A quantitative analysis of Twitter ("X") trends in the discussion of rhinoplasty

Rhinoplasty is one of the most common cosmetic surgical procedures performed globally. Twitter, also known as "X," is used by both patients and physicians and has been studied as a useful tool for analyzing trends in healthcare. The public social media discourse of rhinoplasty has not been previously reported in the field of otolaryngology. The goal of this study was to characterize the most common user type, sentiment, and temporal trends in the discussion of rhinoplasty on Twitter to guide facial plastic surgeons in their clinical and social media practices.

A total of 1,427,015 tweets published from 2015 to 2020 containing the keywords "rhinoplasty" or "nose job" were extracted using Twitter Academic API. Tweets were standardized and filtered for spam and duplication. Natural language processing (NLP) algorithms and data visualization techniques were applied to characterize tweets.

Significantly more "nose job" tweets (80.8%) were published compared with "rhinoplasty" (19.2%). Annual tweet frequency increased over the 5 years, with "rhinoplasty" tweets peaking in January and "nose job" tweets peaking in the summer and winter months. Most "rhinoplasty" tweets were linked to a surgeon or medical practice source, while most "nose job" tweets were from isolated laypersons. While discussion was positive in sentiment overall (M = +0.08), "nose job" tweets had lower average sentiment scores (P < .001) and over twice the proportion of negative tweets. The top 20 most prolific accounts contributed to 14,758 (10.6%) of total "rhinoplasty" tweets. Exactly 90% (18/20) of those accounts linked to non-academic surgeons compared with 10% (2/20) linked to academic surgeons.

Rhinoplasty-related posts on Twitter were cumulatively positive in sentiment and tweet volume is steadily increasing over time, especially during popular holiday months. The search term "nose job" yields significantly more results than "rhinoplasty," and is the preferred term of non-healthcare users. We found a large digital contribution from surgeons and medical practices, particularly in the non-academic and private practice sector, utilizing Twitter for promotional purposes.