Designing Effective Surgical Messaging on Instagram: Evidence from a Robotic Nipple-Sparing Mastectomy Campaign

INTRODUCTION

In today’s healthcare landscape, social media has become a powerful tool for hospital marketing. It enables institutions to strengthen their brand identity, build patient relationships, and establish credibility as trusted healthcare providers. Unlike traditional one-way communication channels, social media platforms allow for two-way interaction, allowing hospitals to receive feedback, respond to questions, and promote real-time healthcare-related events. This interactivity gives hospitals a distinct advantage in raising awareness, shaping patient attitudes, and influencing healthcare decisions. Platforms such as Instagram, Facebook, and YouTube are critical due to their extensive reach, visual appeal, and ability to simplify complex medical information into easily understandable formats. In the rapidly growing Indian healthcare industry, social media offers a cost-effective and efficient way to enhance outreach and increase patient awareness.^[1]

Against this backdrop, robotic nipple-sparing mastectomy (RNSM) has emerged as a sophisticated surgical procedure for breast cancer treatment, combining clinical efficacy with superior cosmetic outcomes.^[2] While medical literature has focused mainly on the clinical and technical benefits of RNSM, there is limited research on how hospitals communicate such innovations to the public through digital platforms. This gap is significant given the increasing reliance of patients on social media for health-related information and decision-making. The current study addresses this intersection by examining how a multispecialty hospital in South India used Instagram to raise awareness about RNSM.

The hospital’s campaign employed a range of content themes, including educational information, patient reviews, and surgeon-led communication, delivered through diverse content formats such as static posts, reels, and carousels. Engagement was assessed using Instagram-specific metrics, likes, comments, shares, saves, and engagement rate by reach (ERR), to evaluate the effectiveness of these strategies. By analysing content themes and formats, this research seeks to identify approaches that generate the highest patient engagement, thereby offering insights into hospitals in designing evidence-based, patient-centred social media campaigns.

Previous studies have highlighted the role of social media in influencing healthcare decisions in India. For example, a cross-sectional study found that adults visiting a tertiary care centre identified social media as a key determinant in their health-related decision-making, underlining its role in awareness and enabling informed healthcare choices where traditional outreach channels remain limited.^[3] Aurangzeb et al. further demonstrated through content analysis that orthopedic surgeons on Instagram primarily employed educational content, consistently achieving higher engagement than promotional or testimonial posts. Infographics and carousel posts were effective in simplifying complex information and engaging diverse audiences, illustrating the importance of well-crafted educational communication in maximising patient interaction.^[4]

In addition, research has shown that hospitals with structured social media strategies, supported by dedicated staff and patient-inclusive communication, achieve stronger engagement and build greater trust with consumers. Patient-focused and credible content is central to cultivating loyal online communities.^[5] Public health and nursing campaigns, such as those documented by Faustino et al., have successfully used Instagram for targeted health education, capitalising on the platform’s visual storytelling features to improve retention and accessibility across demographics.^[6] Furthermore, studies demonstrate that Instagram campaigns employing credible influencers and visually appealing content significantly increase engagement and foster positive health behaviours, particularly when promoting advanced surgical techniques and medical innovations.^[7]

This convergence of surgical innovation and digital engagement underscores the potential of platforms like Instagram to bridge the gap between medical advancement and public awareness. The findings are expected to guide hospitals in formulating social media strategies that raise awareness and strengthen engagement, ultimately aligning institutional communication with patient-centred healthcare promotion. The objective of this study is to evaluate the effectiveness of a hospital-led Instagram campaign promoting awareness of RNSM by comparing engagement across content themes and formats, using standard Instagram interaction metrics and ERR as the primary indicator of campaign performance. This will be accomplished by comparing engagement across various content themes and assessing the impact of different content formats, including static images, carousels, and reels.

