesthetic procedures after Instagram gained popularity in April of 2012.

Background: The optimal timing between last neoadjuvant chemotherapy (NAC) session and mastectomy with immediate reconstruction (MIR) procedures has sparse data to support optimization of postoperative outcomes. Current literature suggests that timing is not a predictor of complications in patients undergoing implant-based reconstruction following NAC and other literature suggests guidelines based on tumor staging. To the best of our knowledge, this is the largest and most recent study characterizing the effect of time between NAC and mastectomy with immediate reconstruction on postoperative complications.Methods: Patients in the Optum Clinformatics Data Mart that underwent all billable forms of breast reconstruction following NAC were identified via CPT and ICD-10 codes. Data concerning these patient's demographics, comorbidities, oncologic treatment, and outcomes were collected by querying relevant reports of CPT, ICD-9, and ICD-10 codes. To meet inclusion criteria, patients needed to have an encounter for antineoplastic chemotherapy within 1 year of their associated reconstruction.Patients with other invasive procedures unrelated to their mastectomyreconstruction pairing within 90 days of reconstruction were excluded. Outcomes analysis was limited to the 90-day postoperative period. The time between the last recorded chemotherapy encounter and breast reconstruction was computed. A multivariate logistic regression analysis was performed to ascertain the effects of age, race, coexisting conditions, reconstruction type (autologous or implant-based), and time between NAC and reconstruction on the likelihood of any common postoperative complication occurring. Linearity of the continuous variables with respect to the logit of the dependent variable was confirmed. Odds ratios and corresponding 95% confidence intervals were calculated.

Background Patients routinely use social media to locate providers, review before-and-after photographs, and discuss experiences, making it a powerful marketing tool for plastic surgeons. Few studies have systematically evaluated plastic surgery app content. Objectives Our study aims to analyze engagement levels and content posted by top plastic surgeon influencers on Instagram (Menlo Park, CA). Methods We conducted a cross-sectional study to identify the top ten global plastic surgeons on Instagram in February 2022. Influencers were ranked based on number of followers and their latest 20 posts were analyzed. A total of 200 posts were categorized by two independent trainees as one of the following: marketing, education, personal, and miscellaneous. The number of likes was recorded as a proxy for engagement and average engagement for each category was calculated. Results The top ten influencers work primarily in private practice focusing on aesthetic procedures. Out of 200 categorized posts on Instagram, marketing posts had the greatest presence (64.5%), followed by personal (20%), miscellaneous (11%), and educational (4.5%). More still images were posted (56.5%) than videos (43.5%). Highest average engagement was for personal content (p = 0.005). No significant differences in engagement levels were found between photo and video content (p = 0.24). Conclusions While most content posted relates to marketing efforts, many influencers are also using social media to post about their personal lives and promote their ancillary businesses. Although marketing content was most common, engagement levels were highest for personal and educational content, and no significant differences in engagement were found between videos and photos.