Endorsements Using Social Media in Plastic Surgery: Protect… : Plastic and Reconstructive Surgery

Over the past decade, there has been a surge in the utilization of social media by plastic surgeons and individuals seeking plastic surgery procedures.1 Plastic surgeons use social media as a means of direct-to-consumer marketing, while patients use social media to share their results, post reviews about their experiences, and communicate with plastic surgeons. Independent endorsements and positive reviews on social media are valuable to practicing surgeons. Since many social media users have a large number of followers, positive endorsements can help surgeons promote their brand and service. Influencers, a term used to describe credible users with a large number of followers (often thousands to millions) on a platform, are of the greatest value because of their wide outreach.

Since influencer endorsements can be akin to celebrity endorsements, influencers are approached by top brands to endorse company products in an effort to tap into the vast online consumer market. These practices are also present within our profession of plastic surgery. In November of 2019, the Federal Trade Commission, a national organization that protects consumers, released a statement mandating that social media influencers who endorse a product “make it obvious when you have a relationship (‘material connection’) with the brand.”2 Specifically, the Federal Trade Commission requires influencers to “make sure people will see and understand the disclosure” by superimposing the disclosure over a picture so that viewers can easily read it, or by explicitly stating the disclosure in an endorsement video.

Although helpful guidelines on social media posts and use have been published, they do not explicitly discuss social media endorsements.3,4 Currently, Section 2, Article I(F)(7) of the American Society of Plastic Surgeons’ Code of Ethics makes it clear that false, deceptive, or misleading posts on social media, such as undisclosed paid endorsements, constitute a breach of the Code.5 This guideline applies to patients who receive free products or discounted procedures in exchange for a tag on social media. With the new rules put forth by the Federal Trade Commission, there is more clarity on how a social media influencer should appropriately endorse a service or procedure offered by a plastic surgeon when there is a “material connection.” For a patient receiving a discounted or free procedure or product in exchange for agreed social media endorsement of a plastic surgeon, the new Federal Trade Commission rules suggest that a clear and explicit disclosure at the start of a video, or superimposed on a photograph, is mandatory. A disclosure by the patient would make it clear that the post is a paid advertisement and would be in compliance with the American Society of Plastic Surgeons’ Code of Ethics.

To protect our members, we believe it is important for the community of plastic surgeons (including our trainees) to be aware of these updates from the Federal Trade Commission. Although regulating bodies will not screen every social media post, we hope this message will serve as a timely update to allow plastic surgeons to continue to use social media in a safe, professional, and ethical manner.


The authors have no relevant financial disclosures or conflicts of interest to report in relation to the content of this article.


1. Sorice SC, Li AY, Gilstrap J, Canales FL, Furnas HJ. Social media and the plastic surgery patient. Plast Reconstr Surg. 2017;140:1047–1056.

2. Federal Trade Commission. Disclosures 101 for social media influencers. Federal Trade Commission. 2019. Available at: Accessed March 28, 2020.

3. Bajaj A. Social media focus: Consider this before you share your post. PSN Extra. 2019. Available at: Accessed March 28, 2020.

4. Gould DJ, Grant Stevens W, Nazarian S. A primer on social media for plastic surgeons: What do i need to know about social media and how can it help my practice? Aesthet Surg J. 2017;37:614–619.

5. American Society of Plastic Surgeons. Code of ethics of the American Society of Plastic Surgeons. Accessed April 2, 2020.


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