(Reuters Health) - Some plastic surgeons have gained large social media followings by sharing theatrical videos of surgery with entertainment, rather than education, in mind. Now experts are proposing ethics guidelines to ensure that the content of plastic surgery videos on social media isn’t harmful to patients.

Too often, plastic surgery videos cross an ethical line, exploiting patients and luring future customers with flashy before-and-after images that gloss over the dangers of surgery, doctors argue in the proposed ethics guidelines published in the journal Plastic and Reconstructive Surgery.

To refocus videos on education and prevent exploitation, the guidelines stress that patients should be asked to consent to filming in advance and be allowed to refuse the request. Because online videos might be manipulated and widely shared, patients should also understand that their image might be used for something their doctor didn’t sanction and that content is difficult to remove online once it’s posted.

“Plastic surgery is uniquely drawn to social media because we tend to do more marketing and we are a visual specialty,” said Dr. Clark Schierle, senior author of the guidelines and a plastic surgeon at Northwestern University’s Feinberg School of Medicine in Chicago.

“In general, there should be an effort to avoid distractions from the actual surgery itself and sharing any content that makes the patient identifiable without specific consent,” Schierle said by email.

Many plastic surgeons question the ethics of broadcasts done more for entertainment and marketing than for education, the authors said, and have called for the development of more structured oversight and guidance in this area.

The guidelines - the first to address sharing videos of plastic surgery on social media - will be presented October 6 at the American Society of Plastic Surgeons (ASPS) annual meeting in Orlando.

“We hope this will make its way into the official ethical code of conduct for board-certified plastic surgeons,” Schierle said.

Plastic surgeons, like others in the medical profession, should adhere to ethical standards that prioritize decisions that will not harm patients, the guidelines argue.

Even when patients agree to be filmed and have videos shared online, doctors still have an obligation to protect patients’ privacy and portray them in a respectful manner, the guidelines stress.

Any marks or identifying features on patients should be obscured in videos so that patients can’t be easily discovered online. Patients faces shouldn’t be shown unless the explicitly consent to this and are told this will allow viewers to identify them and name them in any social media posts using the video.

“Video shared may impact the patient socially or professionally in the future,” Schierle said.

Patients also shouldn’t feel pressured to allow videos, and they should know their medical care won’t be influenced by whether or not they consent. When patients do permit filming, surgeons should make sure it doesn’t interfere with the procedures, and they should have another person do the filming so they can concentrate on the patient.

“The public has a right to see uncensored video from the operating room if they are interested, and we are all for the dissemination of good-quality information,” Schierle added. “Where we have concerns is in video that is of a more entertaining or self-serving nature at the expense of the patient.”

SOURCE: bit.ly/2fP36ZE Plastic and Reconstructive Surgery Journal, online September 28, 2017.