Social Media’s Unfiltered Truth: Evaluating TikTok’s Dermal Filler Videos

Social Media’s Unfiltered Truth: Evaluating TikTok’s Dermal Filler Videos

With over 3.4 million soft tissue filler procedures performed in the United States in 2020, dermal fillers remain immensely popular as individuals pursue a more youthful, sculpted appearance. However, as demand continues to soar, so too do the potential risks. The recent news of counterfeit Botox circulating in the market served as a stark reminder that these types of procedures should always be administered by highly trained professionals in a controlled setting. With social media platforms like TikTok being a significant source of consumer information and trends, it is crucial to understand the quality and accuracy of the information being shared on these platforms.

While many of these viral videos capture significant attention and provide a glimpse into various cosmetic procedures, their accuracy and reliability are often questionable and raise concerns about the quality of health information being shared. For this reason, a recent study sought to examine several of these dermal filler videos found on TikTok to evaluate the quality of the health information contained within them.

Study Background and Method

The main objective of the study was to analyze the quality of the health information in the dermal filler videos being published on TikTok.

As a starting point, the authors searched three relevant hashtags including #filler (2.4 billion views), #dermalfiller (132.8 million views), and #fillersinjection (137.0 million views), and for each of these hashtags, links for the top 115 videos returned by TikTok’s algorithm were collected between the period of December 14, 2022, to December 21, 2022. Out of these 115 videos, only those that were in English, related to dermal fillers, and not duplicates were included.

Researchers further included the descriptive characteristics of each of the videos, including its written caption, publication date, video duration, number of views, number of likes, number of comments, number of times favorited, number of times reposted, the content type (i.e. educational, educational/personal testimony, educational/promotional, promotional, promotional/personal testimony, comedy, comedy/personal testimony, comedy/promotional, and personal testimony).

In addition, the uploader account’s characteristics were also recorded by the researchers. This included the username, account type (i.e., Physician, Physician Assistant, Nurse, Aesthetician, Clinic [includes spas, clinics, plastic surgery practices, and dermatology clinics], Patient/General Public [includes patients and the general public], and Other [includes aesthetics training academies, pharmacists, and news outlets]), physician specialty, and presented gender.

Two independent reviewers then used the DISCERN instrument to evaluate the quality of health information within these videos. DISCERN is a validated tool designed to provide users with a reliable way to assess consumer health information. It comprises 15 questions, with each representing various quality criterion and an added 16th question that provides an overall quality rating. Each question is rated using a scale of 1 to 5.

Study Results

The videos included in the final analysis had a total of 212 978 631 views and 13 426 925 likes.

Researchers noted that the mean DISCERN score for the TikTok videos was 1.64 (SD 0.33) which indicated that they were significantly low in quality. However, there was a high level of inter-rater agreement, as calculated by Pearson’s coefficient, showing a score of 0.869. The DISCERN criteria for which there were the lowest mean scores were:

Does it describe what would happen if no treatment is used? (1.01)

Is it clear when the information used or reported in the publication was produced? (1.02)

Does it provide details of additional sources of support and information?

Does it provide support for shared decision-making? (1.04)

Concerning uploader account type, results showed that videos posted by Physician Assistant accounts had the highest mean DISCERN score at 1.92, while those posted by Clinic accounts showed the lowest mean DISCERN score at 1.53. While there were noticeable differences between some account types, Physician and Physician Assistant accounts had much higher quality scores compared to other uploader types.

Looking at the content type of the videos, the results showed that videos characterized as entirely educational had the highest mean DISCERN score at 1.99, while those categorized as comedy/personal testimony had the lowest mean DISCERN score at 1.30. In a comparison of Physician Assistant and Clinic accounts, it was found that 70% of the Physician Assistant videos were categorized as entirely educational while this was only true for 5.2% of the Clinic videos. On the other hand, only 10% of the Physician Assistant videos were categorized as entirely promotional while this categorization was given to 55.2% of the Clinic videos.

The study found that “only 21% of the most popular dermal filler TikTok videos were categorized as educational.”

Furthermore, a total of 18 videos (7%) explicitly promoted non-FDA-approved methods, which garnered a total of 5 532 291 views and 559 635 likes.

It is interesting to note that the findings of this study echo an earlier 2023 study conducted by Zargaran et al. This systematic review, published in the Aesthetic Surgery Journal, examined TikTok in plastic surgery. Their results also indicated a mean DISCERN score across all the videos of 1.91, indicating poor quality as well as Physician videos scoring notably higher than nonphysician videos.

Conclusions

With TikTok, and social media in general, set to continue to be sources for consumer health information, it is vital that the public are made aware of the possible misinformation that can exist.

Researchers from this study have made some recommendations going forward as it relates to improving the quality of the content shared on these platforms. These include:

For highly trained medical professionals to create and share more TikTok videos with educational intent.

That the video component incorporates a message promoting shared decision-making as well as utilizing captions for supplementary information and references.

They conclude by stating “TikTok provides an excellent opportunity for medical professionals to reach patients and provide valuable educational health information. However, currently, the majority of TikTok videos suggested by TikTok’s algorithm on dermal fillers are posted by unlicensed individuals, lack quality, and sometimes promote non-FDA-approved methods. This underscores the need for more qualified and highly trained medical professionals to share high-quality educational content that includes proper citation information, additional sources of information, and support for shared decision making.”

Sources:

De Baun, H., Cerri‐Droz, P., Khan, S., Alper, D., & Rao, B. (2024). A cross‐sectional analysis of TikTok’s most popular dermal filler videos. Skin Health and Disease. https://doi.org/10.1002/ski2.390

Zargaran, A., Sousi, S., Zargaran, D., & Mosahebi, A. (2023). TikTok in Plastic Surgery: A Systematic Review of its Uses. Aesthetic Surgery Journal. Open Forum, 5. https://doi.org/10.1093/asjof/ojad081