Twitter for Plastic Surgeons who are Too Busy to Tweet

Dr. Olivier Branford’s Tech Talk Presentation at Plastic Surgery the Meeting on October 17, 2015 in Boston, MA.
by Olivier A Branford MA, MBBS, PhD, MRCS, FRCS(Plast) @OlivierBranford & Patrick Mallucci MD, FRCS, FRCS(Plast). @PatrickMallucci

The question is not do you have enough time for social media, but rather can you afford not to tweet?

Twitter it is a versatile online social networking service allowing users to post short messages of up to 140 characters, images, and links to websites. By December 2014 Twitter had 500 million registered and 284 million active users, posting over 500 million tweets daily. Twenty nine percent of users check Twitter multiple times per day. The fastest growing social demographic on Twitter is the 55-64 year age bracket. The company has increasingly promoted its news and information-network strategy, leading to the current evolutionary state of the service.

There are a number of reasons why plastic surgeons should use Twitter. As we recently detailed in a submission to this journal the promotion of scientific articles using social media can help ensure that research reaches a much wider audience (1). By controlling the content and flow of this information yourself it will be delivered in a far more accurate way than would be achieved by relying on marketing teams or journalists to do so for you. When surgeons tweet it helps to combat the dominance of tabloid newspapers on social media covering plastic surgery news. Perhaps then we can help to move the focus away from the media obsession with celebrities to feature more interesting plastic surgical scientific achievements. The internet has an educational role and has become the first port of call for many patients wanting to know more. As far back as 2011 a poll from the American Academy of Facial and Plastic and Reconstructive Surgery showed that almost half of the patients surveyed obtained information from Twitter and Facebook before surgery, whereas the number of patients who sought information from friends had already then fallen to less than 50 percent (2). These opposing trends are likely to have continued. This is a reflection of the fact that Twitter is maturing into an information network rather than a social network.

Social media is essential to a modern marketing strategy in both the state funded sector and the private sector as healthcare provision increasingly reflects the business marketplace with an ever-expanding number of options for patients to choose from. In the competition for service provision and patients the emerging leaders will be those with an awareness of their public image and that of their institution. It is not sufficient to have good outcomes in such a market – those results must be publicly available. Patients are increasingly expecting to see their surgeons on social media. Twitter is ranked as one of the top ten most visited websites worldwide and has been the third most used social network. While some users have moved away from Facebook, and Instagram does not have the functionality or scope of Twitter, until the next big platform comes along surgeons would be wise to get up to speed with the intricacies of tweeting.

We have found Twitter to be a useful networking tool not only within the world of plastic surgery but also to meet those outside of our profession who may have interesting collaborations to offer. Much has been published about the benefit of bringing together completely different disciplines and their approaches to problems resulting in path-breaking innovations (3). Where else would plastic surgeons meet artists for example who might influence their work and where else better to do this than Twitter? In addition we have also found Twitter to be a useful communication tool in our national collaborative multidisciplinary academic projects such as @iBRAstudy and @Surgery_Trials.

Social media is here to stay. Surgeons of all specialities have been slow to take up social media and marketing companies have taken advantage of lack of understanding in order to charge high rates for their services. Do surgeons really want a marketing team with little or no medical knowledge to represent their views, and at a premium price? There are some excellent public relations (PR) teams already attached to great plastic surgery institutions such as at Plastic and Reconstructive Surgery Journal. They may well be your best contacts as they really know their plastic surgery PR. Social media gives surgeons a platform to work with them. There really is not that much to learn about using Twitter. Surgeons can quickly build up several thousand genuine followers themselves without resorting to paying commercial companies to do so as we have shown using the following strategies. The question is not should you be involved in social media? But rather, can you afford not to be?…

Our top 25 tried and tested Twitter tips for plastic surgeons who are too busy to tweet

When starting out on Twitter it is worth experimenting with what works for you but in the interests of efficiency here are some time saving tips derived from our experience of using the platform, supported by statistical data from a report in the Huffington Post (4).

What do you tweet about?

