For many years, there have been rumors of censorship in the plastic surgery community. Well-known doctors have been speaking out from conference stages and on social media platforms. They claim that Meta and TikTok often flag their content. This is especially true when their posts feature before-and-after images of their patients. These clinical photos are a normal part of aesthetic medicine. They’re often shown at plastic surgery meetings and published in scientific journals.
Since at least 2017, social media users from different industries and political views have accused both companies of “shadow-banning”. Both Meta and TikTok have publicly denied some of these claims. There isn’t one clear definition of shadow-banning. But people usually use the term when their content seems to perform poorly for no obvious reason.
Plastic surgeons I talked to say that shadow-banning can happen in different ways for them. It can mean their accounts become less visible, their posts (especially before-and-after images) are restricted, or they have a big drop in reach, views, engagement, and the ability to boost their profiles. Sometimes, what they describe is like active content moderation. For example, they get notified that a post broke the rules and can’t be shared widely. Other times, shadow-banning is more mysterious, like a post being hidden from followers. But in short, some plastic surgeons simply say it’s censorship.
New research gives some support to these claims. It was led by board-certified plastic surgeon Jerry Chidester, MD, and done with plastic surgeons at Harvard Medical School Teaching Hospital. In 2024, Dr. Chidester surveyed plastic surgeons on Instagram. Out of 107 respondents, 68% said they had been shadow-banned on the platform. And 85% noticed that their page’s visibility had gone down in the past year.
It’s important to note that the plastic surgeons who took the time to respond might be more likely to have experienced shadow-banning. This is called self-selection bias. Dr. Chidester knows about this limitation and tried to deal with it in the survey. He said, “We looked at responses based on follower count. Even plastic surgeons with a low number of followers were still being shadow-banned.” He also added, “We had the requirement that plastic surgeons be active on social media, hoping to reduce the selection bias.” In the future, he wants the American Society of Plastic Surgeons to survey all its members to get a better understanding of shadow-banning.
One plastic surgeon who speaks out against this alleged censorship is Otto Placik, MD, a board-certified plastic surgeon in Chicago. Dr. Placik, who is 62, was one of the first in his generation to use social media. At that time, most doctors his age thought it was an “undignified” and “desperate” thing to do. He has become popular on Instagram, with over 100,000 followers. But he thinks the platform has become more and more restrictive over the years. Almost every day, he gets alerts that his posts, which are usually before-and-after images of breast and body procedures (with sensitive parts covered), have been removed or can’t be shown to people who don’t follow him. Through in-app notifications, he’s told that the posts “may contain nudity or sexual activity” and that many of his posts are labeled “sexually explicit or suggestive”. Dr. Placik can then choose to appeal Instagram’s decision or change or delete the posts. He says that at this point, “I’d have to delete all of my content to follow the rules.”
And according to Meta’s recent statement, the appeals process can be “frustratingly slow and doesn’t always lead to the right result.” Meta also said in the same announcement, “We’ve added more staff to this work. And in more cases, we now need multiple reviewers to make a decision before taking something down.”
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