Dermal Filler Videos With Low Quality Health Information Garner High Viewership on Social Media

The American Society of Plastic Surgeons reported that in 2020, more than 3.4 million soft tissue filler procedures were performed in the US.¹

Social media, TikTok in particular, has served as a growing platform for health information, and likewise, health misinformation. However, the quality and reliability of health-related content on TikTok remain underexplored, according to researchers of a recent study published in Skin Health and Disease.²

The study, "A cross-sectional analysis of TikTok's most popular dermal filler videos," sought to review the content quality, particularly in the health information domain, of dermal filler videos on the social media platform.

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Background and Methods

Researchers conducted an analysis, focusing on 3 key hashtags: #filler, #dermalfiller, and #fillersinjection. Using TikTok's search algorithm, they gathered links to the top 115 videos for each hashtag between December 14 and December 21, 2022. Only videos in English, directly related to dermal fillers, and devoid of duplicates were included in the study.

For each video, researchers recorded numerous descriptive characteristics, including the caption, publication date, duration, views, likes, comments, favorites, reposts, and content type. Additionally, uploader account details such as username, account type, physician specialty, and presented gender were documented.

To evaluate the quality of information presented, 2 independent reviewers employed the DISCERN instrument—a validated tool comprising 15 questions, each representing various quality criteria, and an overall quality rating.

Findings

The analyzed videos amassed a total of 212,978,631 views and 13,426,925 likes.

However, the average DISCERN score for these videos was concerningly low at 1.64 (SD 0.33), indicating a significant deficiency in quality. Inter-rater reliability, measured by Pearson's correlation coefficient, was notably high at 0.869 (p < 0.001).

Among the DISCERN criteria, those pertaining to describing treatment consequences, indicating information production dates, and providing additional support and shared decision-making were particularly lacking.

Uploader accounts were categorized into 7 groups, with videos posted by physician assistant accounts garnering the highest average DISCERN score (1.92) and those by clinic accounts receiving the lowest (1.53). While statistically significant differences were observed between certain account types, physician and physician assistant accounts collectively exhibited significantly higher quality scores than other uploader types.

Videos were further classified based on content type, revealing that educational videos received the highest average DISCERN score (1.99), whereas comedy/personal testimony videos scored the lowest (1.30).

Only 21% of the most popular dermal filler videos fell into the educational category.

Conclusions

The study sheds light on the concerning landscape of dermal filler information on TikTok, emphasizing the urgent need for improvement in content quality, according to researchers.

While TikTok serves as a powerful platform for health education, the majority of popular videos lack reliability and may even promote unsafe practices. Videos posted by highly trained medical professionals, particularly physicians and physician assistants, exhibited superior quality.

To enhance the quality of dermal filler information on TikTok, study authors proposed several recommendations:

• Medical professionals should actively engage in creating educational content, leveraging TikTok's reach to disseminate accurate information and dispel myths
• Efforts should be made to incorporate supplementary information, such as citation details and support for shared decision-making, within video captions
• Addressing the dynamic nature of TikTok's algorithm and ensuring ongoing monitoring of content quality are necessary

"TikTok provides an excellent opportunity for medical professionals to reach patients and provide valuable educational health information. However, currently, the majority of TikTok videos suggested by TikTok's algorithm on dermal fillers are posted by unlicensed individuals, lack quality, and sometimes promote non-FDA-approved methods," according to authors de Baun et al. "This underscores the need for more qualified and highly trained medical professionals to share high-quality educational content that includes proper citation information, additional sources of information, and support for shared decision making."

References

1. American Society of Plastic Surgeons. Plastic surgery statistics report. 2020. https://www.plasticsurgery.org/documents/news/statistics/2020/plastic-surgery-statistics-full-report-2020.pdf. Accessed May 14, 2024.
2. de Baun H, Cerri-Droz P, Khan S, Alper D, Rao B. A cross-sectional analysis of TikTok's most popular dermal filler videos. Skin Health Dis. May 6, 2024. https://doi.org/10.1002/ski2.390