Facial Plast Surg 2022; 38(02): 124-130
DOI: 10.1055/s-0041-1741502
Original Article

The Quality of Online Information on Cosmetic Injectable Fillers: Current Status

1   Department of Ear, Nose and Throat Surgery, Great Ormond Street Hospital for Children, London, United Kingdom
,
Alexander S. North
2   Department of Ear, Nose and Throat Surgery, St George's University Hospital, London, United Kingdom
,
3   Department of Neurology/Stroke Medicine, Royal Surrey County Hospital, Surrey, United Kingdom
,
Hanna D'Souza
4   GKT School of Medical Education, King's College London
,
Maja Kaladjiska
3   Department of Neurology/Stroke Medicine, Royal Surrey County Hospital, Surrey, United Kingdom
,
Alwyn D'Souza
5   Department of Ear, Nose and Throat Surgery, University Hospital Lewisham, London, United Kingdom
› Author Affiliations
Funding None.

Abstract

Web-based health information plays an increasingly vital role in spreading health information. Many patients interested in aesthetic surgery study the procedure on the Internet. This study aims to evaluate the quality of online health information on injectable fillers using the modified “Ensuring Quality Information for Patients” (EQIP) tool. Nine different search terms, including “fillers,” “fuller cheeks,” “wrinkle removal,” and “antiwrinkle treatment” were identified and queried on Google. Unique links from the first three pages of each search term were identified and evaluated if the contents were in English language and were for general non-medical public use. A total of 172 websites were analyzed, with a median EQIP score of 20. In total 129 websites belonged to aesthetic practitioners, of which 81 were operated by medical doctors. Eighty-three percent of websites disclosed some forms of postoperative complications, most commonly edema (74%) and bruising (73%). Blindness and tissue necrosis were only mentioned by 12 and 10% of the websites, respectively. The current health information available on injectable fillers is of poor quality. While many do provide some information on risks, the majority of websites fail to disclose severe complications and quantifying risks. This poses a barrier against informed decision-making and may lead to unrealistic expectations. Patient satisfaction and expectations may be improved by developing better online education resources on fillers.

Note

The authors confirm that the ethical policies of the journal, as noted on the journal's author guidelines page, have been adhered to. Formal ethical approval was not required as there was no involvement of patients in any form with this study.


