Sir: We are most pleased to respond to this important communication from Fan et al. We enjoyed reading their findings and found that their work meshed nicely with our recent study “What Does the Public Think? Examining Plastic Surgery Perceptions through the Twitterverse,”1 and advances our understanding of how plastic surgery–related interactions on Twitter occur. The authors did an admirable job of sampling 3000 tweets in April of 2018, using Twitter’s application programming interface and gephi.org. They generated visual representations of networks of tweeters or “nodes” within the hashtag #PlasticSurgery. Their analysis provided insights into how different communities interacted with each other within the Twitter platform. We were fascinated to see that the authors, through a different investigation medium, were able to corroborate our findings: that a discrepancy exists between board-certified plastic surgery communities’ interactions on Twitter and members of the public. In essence, the two networks or “nodes” were not “talking” to each other, as much as they were interacting within their own networks. Although, the use of the plastic surgery hashtag—as promoted by Dr. Olivier Branford and the American Society of Plastic Surgeons—has helped minimize this separation, it still exists. This finding appears to be consistent across other social media platforms, such as YouTube, where Ward et al.2 recently found that most online videos on that platform, although highly accessed by the public, also contained an abundance of inaccurate information that was not provided by board-certified surgeons. In today’s world, where social media had broad social, political, and economic implications, we agree with the authors that this matters. We need to be actively involved in the public dialogue surrounding our specialty and have an active role into how our specialty is represented on social media platforms. As more plastic surgeons influence social media content and deliver more information to the public, the next question will be how we can engage more members of the public with content that originates from board-certified plastic surgeons and organizations now that we know that a gap exists in the interactions between those two communities. How can we invoke more positive emotions in our content, to elicit more interactions, as suggested by our study and by Dr. Furnas?3 How can we ensure that the educational information we provide, and that is the most sought-out content by patients, as Dr. Branford’s study4 has found, is consistently accurate? What format should our content be in? Which social media platform is the best to reach the public? Most importantly, how can we be advocates for our specialty in this public medium, without compromising our profession’s image or patient care? The more we understand how social media interactions occur and what influences sharing, the more we, as plastic surgeons, can harness and use this powerful tool to promote our specialty, interact with colleagues, and educate the public by sharing reliable information. We hope that these studies are an impetus for future studies, to help move us toward achieving these goals. DISCLOSURE None of the authors has a financial interest in any of the products or devices mentioned in this communication. Abeer Kalandar, B.M.Sc., B.M.B.Ch.Sarah Al-Youha, Ph.D., F.R.C.S.C.Jason Williams, M.Ed., F.R.C.S.C.Division of Plastic SurgeryDalhousie UniversityHalifax, Nova Scotia, Canada
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Jan 1, 2020
T Gorban 
Open Access
