Online reviews after 'tummy tuck'—Cosmetic results aren't the only factor affecting positive ratings

For patients undergoing "tummy tuck" surgery (abdominoplasty), satisfaction with the aesthetic outcome is the main factor affecting whether they write a positive or negative online review for their plastic surgeon, reports the March issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).

But interactions with office staff and postoperative follow-up by the surgeon also influence plastic surgery ratings on online review sites, according to the study by ASPS Member Surgeon John Y.S. Kim, MD, of Northwestern University Feinberg School of Medicine and colleagues.

Just Three Percent Rate of Negative Online Ratings after Abdominoplasty

The researchers analyzed ratings of plastic surgeons on three popular review sites: Google, Yelp, and RealSelf, which is dedicated to plastic/cosmetic surgery ratings. The study included nearly 800 reviews written by patients who underwent abdominoplasty in six metropolitan areas: New York, Los Angeles, Chicago, Houston, Philadelphia, and Miami.

Dr. Kim and colleagues performed a quantitative analysis to identify statistically significant themes affecting patient satisfaction after abdominoplasty. Across the three sites, 86 percent of reviews were positive (4 or 5 stars) and 14 percent were negative (1 or 2 stars).

• Good aesthetic outcomes were the "dominant driver" of positive reviews. "No patient who reported being happy with their aesthetic results left a negative review, indicating that a good aesthetic outcome virtually guarantees a positive review," the researchers write.
• Interactions with office staff were the next most important factor—all reviews mentioning negative staff interactions were negative reviews.t
• Postoperative care and follow-up by the plastic surgeon was also associated with patient satisfaction. In some cases, patients who were satisfied with follow-up care left good reviews despite cosmetic problems or complications.

Other factors—including surgical complications and the costs of surgery—were classified as "nondominant" factors. "Performance on these factors, while influential to satisfaction, is overshadowed by other factors," Dr. Kim and coauthors write. "Because online reviews are few and polarizing," the researchers note, "they are unlikely to be representative samples of a surgeon's total practice."

In a previous qualitative analysis of online ratings after breast augmentation, Dr. Kim and colleagues found that reviews were affected not only by aesthetic outcomes, but also by interactions with the plastic surgeon and staff. The new study is the first quantitative analysis of factors affecting patient satisfaction after cosmetic surgery.

While identifying cosmetic outcomes as the predominant factor, the study shows that interactions with office staff also contribute to positive reviews of plastic surgeons. "The fact that interactions with staff and postoperative care were almost as important as the actual aesthetic outcome speaks to the importance of the 'service' aspect of plastic surgery," Dr. Kim comments. "In essence, patients have expectations for quality of care that go beyond the operating room."