Social media is becoming a battleground in the fight over who is qualified to do plastic surgery.

As sites like Instagram and Snapchat become the go-to destinations for information for many patients, especially younger ones, plastic surgeons are intensifying their efforts to compete with one another, and with the increasingly dominating online presence of practitioners who aren’t specially trained in plastic surgery.

On Instagram, providers such as @therealdrmiami (with 655,000 followers recently), @docvegas (170,000), @dr.bbl (86,000) and others offer cosmetic services with a dizzying array of photos, videos and specials such as “Tummy Tuck Tuesday” and “First person to screenshot my Instagram site showing 50K followers gets 50 percent off procedures.”

It is all an effort to grab the attention of the estimated 40% of patients who say social media strongly influenced their choice of doctor for aesthetic plastic surgery, according to a study published in the April 2015 Aesthetic Plastic Surgery.

Board-certified plastic surgeons appear to be falling behind in the battle for social-media attention. Researchers at Northwestern University Feinberg School of Medicine found in a study published last month that less than 18% of the most popular surgery-related posts on Instagram were posted by plastic surgeons licensed by the American Board of Plastic Surgery. Many others were posted by doctors in other fields, such as gynecologists or emergency-medicine doctors, who didn’t undergo the six years of specialized training required for plastic surgery board certification. For other practitioners, the training can typically range from a one-year fellowship to a weekend course.

“All this confusing marketing is putting people at risk,” says Clark Schierle, a board-certified plastic surgeon at Northwestern Medicine in Chicago and senior author of the recent study in the Aesthetic Surgery Journal. Dr. Schierle adds that patients might not realize they are getting a doctor without a plastic surgeon’s training and experience.