MATERIAL AND METHODS

We conducted a retrospective descriptive cross-sectional study of an Instagram awareness campaign on RNSM run by the digital marketing department of a South Indian multi-specialty hospital. The observation window encompassed all campaign posts published on the hospital’s verified business account between April and May 2025. Analytics were obtained from the platform’s Instagram professional (business) dashboard.

This was a secondary analysis of account-level analytics. Eligible items were feed posts (static images, carousels, or reels/short videos) that explicitly related to RNSM based on the caption, on-image text, or campaign tagging/hash tagging. Stories/highlights and paid advertisements were not included unless otherwise stated. Two reviewers independently screened items for eligibility; disagreements were resolved by consensus. Each included post was assigned a unique study identifier (P01-P15) to avoid duplication.

To reduce right-censoring, metrics for each post were captured seven days after publication (primary analysis window). As a robustness check, we repeated the extraction at 14 days for the sensitivity analyses as reported in the Supplementary Material 1.

RESULTS

Across 15 campaign posts (April-May 2025), the mean post-level ERR was 15.14%, while the reach-weighted ERR was 8.72%, reflecting format-mix effects. Reels generated 86.5% of total reach (342,384/395,935) but a lower average ERR (5.19%), whereas static posts achieved the highest average ERR (27.84%) with substantially lower reach (51,654). Carousels contributed minimally (ERR 2.10%, reach 1,897). By theme, technology/surgeon-centric and awareness/preventive content showed the strongest average ERRs (21.86% and 21.66%, respectively), followed by educational (14.26%), with testimonials lowest (2.09%). Impressions exceeded reach across formats, indicating re-exposure. These patterns remained directionally stable in sensitivity checks that excluded small-reach posts.

The campaign focused most on informational content (n = 8, 53.3%), then technology & surgeon-centric content (n = 3, 20.0%), patient-centric testimonials (n = 2, 13.3%), and awareness & preventive screening (n = 2, 13.3%). This shows that compared to the rest, the hospital prioritises promoting informational content regarding RNSM.

Based on analysing the utilisation of the post types, statics were the most predominant (n = 7, 46.7%), followed by reels (n = 5, 33.3%) and carousels (n = 3, 20.0%). The greater ratio of static posts reflected the intent to deliver in-depth informational messages, whereas reels were leveraged as high-reach awareness drivers.

Table 2 consolidates the themes and types of content. Informational content was distributed across all post types (static, reel, carousel). Patient-centric testimonials were delivered only through carousels. Technology- and surgeon-centric posts were predominantly static, highlighting professional credibility, whereas awareness-related contents were evenly split between statics and reels.

Table 3 presents the granular performance figures, summarising post-level results across themes. Informational posts showed an average ERR of 14.26% with substantial variability, ranging from 36.6% for P05 (static) to 1.71% for P06 (static). Patient testimonial posts yielded a lower average ERR of 2.08%, reflecting limited interaction despite their credibility-focused nature. Technology- and surgeon-centric posts performed more strongly, with an average ERR of 21.85%, driven by the exceptional performance of P11 (static) at 35.55%. Awareness-oriented posts also demonstrated high engagement, achieving an average ERR of 21.66%, led by P14 (static), which recorded an ERR of 36.76%

As summarised in Table 4, static posts surpassed reels and carousels in engagement. Statics had the highest average ERR (27.84%), despite lower reach than reels, showing deeper engagement with the audience. Reels had the highest reach (3,42,384) and impressions, but had a lower ERR (5.19%), highlighting their effectiveness as awareness drivers rather than engagement tools. Carousels had the least effective ERR (2.10%). Across content types, impressions consistently outpaced reach, which has been indicated in Table 4, suggesting repeated exposure and improved message retention, for example, carousel posts collectively reached 1,897 users but registered 2,768 impressions, indicating re-engagement.

Taken together, the campaign combined scale and depth effectively: reels acted as awareness amplifiers (very high reach, modest ERR), while static educational and technology/surgeon posts produced deeper engagement (highest ERRs). Theme-wise, technology/surgeon and awareness content outperformed educational and testimonial posts on interaction rates. The dual reporting of mean and reach-weighted ERR, along with sensitivity analyses and evidence of repeated exposures (impressions > reach), supports the robustness of these findings and aligns with the abstract’s conclusion that a format-aware, theme-driven strategy is effective for communicating RNSM on Instagram.

