Key Takeaways
- 1RealSelf earns revenue from surgeons who pay for premium placement
- 2Multiple patients report negative reviews being deleted or stuck "pending"
- 3Always cross-reference reviews on Google, Reddit, and Yelp
- 4Check state medical boards for disciplinary actions
- 5Use RealSelf for photos, but verify ratings elsewhere
If you've researched plastic surgeons online, you've almost certainly used RealSelf. With millions of reviews and before/after photos, it appears to be the definitive resource. But is it?
A growing number of patients—and surgeons—are questioning the platform's reliability. In this guide, we'll examine the concerns, explain how the platform works, and give you a better approach to researching surgeons.
How RealSelf Makes Money
Understanding RealSelf's business model helps explain potential biases. The platform isn't a neutral review site—it's a lead generation service for cosmetic providers.
RealSelf Revenue Sources
- $Sponsored Listings — Surgeons pay to appear higher in search results
- $Premium Profiles — Enhanced features, larger photos, more visibility
- $Lead Fees — Surgeons pay for patient inquiries sent through the platform
What this means for patients: Surgeons who pay more get more visibility—regardless of skill level. The platform has financial incentives to keep paying surgeons happy. Reviews that hurt paying surgeons may be moderated differently than others.
This doesn't mean every review is fake. But it's important context that colors everything on the platform.
The Deleted Review Controversy
The most serious concern about RealSelf involves reports of negative reviews being removed or never published.
Common Patient Complaints
- • Negative reviews stuck "pending" indefinitely
- • Reviews removed for vague "guidelines" violations
- • Surgeon responses with misleading info allowed to stand
- • Unable to update reviews after complications
RealSelf's Position
- • Reviews are moderated for authenticity
- • Some removals are legitimate guideline violations
- • They can't verify every medical claim
- • Moderation rules apply to all reviews
The reality: Both sides have valid points. Some removals are legitimate moderation. Others appear to disproportionately affect negative reviews of paying providers. The lack of transparency makes it impossible to know for certain.
Research Surgeons Across Multiple Platforms
Don't rely on any single review platform. Each has different biases and user bases. Cross-referencing gives you a more complete picture.
Google Reviews
RecommendedHarder to manipulate than specialized platforms. Includes patients who never used cosmetic surgery websites. Shows verified business location.
r/PlasticSurgery and procedure-specific subs (r/rhinoplasty, r/jawsurgery) have candid discussions. Anonymity encourages honest feedback. Search for specific surgeon names.
State Medical Boards
EssentialCheck for disciplinary actions, license status, and malpractice history. This is factual data, not opinion. Every state has a searchable database.
A Better Approach to Research
Here's our recommended process for researching any plastic surgeon:
- 1
Start Broad
Search procedure + your city. Make a list of 5-10 potential surgeons from multiple sources.
- 2
Verify Credentials
Check board certification at certificationmatters.org. Verify license status and disciplinary history with your state medical board.
- 3
Cross-Reference Reviews
Read RealSelf, Google, Yelp, and Reddit. Look for patterns and consistencies—or red flags that appear across platforms.
- 4
Evaluate Their Work
Request before/afters of patients with similar anatomy and goals. Read our guide on how to evaluate before & after photos.
- 5
Get Multiple Consultations
Consult with 2-3 surgeons before deciding. Use virtual consultations to efficiently compare options.