Please Stop Critiquing Patients' Before-and-After Photos

Are you someone who likes to comment on women's appearance, uninvited, on the internet? Come here. Let's have a talk.

I posted a before-and-after of a patient who had severe, painful capsular contractures and had her implants removed. She has a great result.

A male physician showed up on that post to let the world know that she looked better with the implants and the capsular contracture, that she never should have removed them, and that he hoped she'd wear a padded bra.

This is a patient who was in pain, wanted her implants out, and had a really lovely result.

I responded that it was wild he would type that out and press send on a post about a woman doing something so she feels better, something that was a medical decision as well as a cosmetic one. His response was that objectively, she looked worse, and that he'd be mad at his wife if that were her result.

He's a doctor, too, and I can't help wondering how he talks to his own patients.

And he's not the only one. I've even seen someone comment that a cancer patient looked better before her mastectomy.

Here's something I don't think people who do this quite understand:

Different people have different aesthetics. Some people like a certain look for their bodies, their makeup, their hair, their clothing, and other people like something totally different. There's no right or wrong.

So what makes someone feel they need to let people know how their body should look?

When a plastic surgeon puts a before-and-after up, we're not asking for your critique. The patient isn't asking for your critique.

The whole point of a before-and-after is to educate. What does it look like when someone has an implant taken out? When someone gets an implant? When someone gets a tummy tuck? What do different bodies look like after different procedures? That's the goal. (If you're looking at them to choose a surgeon, here's how to evaluate before-and-afters properly.)

The same morning, I saw one of my colleagues post a before-and-after, and there were multiple nasty comments critiquing the result and critiquing the patient's decision.

This is a real person. That patient is almost certainly following their surgeon. They're almost certainly one of the followers, and they saw every one of those comments.

Nobody would do that in person. It isn't any different online. (I've written before about the cruelty of online "snark" aimed at people who are sick.)

I am super protective of my patients, because it is such a kind gift for them to let me use their before-and-afters. They're the reason the next patient can see what a contracture repair or an explant actually looks like.

• There's no objectively correct aesthetic. Different people want different things for their own bodies
• Before-and-afters exist to educate, not to invite a critique of the patient
• The patient is a real person who almost certainly reads the comments
• Removing painful implants is a medical decision as well as a cosmetic one, and it's hers to make
• If you comment on a patient's body this way on my posts, I'll block you