  1. If you find something interesting then others will too: If you saw this headline in a newspaper would it grab your attention?
  1. Start by retweeting interesting content. It’s one of the best ways to get noticed by other users, to start a conversation and to have them follow you. However, do not share content you haven’t read. Establish yourself as a plastic surgery industry thought leader by adding commentary to the links that you tweet, although make sure that you present a balanced opinion. The democratic nature of twitter means that opinion will quickly turn on one-sided debate. Curate content from a wide variety of sources – the most efficient way to do this is to put your favorites into lists, allowing you to quickly see the most important original content from selected groups of people. These are free to subscribe to and you can invite others to follow your lists. You can check in to your list a couple of times per week and retweet all the interesting content in a matter of a few minutes.
  1. Say something original: Be the news! Generate your own leads that will be retweeted. Paraphrase one of your studies and attach the link to it. Tweets with links are 86 percent more likely to be retweeted. ‘Hit counts’ and tweets have been shown to correlate well with academic citations leading authors to propose a “Twimpact factor” for scientific studies (5,6). Post links to your e-books and YouTube videos. As Twitter is a public domain the most successful tweets will involve translational studies with ‘real-life’ relevance. Remember to add the journal @username to your tweets (for example @prsjournal, which allows you to mention or reply to users) and the digital editorial team are likely to retweet your work. Retweet links to any blogs or magazine articles that have appeared about your work and where possible connect those tweets to the authors of those blogs and the original journal using their @username. They will then promote your article further by retweeting you. In effect the authors of those blogs do your marketing for you, promoting you by trying to increase the readership of their own blogs by featuring your work. If someone asks you a question on Twitter then answer it. Twitter is a two way conversation: Tweet questions to encourage replies. If someone regularly retweets you then support them too.
  1. Add a picture. We have invariably found that attaching a photograph or figure to a tweet gives rise to the greatest number of views (Figure 1): Studies have shown that tweets with images get twice the engagement of those without. Try to have a picture in at least every three or four tweets. Twitter sends you a weekly update so you can easily see what kind of tweets your followers are most interested in.
  1. Timing of tweets. This depends on different time zones – so schedule really important tweets four times throughout the day using different angles to cover these. Afternoon tweets within any one time zone are more widely read than morning tweets. There is 17 percent more engagement at weekends. However if you tweet during rush-hour it may be the most efficient use of your time and will provide interest to those also stuck on public transport in your own time zone.
  1. Decide if you want to separate your educational and promotional Twitter activities and postings as your feeds will be very different. Don’t be entirely self-promotional on twitter – no one wants to read about how clever you are all the time! 80 percent of posted tweets are about users themselves and their achievements: Followers quickly lose interest.
  1. Add hashtags to your tweets but not more than three otherwise the tweet becomes unreadable. For example #plasticsurgery. This allows you to join relevant topic grouped conversations and doubles your chance of engagement. Structure your tweets efficiently: Key message; link; #hashtag. Keeping your tweets under 140 characters allows other to add comments when they retweet you. And tweets with less than 100 characters get 17 percent more engagement. If you use the word “retweet” (sparingly) your tweet has a 23 times higher chance of being retweeted!

Engaging with others on Twitter

  1. Use #FF – for “Follow Friday” and list the people you admire and get on with – it is the equivalent of introducing contacts to each other at a conference and benefits everyone. You don’t only have to do this on Fridays: #FS is fine too…
  1. Don’t complain or argue on Twitter – people like to follow positive people. There is no place for Twitter rage. Don’t get into arguments: Professional jealousy and discord exist on Twitter as they do elsewhere but rise above it. For offensive Twitter trolling just press ‘block’. Sadly there is no real life counterpart.
  1. Engage with key thought leaders in plastic surgery. These may be individuals such as @DrRodRohrich or institutions that represent plastic surgery such as @prsjournal and @ASPS_News. In order to reach a wider audience, connect and engage with the tweeters in your niche who are the most vocal, followed by the greatest number and are considered to be experts in their field. Find these leaders either through Twitter searches or by visiting key websites and blogs in your niche and clicking on their Twitter button. Build an honest and personal relationship with these thought leaders. That requires going beyond favoriting and retweeting. Talk to them! Use their @username, and say something thoughtful about what they tweeted. They may well then retweet you to their numerous followers.
  1. Remember the bigger the institution the more likely they are to have a dedicated individual or PR team managing the Twitter account. In the world of plastic surgery social media these PR individuals have become the stars and have great influence, so be cordial with them.
  1. Twitter is not only a broadcasting tool, it’s also an excellent way to keep track of what people are saying about your business and niche. Set up a constant search for a specific keyword, your brand name or a common hashtag on Tweetdeck or Hootsuite. Check periodically and respond where necessary.
  1. Tap into hot topics and lively discussions – Use a service like Topsy or Social Mention to find out what’s being talked about on social media at any given time. Find a way to connect these topics to your work and create interesting content that will draw in new readers.
  1. Always remember that you are dealing with people. So thank them for following you. Comment politely on their tweets.
  1. Individuals are much more likely to follow you than major organisations are. You can see how many people someone follows. If they only follow film stars they may not follow you.
  1. If a message is relevant to an organisation or individual then put their @username in your tweet. The chances are they will retweet you to all their followers. That may lead to an exponential increase in your following and your potential audience.
  1. Touch base regularly with your good contacts with direct messages (DMs), #FFs, by retweeting them, by responding to their tweets or asking their opinion on something. It is vastly more productive than simply sending an SMS message.
  1. Use JustUnfollow to speed up managing your twitter contacts by semi-automation: If someone doesn’t follow you back or only tweets every 6 months simply wipe them away in batches. Follow 25 people with similar interests to you per day and reciprocal followers will soon add up. We have found that overall over 25 percent of people quickly follow back.

