LAUSR

The authors of “The Impact of a Plastic Surgeon’s Gender on Patient Choice” are to be commended for their well-designed and executed study on an important aspect of the drivers and marketing of elective aesthetic surgery.1 The overwhelming majority of patients seeking aesthetic surgery in the United States are females,2 with no prior study addressing specifically whether these patients prefer gender concordance with their surgeon. Ideally, in order to isolate for gender preference, a sample of females actively seeking aesthetic surgery would be asked whether they preferred a male or a female surgeon, with all other surgeon factors being the same. This sample would be difficult to execute in practice, given that rarely are all the other surgeon factors the same, or nearly the same, which is why this particular study is so interesting, and valid. The authors’ unique practice environment allowed for the reduction or elimination of several potentially confounding factors in this study. The authors, FLC and HJF, have an almost identically matched practice in terms of surgeon age, training, time in practice, practice mix, and reputation.3,4 In effect, this well-matched “couple” differs almost exclusively in gender, allowing them to answer the question, “Do female patients prefer a woman surgeon for aesthetic surgery?” Like the authors of the study, the authors of this commentary are another “couple” who are likewise well matched in all of the identical factors. Drs Furnas and Canales utilized their entirely aesthetic surgery practice, consisting of one female and one male surgeon, to prospectively sample two hundred consecutive patients (all female) inquiring into the practice, to determine if they preferred a male or a female surgeon. They found that 46% of patients had no gender preference, 26% requested a female surgeon, and 1% requested a male surgeon, which was statistically significant (P < 0.001). The remaining 27% requested a specific surgeon by name before being asked whether they preferred a male or female surgeon, with these numbers being roughly equivalent between those preferring the male surgeon (14.5%), and the female surgeon (12.5%), with no statistical significance between the two (P = 0.683). The authors contend this cohort of patients requesting a surgeon by name is representative of patients who chose a surgeon on the basis of reputation alone, not gender, so they were effectively negated from the overall number of patients with a gender preference. This would indicate that a majority (73%) of women have no gender preference in their surgeon, and those who do overwhelmingly prefer a woman, at a ratio of 26 to 1. Although we do not know definitively how many of those patients who chose a surgeon by name used gender as a factor in their choice, it would be reasonable to assume gender of the surgeon played some role in their choice. If all of these patients were attributed to a gender preference group, those preferring a female surgeon would increase from 26% to 38.5%, and those preferring a male surgeon would increase from 1% to 15.5%. Those without a gender preference would remain at 46%. It is interesting