Professional Instagram Use by Ontario Plastic Surgeons: Content Patterns and Engagement by Practice Setting

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Introduction Although social media is widely used in plastic surgery, differences in content and posting patterns across practice settings are poorly understood. This study characterized Ontario plastic surgeons Instagram posting patterns and audience engagement by practice setting. Methods This observational cross-sectional study analysed publicly accessible professional Instagram profiles of registered academic, community, or mixed practice plastic surgeons in Ontario. Up to 30 posts (posted on or after January 1, 2020) per account were coded by content type and clinical domain. Chi-square, Kruskal-Wallis, and analysis of variance tests were used to evaluate the association between surgeon characteristics, posting patterns, and engagement rates. Results Eighty-six of 261 (33%) plastic surgeons had professional Instagram profiles, yielding 2032 posts. Pre-/post-procedure results (32%) and facial aesthetics (20%) were the most represented content type and domain, respectively. Academic surgeons posted significantly more announcements, research, and reconstructive content ( P < .001), while community surgeons posted significantly more advertising/promotional ( P = .02) and facial aesthetics ( P < .001) content. Engagement rates were highest for academic surgeons, personal posts, and craniofacial content, with significant differences among practice types, content categories, and domains ( P < .001). Conclusions Instagram use among plastic surgeons varies substantially by practice setting. Cosmetic content dominates posting volume, whereas reconstructive and academic content, despite higher observed engagement, remains under-represented. These findings identify content-practice mismatches that warrant further qualitative, longitudinal, and interventional study before practice recommendations can be made.