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Social media has many cosmetic doctors and their patients on pins and needles

Our Internet-fueled exhibitionism knows no bounds, and its latest frontier? Cosmetic improvements. Two recent examples: The Los Angeles radio host who live-tweeted her peel, and the Boston hairstylist who filmed a video of himself getting collagen injections for YouTube. But one person’s PR can be another person’s Botox headache. Although most physicians credit social media with helping their businesses by giving them easy, free marketing and exposure, the technology has also led us to out—intentionally or not—our friends, strangers and even billionaire teen idols and their procedures.

Boston cosmetic dermatologist Dr. Ruth Tedaldi remembers the day when a certain young heartthrob paid a visit to her practice. How could she forget? It didn’t take long, she says, for another patient’s reveal of the megastar’s presence in her office to reach the Twittersphere. “By the time he left, there was a line of young girls in our parking lot.” Rumors, of course, spread that he was getting Botox. but Tedaldi describes his skin concern on that occasion as a simple “teen issue.” 

“With the prevalence of cell phones in our daily life, this issue is a 24/7/365 possibility, similar to people being caught on Google Earth walking out of an adult bookstore,” says Monique Ramsey, a San Diego marketer and social media consultant who work exclusively with cosmetic physicians. That’s why Tedaldi’s more private clients, including local TV anchors, often refuse to enter the waiting room until the minute she’s ready to see them.

Nichole Brennan, of Skin Deep Med Spa in Boston, had a male client—“very private, a real manly man”—who took every precaution to keep people from knowing that he was getting Botox. Even his wife, another regular of Brennan’s, didn’t know. Until, Brennan says, the social media–addicted hairstylist downstairs from her posted to Facebook: “Guess who I just saw walking into Skin Deep????” (Name redacted!!!!)

To counteract conflicts, most physicians have trained their front desk staff to schedule mindfully—which means no same-day appointments for known friends, neighbors, colleagues or, sometimes, husbands and wives. Brennan also has a rule against booking two male clients in a row. Both Tedaldi and Los Angeles cosmetic dermatologist Dr. Jessica Wu have gone so far as to set up private VIP waiting rooms and separate back entrances, which work most of the time. And even though the waiting area of Cambridge, Massachusetts, aesthetic dermatologist Dr. Ranella Hirsch seats only one or two people, decreasing the potential for unwanted run-ins, it didn’t prevent one patient from recently outing another. “That’s why we refuse to utilize auto computer scheduling even though we have the software,” says Hirsch. “You need a live person who makes sure privacy is protected and that people who shouldn’t bump don’t.”

But honoring professional obligations to confidentiality is one thing; teaching patients to mind one another’s privacy and forgo mentions on the valuable outlet that is social media is another. As a result, many doctors have mixed feelings. Rhode Island cosmetic dermatologist Dr. Ellen Frankel posts signs in her lobby reminding patients to not use their cell phones but awards them with discounts if they post their appointment to Facebook when they show up. 

“The way I feel about cosmetic dermatology is that everybody’s doing something,” says Tedaldi. “If you have incredible angst and insecurity or if you’re just an unbelievably private person, you have to adjust your life. Doctors are never going to tell anyone else what you’re there for. You could be there for a mole check. But how am I going to stop people from noticing someone, or control every person in my waiting room? That’s just ridiculous.”