Managing your account

  1. Limit the time you spend on Twitter and use your time there wisely and efficiently. Tweet quality not quantity. Twitter is a valuable listening and advertising tool. But it’s easy to get absorbed into it and forget that you are there for educational or business purposes. It’s also easy to get discouraged quickly and abandon it altogether. Twitter is more of a marathon than a sprint. Keep at it regularly in small doses and the benefits will become apparent.
  1. Take care with information about yourself. Do post a photo of yourself and think about your bio as followers want to know that you are an approachable individual. While showing some degree of individuality in your personality is important for a regular following no one wants to know what a plastic surgeon had for lunch so avoid being mundane. If you feel you have really nothing to say then maybe Twitter is not for you. In terms of security avoid posting your whereabouts when you can avoid it. If you are at a conference overseas it may be wiser to tweet after you get home.
  1. Beware of allowing marketing teams to manage your twitter feeds. They will not conduct tweets with the same ethical discipline as you. We have seen large organisations make hasty retreats on their tweets as people are very quick to pick up inappropriate content. Have the same high personal standard on Twitter as you have with your own practice. Never put any patient identifiable information in your tweets.
  1. If your tweets become very popular then marketing teams will want to become associated who you as a result of your social media presence and they will effectively do your marketing for free in order to promote themselves. There is mutual benefit here: Send them details of your most interesting studies and they may blog about them.
  1. Put twitter on your website. The more educational your postings are and the more interconnected your social media is the higher up your website will appear on Google searches without paying a dollar.
  1. Do not automate your Twitter responses as people can always tell and they will stop following you. Similarly don’t send auto-DMs.
  1. Most importantly check out the PRS “Author Check List” (7). This is an invaluable tool with information and advice on social media promotion after the acceptance of your article by PRS. Our social media experience with PRS has provided us with a combined Twitter following of over 7,000 new users since the publication of our September 2014 article with over 12,000 views of our tweets per week. This has also generated countless blogs and mainstream press articles (8-14).

Twitter has roles in public education, communication and marketing as applied to plastic surgery. With the few simple rules that we have outlined above surgeons will be surprised at how quickly they can master Twitter themselves and never look back. We wish them happy and efficient tweeting!

@OlivierBranford @PatrickMallucci


Copyright © 2014 American Society of Plastic Surgeons. All Rights Reserved.

 For inquiries about requesting permissions for this blog, please contact

For more information, please read:
Population Analysis of the Perfect Breast: A Morphometric Analysis

Publicize or Perish! A Guide to Social Media Promotion of Scientific Articles: Featuring the Plastic and Reconstructive Surgery “Author Tool Kit”


  1. Branford OA, Mallucci P. Publicize or Perish! A Guide to Social Media Promotion of Scientific Articles: Featuring the PRS “Author Tool Kit”. Submitted to Plast Reconstr Surg. January 2015.
  2. Accessed January 6, 2015.
  3. Johansson F, ed. The Medici effect: What elephants and epidemics can teach us about innovation. Watertown, Massachusetts: Harvard Business Review Press; 2006.
  4. Accessed January 6, 2015.
  5. Perneger TV. Relation between online “hit counts” and subsequent citations: prospective study of research papers in the BMJ. BMJ 2004;329:546-547.
  6. Eysenbach G. Can tweets predict citations? Metrics of social impact based on Twitter and correlation with traditional metrics of scientific impact. J Med Internet Res. 2011;13:e123.
  7. Accessed January 6, 2015.
  8. Accessed January 6, 2015.

  1. Accessed January 6, 2015.
  2. Accessed January 6, 2015.
  3. Accessed January 6, 2015.
  4. Accessed January 6, 2015.
  5. Accessed January 6, 2015.

Copyright © 2014 American Society of Plastic Surgeons. All Rights Reserved.

 For inquiries about requesting permissions for this blog, please contact



  1. Pingback: YOUR Award-Winning Journal: PRS | PRSonally Speaking

  2. Pingback: PLASTIC SURGERY – “TOO BUSY TO TWEET” | World Health Innovation Summit

  3. Pingback: How I Got My #PlasticSurgeon Father on Twitter | PRSonally Speaking

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