Impact of Before and After Photographs on Parents of Children With Cleft Lip.

Introduction: Cleft lip with or without palate (CL/P) is a common facial deformity requiring surgical intervention whose aesthetic outcomes are typically represented by Before and After Photographs (BAPhotos). With the growing presence of social media, there are concerns about the role of BAPhotos in plastic surgery and their impact on patient's expectations. Methods: A retrospective analysis of quality assurance survey and interview data was conducted to explore the impact of BAPhotos on parents and their expectations in the context of CL/P. Results: Thirty-five parents were interviewed regarding use of BAPhotos; 91% viewed BAPhotos on the following platforms: Google (n = 26), Facebook (n = 8), Instagram (n = 4), YouTube (n = 4), Snapchat (n = 1), and Other (n = 11). Half of the parents believed that BAPhotos influenced their treatment expectations and these parents were not less satisfied with their child's surgical outcome than those who did not perceive being influenced (Mann-Whitney U = 124.5, P = .05). A higher proportion of parents who viewed BAPhotos on social platforms felt that their treatment expectations were influenced by BAPhotos (χ2, X (df = 1) = 4.49, P = .03). Thematic analysis revealed that parents' emotional reaction to BAPhotos was shaped by the context of the photos; photos on social platforms that include patient stories (ie, Instagram, Facebook) were more often sources of emotional support. Conclusion: This study furthers our understanding of the impact BAPhotos have on parents of children with CL/P and areas of education regarding the dissemination of BAPhotos which have the potential to positively impact viewing of these photos.