DISCUSSION

This study evaluated a hospital-led Instagram campaign on RNSM using ERR as the primary outcome, reporting both the mean of post-level ERRs (15.14%) and the reach-weighted ERR (8.72%). The divergence between these metrics reflects format mix effects, particularly the dominance of high-reach reels with lower per-viewer interaction, reinforcing why normalised and weighted views of engagement should be presented together for campaign appraisal.^[8] Even with the conservative reach-weighted denominator, overall performance exceeded the 2025 healthcare benchmark of 1.6%,^[8] supporting the utility of Instagram in disseminating specialised surgical information.

Content characteristics mattered. Educational and awareness themes achieved consistently higher ERR than testimonials, which likely build credibility but invite fewer lightweight interactions, patterns reported in specialty and hospital studies.^[4,9,10] By format, statics produced the highest ERR (27.84%) despite lower reach. In contrast, reels delivered very high reach (86.5% of campaign reach) with modest ERR (5.19%), aligning with platform mechanics that privilege distribution over depth.^[11] This supports a complementary strategy: use reels to expand top-of-funnel awareness and statics to deepen understanding and intent. The strong performance of technology/surgeon-centric statics (e.g., P11 at 35.55%) suggests that credibility signalling can be effective when packaged as concise, didactic visuals—convergent with orthopaedic Instagram findings that educationally framed posts outperform pure promotion.^[4] Repeated impressions relative to reach and the inherently visual nature of Instagram likely aid comprehension and recall for complex procedures like RNSM, echoing evidence that social campaigns can improve public health awareness and support favourable behaviours.^[12]

Methodologically, we mitigated common biases by (i) normalising interactions to reach (ERR), (ii) reporting both mean and reach-weighted campaign ERR, (iii) flagging small-denominator posts and confirming stability in sensitivity analyses, and (iv) fixing a T+7 data-lock with a T+14 check (no change in rank ordering). These steps improve comparability with sector norms and with prior hospital social media analyses.^[8-13]

Limitations include the small sample (n = 15) and real-world, non-random content distribution by theme/format; limited power constrained formal modelling. Results are platform- and account-specific, limiting generalisability to other social media accounts, populations, or healthcare contexts, and we did not audit content accuracy, readability, or consent phrasing beyond institutional policy. We also lacked downstream behaviour and clinical endpoints (e.g., profile taps, appointment bookings, and screening uptake), which would more directly connect engagement to patient action. Future work should incorporate adjusted rate models with covariates (day/time, boost status), quality/ethics audits, and link analytics to funnel metrics (taps/DMs/appointments) and patient-level outcomes.

Practice implications. For specialised surgery communication, pair reels (awareness/scale) with static educational tiles (depth/intent), maintain a steady cadence of awareness and technology/surgeon content framed didactically, and deploy testimonials sparingly or in formats that nudge interaction (e.g., Q&A overlays, carousel “myth vs fact”). Benchmark both mean and reach-weighted ERR to avoid format-mix bias.

CONCLUSION

A targeted Instagram campaign can effectively communicate specialised surgical innovations such as RNSM, outperforming healthcare engagement benchmarks even under reach-weighted estimation. Static educational and technology/surgeon-centric posts delivered deeper engagement, while reels broadened reach, supporting a dual-track strategy that balances awareness with comprehension. Testimonials contributed credibility but drew lower interaction, consistent with prior literature. Hospitals and policymakers should prioritise evidence-based educational visuals and transparent credibility signals, track ERR alongside reach-weighted metrics, and link analytics to downstream actions to evaluate impact on decision-making. Future studies integrating qualitative feedback, cross-platform analytics, and patient-level outcomes will help refine best practices for digital surgical communication.