Currently submitted to: Journal of Medical Internet Research
Date Submitted: May 14, 2026
Open Peer Review Period: May 14, 2026 - Jul 9, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Multinational Assessment of Readability in Online Informed Consent Forms for Implant-Based Breast Augmentation
ABSTRACT
Background:
Breast augmentation is one of the most performed aesthetic surgical procedures worldwide. Given its elective character and potential complications, clear and comprehensible informed consent is essential.
Objective:
To evaluate and compare the readability of online informed consent forms for implant-based breast augmentation in languages used in countries with the highest procedural volumes according to the 2024 ISAPS survey.
Methods:
The phrase “breast augmentation consent form” was translated into eight languages and searched using Google in private mode. After applying exclusion criteria, 77 documents were analysed. Readability was assessed using the LIX index.
Results:
The overall mean LIX score was 53 ± 9, corresponding to very difficult texts. Significant differences in readability were observed between languages (P < .001). English-language forms demonstrated the lowest mean LIX (46 ± 7), classified as difficult, whereas Portuguese (55 ± 9), Italian (58 ± 6), and Turkish (63 ± 2) reached very difficult or highly complex levels. No document achieved an “easy” or “moderately difficult” classification. There were no statistically significant differences in readability between private and non-private practice sources, nor any correlation between the number of available forms and mean LIX values.
Conclusions:
Online consent forms consistently exhibit high linguistic complexity, underscoring the need for systematic simplification and standardisation.
Citation
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