Supplementary Material



Publication History

Article published online:
03 February 2022

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  • References

  • 1 Kim J-E, Sykes JM. Hyaluronic acid fillers: history and overview. Facial Plast Surg 2011; 27 (06) 523-528
  • 2 Ballin AC, Brandt FS, Cazzaniga A. Dermal fillers: an update. Am J Clin Dermatol 2015; 16 (04) 271-283
  • 3 Ogilvie P, Thulesen J, Leys C. et al. Expert consensus on injection technique and area-specific recommendations for the hyaluronic acid dermal filler VYC-12L to treat fine cutaneous lines. Clin Cosmet Investig Dermatol 2020; 13: 267-274
  • 4 Department of Health. Review of the regulation of cosmetic interventions final report April 2013. 2013 April Accessed September 24, 2021 at: https://www.gov.uk/government/publications/review-of-the-regulation-of-cosmetic-interventions
  • 5 American Society of Plastic Surgeons. 2019 National Plastic Surgery Statistics. 2019 Accessed September 24, 2021 at: https://www.plasticsurgery.org/documents/News/Statistics/2019/plastic-surgery-statistics-report-2019.pdf
  • 6 American Society of Plastic Surgeons. Report of the 2010 Plastic Surgery Statistics Report of the 2010 Plastic Surgery Statistics 2010 Plastic Surgery Statistics. 2010 Accessed September 24, 2021 at: https://www.plasticsurgery.org/documents/News/Statistics/2010/plastic-surgery-statistics-full-report-2010.pdf
  • 7 Haneke E. Managing complications of fillers: rare and not-so-rare. J Cutan Aesthet Surg 2015; 8 (04) 198-210
  • 8 Chiang YZ, Pierone G, Al-Niaimi F. Dermal fillers: pathophysiology, prevention and treatment of complications. J Eur Acad Dermatol Venereol 2017; 31 (03) 405-413
  • 9 Rayess HM, Svider PF, Hanba C. et al. A cross-sectional analysis of adverse events and litigation for injectable fillers. JAMA Facial Plast Surg 2018; 20 (03) 207-214
  • 10 Heydenrych I, Kapoor KM, De Boulle K. et al. A 10-point plan for avoiding hyaluronic acid dermal filler-related complications during facial aesthetic procedures and algorithms for management. Clin Cosmet Investig Dermatol 2018; 11: 603-611
  • 11 Sito G, Manzoni V, Sommariva R. Vascular complications after facial filler injection: a literature review and meta-analysis. J Clin Aesthet Dermatol 2019; 12 (06) E65-E72
  • 12 Tran AQ, Lee WW. Vision loss and blindness following fillers. J Dermatol Skin Sci 2021; 3 (02) 1-4
  • 13 Montemurro P, Porcnik A, Hedén P, Otte M. The influence of social media and easily accessible online information on the aesthetic plastic surgery practice: literature review and our own experience. Aesthetic Plast Surg 2015; 39 (02) 270-277
  • 14 Wollmann K, der Keylen PV, Tomandl J. et al. The information needs of internet users and their requirements for online health information—a scoping review of qualitative and quantitative studies. Patient Educ Couns 2021; 104 (08) 1904-1932
  • 15 Moult B, Franck LS, Brady H. Ensuring quality information for patients: development and preliminary validation of a new instrument to improve the quality of written health care information. Health Expect 2004; 7 (02) 165-175
  • 16 Palma AF, Zuk G, Raptis DA. et al. Quality of information for women seeking breast augmentation in the Internet. J Plast Surg Hand Surg 2016; 50 (05) 262-271
  • 17 Zuk G, Palma AF, Eylert G, Raptis DA, Guggenheim M, Shafighi M. Systematic review of quality of patient information on liposuction in the internet. Plast Reconstr Surg Glob Open 2016; 4 (06) e759
  • 18 Shamil E, Scenza GD, Ghani SA. et al. A quality assessment of online patient information regarding rhinoplasty. Facial Plast Surg 2021
  • 19 Shamil E, Cook P, D'Souza A, Syed I, Joshi A, Rachmanidou A. Patient perceptions of the use of cocaine in sinonasal surgery. Clin Otolaryngol 2021; 46 (06) 1300-1303
  • 20 Google. Google Ads—Get More Customers With Easy Online Advertising. Accessed April 30, 2020 at: https://ads.google.com/intl/en_GB/home/
  • 21 Ghani S, Fan KS, Fan KH, Lenti L, Raptis D. Using the ensuring quality information for patients tool to assess patient information on appendicitis websites: systematic search and evaluation. J Med Internet Res 2021; 23 (03) e22618
  • 22 Raptis DA, Sinanyan M, Ghani S, Soggiu F, Gilliland JJ, Imber C. Quality assessment of patient information on the management of gallstone disease in the internet—a systematic analysis using the modified ensuring quality information for patients tool. HPB (Oxford) 2019; 21 (12) 1632-1640
  • 23 Fan KS, Ghani SA, Machairas N. et al. COVID-19 prevention and treatment information on the internet: a systematic analysis and quality assessment. BMJ Open 2020; 10 (09) e040487
  • 24 Search Engine Journal. Over 25% of People Click the First Google Search Result. 2020. Accessed September 24, 2021 at: https://www.searchenginejournal.com/google-first-page-clicks/374516/
  • 25 International Patient Decision Aid Standards Collaboration. IPDAS Collaboration Background Document. Vol. 2018. 2005. Available at: http://ipdas.ohri.ca/IPDAS_Background.pdf
  • 26 British Medical Association. BMA Patient Information Awards. Vol. 2018. 2018. Available at: https://www.bma.org.uk/library/patient-information-awards
  • 27 General Medical Council. Guidance on professional standards and ethics for doctors Decision making and consent. 2020 Accessed September 25, 2021 at: www.gmc-uk.org/guidance
  • 28 Ricketts D, Roper T, Rogers B, Phadnis J, Elsayed S, Sokol D. Informed consent: the view from the trenches. Ann R Coll Surg Engl 2019; 101 (01) 44-49
  • 29 Anderson OA, Wearne IMJ. Informed consent for elective surgery—what is best practice?. J R Soc Med 2007; 100 (02) 97-100
  • 30 Bunker TD. An information leaflet for surgical patients. Ann R Coll Surg Engl 1983; 65 (04) 242-243
  • 31 George CF, Waters WE, Nicholas JA. Prescription information leaflets: a pilot study in general practice. Br Med J (Clin Res Ed) 1983; 287 (6400): 1193-1196
  • 32 Frueh FS, Palma AF, Raptis DA, Graf CP, Giovanoli P, Calcagni M. Carpal tunnel syndrome: analysis of online patient information with the EQIP tool. Chir Main 2015; 34 (03) 113-121
  • 33 Dorfman RG, Mahmood E, Ren A. et al. Google ranking of plastic surgeons values social media presence over academic pedigree and experience. Aesthet Surg J 2019; 39 (04) 447-451
  • 34 Lopez J, Lopez S, Means J. et al. Financial conflicts of interest: an association between funding and findings in plastic surgery. Plast Reconstr Surg 2015; 136 (05) 690e-697e
  • 35 Shamil E, D'Souza AD. Cosmetic Facial Interventions. In: England RJ, Shamil E. eds. Scott-Brown's Essential Otorhinolaryngology, Head & Neck Surgery 1st ed. London, CRC Press: 2022. chapter 49