Facelift Photo Quality on Social Media: Prevalence of Potentially Misleading Before-and-After Images.

[BACKGROUND] Social media posts of patients before and after facelifts have grown in popularity, with platforms such as Instagram (Menlo Park, CA) allowing surgeons to showcase their work, which may impact patient expectations and physician ethics.

[OBJECTIVE] This study aims to compare image quality and discrepancies between social media before-and-after photosets of patients who underwent facelift surgery, as measured by size, rotation, brightness, and other characteristics in an image review.

[DESIGN] Cross-sectional.

[METHODS] A query of Instagram posts tagged "#faceliftbeforeandafter" was screened to identify 567 posts featuring side-by-side pre- and postoperative images meeting inclusion criteria. Data on image backgrounds, makeup differences, geographic region, and time since surgery were recorded. Face size, rotation, and brightness were objectively compared between pre- and postoperative photos.

[RESULTS] Among the analyzed posts, 66.3% featured smaller postoperative faces (mean decrease of 3.1%, < 0.001), and 73.7% of postoperative photos displayed upward facial rotation. Significant deviations in size and rotation (≥10%) were observed in 15.2% and 10.5% of posts, respectively. Brightness increases ≥10% were noted in 36.9% of postoperative posts. Inconsistent image backgrounds and makeup differences were present in 22.5% of photosets. 85.7% of surgeons posting were based in the United States, and 21.2% of posts occurred within three months after the facelift.

[CONCLUSION] This study highlights that only 25% of posts were of high quality, revealing substantial inconsistencies in Instagram (Menlo Park, CA) facelift before-and-after posts with discrepancies that exaggerate improved postoperative outcomes.