How to do a nose job: Plastic surgeons learn procedures on YouTube

The Internet is awash in helpful how-to videos on everything from boiling an egg to rebuilding an engine — to performing a nose job. A new survey finds that more than half of plastic surgeons have used YouTube to learn a new technique that they then go on to perform on patients.

In a survey of 200 plastic surgeons, Dr. Anita Sethna and her colleagues at Emory University found that approximately 64 percent of respondents had learned from online videos. Most commonly learned online? Nose jobs (rhinoplasty) and injectable procedures, such as Botox, the authors report in JAMA Facial Plastic Surgery.

Though that may sound alarming, Dr. Michael R. Zenn, vice chief of plastic and reconstructive surgery at the Duke University School of Medicine, said for practicing surgeons “these videos are just one piece of the puzzle.” Zenn said he has used videos to learn new surgical techniques, thanks to their convenience, and since 2013 has been making and posting his own videos to YouTube.

Zenn pointed out that surgeons have all gone through extensive training, and that, as continuing education, online videos are not that different from older training methods. Surgeons traditionally pay fees to go to professional meetings where they listen to lectures and watch accompanying videos. In many cases, watching a video online accomplishes the same thing.

They’re also useful for medical education, which follows a “see one, do one, teach one” method of teaching and learning. Dr. Larry Mellick, a professor of emergency medicine and pediatrics at Augusta University Health, said he encourages his medical students to “see” a video on YouTube before he supervises them doing the procedure on their own. He sees YouTube videos as “a phenomenal tool.”

However, some have expressed concern about the quality of resources available on the Internet. A 2012 study of YouTube videos about tonsillectomy, for instance, found that they ranged widely in quality, though only a few were deemed “misleading.” Other researchers have cautioned that posting these videos might harm the professionalism of surgeons or encourage the public to perform DIY medicine at home.

The Internet is “the wild west” of information, acknowledged Sethna. She’s encouraged, though, by the initiatives of some medical societies to improve online video by launching websites, like the Plastic Surgery Education Network, that feature videos vetted by board-certified experts.

Correction: An earlier version of this story misstated Dr. Larry Mellick’s affiliation. The story was updated on March 4, 2016.