From Hashtags to Health Narratives: A Content Analysis of Breast Implant Illness on TikTok

Breast Implant Illness (BII) is a term used to describe a constellation of nonspecific symptoms attributed to breast implants and is increasingly discussed on social media platforms like TikTok. Understanding online discourse surrounding BII is important to better appreciate patient experiences and recognize potential impacts on patient decision-making.

This study aims to assess available information on TikTok regarding BII by examining both video content, quality, and engagement while identifying prevailing trends in the discourse.

TikTok was queried using BII-related hashtags. Relevant videos with over 10,000 views were included. Video engagement metrics, creator type, content, and purpose were analyzed. DISCERN and Global Quality Scale (GQS) scores were utilized to assess the quality of health information.

The analyzed videos accumulated over 116 million views, with patients being the predominant content creators (73.9%). Engagement metrics did not differ significantly between creator types or board certification status, but verified accounts received significantly higher engagement. Personal experience videos were more common (45.7%) than entertainment (28.3%) and education (26.1%) videos, yet entertainment-focused videos received significantly more views and likes (p < 0.05). Overall, video quality was low, with plastic surgeons producing significantly higher DISCERN and GQS scores than patients (p < 0.001).

Social media serves as an important space for BII discourse, but the predominance of anecdotal content over evidence-based knowledge raises concerns about misinformation. Plastic surgeons' videos were higher quality but did not achieve greater engagement, highlighting the need for greater provider participation to strengthen accurate and appropriate patient information.

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