Dr. Daniel Barrett, a board-certified surgeon in Beverly Hills, isn’t your average Instagram influencer. Sure, his feed is carefully curated. He has a tricked out iPhone and a high-quality video camera to craft polished “stories” for his hungry fans. He even has a social media team. But, Dr. Barrett isn’t reviewing makeup palettes or snapping pictures of latte art. He’s recording live surgery. With patient consent, Dr. Barrett shares his cosmetic surgery procedures from start to finish on platforms like Instagram and Snapchat. These relatively uncensored, graphic videos and pictures may seem jarring, even gross, to some. But this kind of thing is immensely popular online. Some surgeons have amassed hundreds of thousands of loyal followers—earning themselves catchy nicknames like “Dr. Miami,” “Dr. BFixin,” and “Dr. Feelgood.” These doctors post surgery videos with irreverent captions, and loud trap music soundtracks. They boast of their before and after shots, and even host Q&As, drawing questions from their pool of followers. It’s a trend that has gone fully global. Just searching through the #plasticsurgery hashtag on Instagram will take you into an operating room on nearly every continent. Posting click-worthy pics isn’t just for show or follows, for it’s proving to be an effective marketing strategy to lure new customers. Doctors with social clout will be the first to tell you that platforms like Instagram bring in substantial new patient referrals. This troubles New York-based board-certified plastic surgeon Dr. Lara Devgan. “Social media is inherently unregulated like the Wild West,” she said, and “it’s hard to know what’s real.” While, Dr. Devgan feels that social media provides greater access to information on cosmetic surgery, which in turn creates a more educated patient, it’s not a world exclusively occupied by board-certified surgeons like Dr. Devgan and Dr. Barrett. There are plenty of shady characters exploiting the lack of regulation online. “I’ve had my before and after photos stolen—used by other doctors as if they’re their own work. I’ve had my own video content—even sometimes with me in it—used by other people,” said Dr. Devgan. In fact, a 2017 study found that when searching one day’s worth of Instagram posts using popular hashtags—only 18% of top posts were authored by board-certified surgeons, and medical doctors who are not board certified made up another 26%. This leaves a huge percentage of potentially unqualified participants. Moreover, any medical doctor, registered nurse, or physician’s assistant can receive credentials to perform basic cosmetic procedures—like Botox injections for example by attending a simple weekend course. Parsing who’s legitimate and who’s not from a social media profile is incredibly difficult for consumers. Watch our latest Quartz News episode to learn more. Quartz News is a weekly video series bringing you in-depth reporting from around the world. Each episode investigates one story, breaking down the often unseen economic and technological forces shaping our future. Click here for previous stories.