#Breastimplantillness: The Role of Tiktok in the Introduction and Portrayal of Breast Implant Illness to the Public

Goals/Purpose: Breast implant illness (BII) has been recently defined as a group of systemic symptoms that arise following breast implants. A proposed contributing factor is the influence of social media, which may quickly propagate information and opinions on BII to a wide audience. Currently, the world’s fasting growing media platform is TikTok, with over 3 billion downloads and the average user engaging with the app for over an hour a day. As the app itself generates content for viewers to consume based on searches and previous interest, our study assesses the content presented to those interesting in breast implant surgery, and whether BII may be introduced through it.

Methods/Technique: The authors identified the top five hashtags related to breast implant surgery on social media: #breastimplants, #breastaugmentation, #siliconeimplants, #salineimplants, #boobjob. Each hashtag was queried in Tiktok within the same week using naïve, newly created accounts. The first 200 videos TikTok recommended for each hashtag were analyzed and cross-referenced on three sperate accounts and devices to ensure congruity. Videos were characterized by creator role, content category and tone, length, number of views and likes, associated hashtags, and the presence of BII information.

Results/Complications: Analysis of 1000 videos represented over 1.8 billion views of videos across the five hashtags. On average, the first 200 videos per hashtag reflected 1.65 hours of viewing content and were congruent between each device. BII content appeared in three of the five hashtags: #breastimplants, #siliconeimplants, #salineimplants. It was the most prominent in #breastimplants, representing 29% of video and 31% of video time. This was significantly more than that seen in #siliconeimplants (p=0.023) and #salineimplants (p=0.020). The creators of BII content were significantly more likely to be patients than medical professionals (83% vs 17%, p<0.001). The soonest in which BII content may be presented unprompted was via #breastimplant, where it was shown on average as the 2^nd video, 39 seconds into viewership.

Conclusion: Public perceptions of BII may be highly influenced by social media. Those searching for breast implant related content on Tiktok may be presented with BII content as soon as their first minute of viewership, and this information is largely created by other patients. This study highlights the quick and significant impact TikTok may have in influencing our breast implant patient population in their perceptions of BII.