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Happy and Unhappy Patients: A Quantitative Analysis of Online Plastic Surgeon Reviews for Breast Augmentation

Dorfman, Robert G. M.Sc.; Purnell, Chad M.D.; Qiu, Cecil B.A.; Ellis, Marco F. M.D.; Basu, C. Bob M.D., M.P.H.; Kim, John Y. S. M.D., M.A.

Plastic and Reconstructive Surgery: May 2018 - Volume 141 - Issue 5 - p 663e-673e
doi: 10.1097/PRS.0000000000004268
Cosmetic: Special Topics
Press Release
Psychosocial Insights
Video Discussion

Background: Online reviews have become modern versions of the word-of-mouth recommendation, and prospective patients are increasingly consulting them before making decisions about their surgical care. The authors’ objectives were to (1) identify trends in the use of online reviews, and (2) important reasons for patient satisfaction and dissatisfaction with aesthetic surgery. The authors selected breast augmentation as the primary procedure of interest.

Methods: Reviews of the top 10 to 20 most reviewed plastic surgeons in each of six large metropolitan areas were obtained from Google, Yelp, and RealSelf. Reviews were assessed for predefined dimensions of satisfaction and dissatisfaction.

Results: A total of 1077 breast augmentation reviews were obtained. Ratings were distributed bimodally, with peaks at five stars and one star. The majority of reviews were positive (87.5 percent). Relative popularity of Google versus Yelp varied across geographic regions, and average rating varied by platform. Between 2011 and 2016, the number of online reviews for breast augmentation grew at an average rate of 42.6 percent per year. Aesthetic outcome was the most commonly cited dimension (69.8 percent of reviews), whereas cost was mentioned in only 7.8 percent of reviews. A substantial minority of negative Yelp (37 percent) and Google (9.4 percent) reviews were written by patients who did not actually undergo surgery. Free-text analysis of heterogeneous reviews (containing positive and negative attributes) classified dimensions as critical, redeemable, or protective.

Conclusion: As the influence of online review platforms continues to grow, understanding drivers of positive and negative reviews may help surgeons improve patient satisfaction.

Psychosocial Insights for this Article are on Page 671e.Video Discussion by Debra Johnson, M.D., is Available Online for this Article.

Chicago, Ill.; and Cypress, Texas

From the Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine; and the Division of Plastic Surgery, North Cypress Medical Center.

Received for publication May 3, 2017; accepted November 20, 2017.

Disclosure:None of the authors has a financial interest in any of the products or devices mentioned in this article.

A Video Discussion by Anne Taylor, M.D., accompanies this article. Go to and click on “Video Discussions” in the “Digital Media” tab to watch.

John Y. S. Kim, M.D., M.A., Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, 675 North St. Clair Street, Suite 19-250, Chicago, Ill. 60611,

Copyright © 2018 by the American Society of Plastic Surgeons