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Patients increasingly utilize the internet for decision-making regarding cosmetic procedures, and online reviews have become both a signifier of patient preferences and a valuable source of data. We endeavored to perform a comprehensive and quantitative review of abdominoplasty reviews.
Methods:
Reviews were systematically obtained from Yelp (www.yelp.com), Google (www.google.com), and RealSelf (www.realself.com) via search terms “plastic surgery”, “tummy tuck”, and “abdominoplasty” for the top 30 surgeons in the top 5 metro areas by population (New York, Chicago, Los Angeles, Houston, Philadelphia) and Miami. Each review was assessed against a panel of 35 concepts that were developed via a modified Grounding Theory approach. Other data of interest included star rating of the physician, word count, and metropolitan area. Only positive (4 and 5 star, or “Worth It”) and negative (1 or 2 star, or “Not Worth It”) reviews were included. Due to the overwhelming number of positive reviews on RealSelf, a random 10% sample of positive reviews were included to provide 90% power.
Results:
Of 794 reviews meeting inclusion criteria, 402 were obtained from RealSelf, 319 from Google, and 73 from Yelp. Between all sources, 683 (86.0%) reviews were positive and 111 (14.0%) were negative. Average Yelp and Google ratings varied by metropolitan area (p=0.4 by ANOVA) with Philadelphia, PA having the highest average rating (5.0) and Miami, FL the lowest (4.4). Overall rating was not associated with the word length of the reviews or cost of procedure. Aesthetic outcome was a major driver of patient satisfaction or dissatisfaction– all 316 reviews mentioning a good aesthetic outcome were positive, and 50 of the 52 two reviews mentioning a poor aesthetic outcome were negative. Notably, only 368 (46.3%) of all reviews mentioned aesthetic outcome at all. Other themes cited were Bedside Manner (364, 45.8%), Surgeon as a Resource (318, 40.1%) and Interactions with Staff (264, 33.2%). Post-Operative Care was the 5th most common theme in reviews overall (185, 23.3%), but second only to Aesthetic Outcome in mentions in negative reviews. Cost of surgery did not appear to be an independent driver of review rating and was almost always perceived in the context of the patient’s outcome. Thirteen reviews from Yelp (3) and Google (10) by patients who had a consult for abdominoplasty but had not undergone surgery were not included in our analysis. Of these, 10/13 (77%) reviews were negative.
Conclusions:
We present the first comprehensive and quantitative analysis of online reviews of abdominoplasty. While aesthetic outcome was the most common determinant of patient satisfaction, it was only noted in half of reviews. Surgeon characteristics such as bedside manner and availability to answer questions were weighted almost as heavily. Negative reviews cited post operative care as a critical factor and cost did not seem to play a significant role in either positive or negative reviews. As surgeons gain greater clarity on drivers of online patient satisfaction, they will be able to utilize this information to provide more responsive and patient-centric care.