title: What Are Your Patients Reading Online About Soft-tissue Fillers? An Analysis of Internet Information.
abstract: BACKGROUND
  Soft-tissue fillers are increasingly being used for noninvasive facial rejuvenation. They generally offer minimal downtime and reliable results. However, significant complications are reported and patients need to be aware of these as part of informed consent. The Internet serves as a vital resource to inform patients of the risks and benefits of this procedure.
  
  
  METHODS
  Three independent reviewers performed a structured analysis of 65 Websites providing information on soft-tissue fillers. Validated instruments were used to analyze each site across multiple domains, including readability, accessibility, reliability, usability, quality, and accuracy. Associations between the endpoints and Website characteristics were assessed using linear regression and proportional odds modeling.
  
  
  RESULTS
  The majority of Websites were physician private practice sites (36.9%) and authored by board-certified plastic surgeons or dermatologists (35.4%) or nonphysicians (27.7%). Sites had a mean Flesch-Kincaid grade level of 11.9 ± 2.6, which is well above the recommended average of 6 to 7 grade level. Physician private practice sites had the lowest scores across all domains with a notable lack of information on complications. Conversely, Websites of professional societies focused in plastic surgery and dermatology, as well as academic centers scored highest overall.
  
  
  CONCLUSIONS
  As the use of soft-tissue fillers is rising, patients should be guided toward appropriate sources of information such as Websites sponsored by professional societies. Medical professionals should be aware that patients may be accessing poor information online and strive to improve the overall quality of information available on soft-tissue fillers.
authors.affiliation: Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; and Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Mona T
authors.initials: MT
authors.lastname: Al-Taha
authors.affiliation: Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; and Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Al Youha
authors.affiliation: Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; and Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Courtney E
authors.initials: CE
authors.lastname: Bull
authors.affiliation: Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; and Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Butler
authors.affiliation: Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; and Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Jason G
authors.initials: JG
authors.lastname: Williams