During the HONcode Certification and re-examination processes, the
Health On the Net Foundation (HON) has been come across with websites
relating to cosmetic surgery. HON has noticed that the
publication of before/after pictures poses
difficulties, since they can create false expectations among website
users, and HON cannot guarantee that these pictures have not been
modified, i.e. HON is not able to verify the authenticity of these
pictures. However, at the same time, these pictures also are a tool for
illustrating medical information and for demonstrating the quality of
work done by a physician. Thus, the question arose how to treat
websites publishing before/after pictures. Therefore, HON decided to
survey to find out what is the public opinion about displaying
before/after pictures on websites.
The survey was conducted by the Health On the Net Foundation and
contained the following closed questions:
- Are you a health professional or a non-health
- Are you an editor of a medical/health website
dedicated to plastic/aesthetic surgery or not?
- If you find before/after pictures on a
- You find this useful?
- It does not bother you?
- You find this suspicious?
- It bothers you?
- HONcode certified website
- Should not display these before/after
- Should be able to display before/after
- Is this questionnaire understandable or not?
respondents were able to provide their contact information as well as
comments regarding the survey. The survey was both in French and
English and was placed on the HON website and alongside the
certificates of the HONcode Certified websites from mid-June until the
end of September, 2011. HON received in total 1,365 responses.
The purpose of the survey was to understand the opinion of the health
professionals and the non-health professionals with regard to the
regulation of publication of before/after pictures.
- 1,365 responses were received. 29.5% of the
responses came from health professionals and 5.9% from respondents who
reported to be webmasters of cosmetic surgery websites.
- 25% of the respondents considered before/after
pictures on websites useful, while 45.3% considered the
pictures to be suspicious.
- 68.8% of the respondents found that HONcode
Certified websites should be able to display before/after pictures,
while 30.2% considered that HONcode Certified websites should not
display before/after pictures.
The majority of the respondents considered the publication of
before/after pictures on websites suspicious. At the same time, the
majority of the respondents also found that the websites should be able
to display these pictures. This means that in order to reduce the
suspiciousness of before/after pictures, actions should be taken, but
that no significant need exists among website users to have the
publication of these pictures prohibited. Therefore, HON is currently
process of developing a guideline regarding the publication of
before/after pictures, taking also into account the valuable comments
given by the respondents of this survey.
The preliminary results in more detail:
 Within the scope of
HONcode Certification, the Health On the Net Foundation defines
before/after pictures as images taken both before and after a medical
procedure, including dental and plastic surgery procedures.