On the heels of a study suggesting plastic surgeons need to increase their visibility on social media, comes a paper spotlighting the need for guidelines to help keep plastic surgeons’ video posts professional and respectful.

Tactful educational video posts showing cosmetic surgery procedures can be good for patients, the doctors posting them as well as the specialty. But videos of surgeons dancing or singing in the operating room, or holding a patient’s tissue post-surgery, with a super-imposed baby face emoji on the image (true story), may harm patients and the profession, according to study author Clark Schierle, M.D., Ph.D., a plastic surgeon and faculty member of Northwestern University Feinberg School of Medicine and director of aesthetic surgery for Northwestern Specialists in Plastic Surgery, in Chicago.

“I think there are a number of areas where some of the more egregious posts cross the line into something that we would argue is in conflict with the principles of medical ethics that date back to Hippocrates,” Dr. Schierle says.

Plastic surgeons behind the controversial posts realize a social media irony: The more outrageous and edgy the video content, the more likely it is to go viral; the more likely they’ll get good and bad comments and coveted shares and followers.

But the social media attention comes at a price to patients — even the specialty and medicine — Dr. Schierle argues.

Sometimes, physicians have a responsibility to protect patients against themselves.

“Twenty-year-old you may see this as a really fun, playful way to express yourself on social media by having your surgery broadcast for the world to see, but 40-year-old you, who is trying to get a job someday might not be too happy when it shows up as the number one search result, when your name is Googled by your future employer,” Dr. Schierle says.

Beverly Hills, Calif.-based cosmetic dentist Matt Nejad, D.D.S., says he posts practice photos and videos to social media and his website.

“I post them to show examples of the quality of my work and also to educate patients on available high-quality treatment options. I especially like to post videos and pictures of the veneer treatment process including planning, 3D-evaluation, fabrication of temporaries and final results achieved,” he tells The Aesthetic Channel.

But Dr. Nejad agrees it’s unethical to use photos and videos without patient permission. It’s also wrong to repost another doctor’s work and pass it off as one’s own, or edit photographs to make results look better than they are.

Today’s “instant gratification society” has created a dynamic and ever changing set of challenges for any professional organization including the medical profession, according to Michael S. Kluska, D.O., president of the American Academy of Cosmetic Surgery.

“One of my positions this past year was to help our members ‘compete’ in this crazy, dynamic environment,” says Dr. Kluska, who is a dual board-certified plastic and reconstructive surgeon and cosmetic Surgeon. “Competition is good as long as it is ethical and within the rules or guidelines of what is fair to all involved. All physicians should practice medicine based on their commitment to the profession, to the patient and the acceptance of the foundation of the Hippocratic Oath including ‘do no harm’ and respect the patient and respect the authority and privilege that has been given to the physician with their medical degree.”