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surgery (Figure 3A). Most respondents (60.4%) would choose a private practice surgicenter for the site of their surgery followed by a university medical center (36.5%) and a community hospital (4.1%). The rate of preference for surgery location (surgicenter vs university medical center) was significantly different for those individuals who had undergone prior plastic surgery versus those who had not (83.3% vs 56%, respectively; P = .03). There was no statistically significant correlation between preference for surgery location and age, sex, or income (Figure 3B). Table 1. Respondent demographics. Age, y, mean (range) 34.5 (18-67) Income,a $, mean (range) 91 298 (0-500 000) Sex Male 15 (15.6) Female 81 (84.4) Marital status Yes 54 (56.3) No 42 (43.8) Previous plastic surgery Yes 16 (16.7) No 80 (83.3) Values are presented as No. (%) unless otherwise indicated. a Adjusted mean ± SD, without participants who reported an annual income of $0: $106 886 ± $9067. Figure 1. (A) Responses to the question, “Do you draw a distinction between a plastic surgeon and a cosmetic surgeon?” (B) Responses to the question, “Which of the following training paths can produce a cosmetic surgeon?” Anes, anesthesiologist; Derm, dermatologist; OB-Gyn, obstetrician/gynecologist. Downloaded from https://academic.oup.com/asj/article/33/4/585/204723 by guest on 19 August 2022 588 Aesthetic Surgery Journal 33(4) Discussion Demand for cosmetic surgery in the United States continues to rise even with the backdrop of economic recession. Furthermore, an increasing number of providers from plastic surgery backgrounds and non–plastic surgery backgrounds alike are offering services to cosmetic patients. Understanding the general public’s interests as well as the factors they consider when selecting both procedure and surgeon are vital to the success of any cosmetic practitioner. This study attempted to investigate not only the general public’s interest in cosmetic surgery but also the criteria considered by members of the public when moving forward with procedure and provider selection. Our study findings are consistent with the continued demand for aesthetic surgery. Nearly 90% of respondents reported that they would consider plastic surgery in the future. Furthermore, our survey results suggest that cosmetic surgery is becoming increasingly socially acceptable, since not a single respondent cited concern over what others might think of them as a reason not to proceed with surgery. This seems to indicate that the negative stigma that may have been previously present for plastic surgery has been reduced. An interesting finding in our survey relates to the public perception of the “cosmetic surgeon.” Hamilton et al6 previously investigated this issue and found that the general public considered a cosmetic surgeon different from a plastic surgeon, with the former being thought of as a more temporary, less trained provider. Nearly 70% of respondents in our study also drew a distinction between a plastic surgeon and a cosmetic surgeon. However, only 8 of the 96 respondents correctly pointed to the fact that any physician with a medical degree was legally qualified to perform cosmetic surgery. The remainder of respondents felt that the cosmetic surgeon population was composed of either trained surgeons only or some arbitrary combination of surgical and nonsurgical practitioners (dermatologists, dentists, etc). This is made even more remarkable by the Figure 3. Responses to the question, “How important would each of the following be when considering your plastic surgeon?” Respondents rated each category on a 0 to 10 scale, with 10 representing the most important factor. (B) Responses to the question, “Where you would prefer to have plastic surgery done?” Figure 2. (A) Responses to the question, “On which part of the body would you be MOST interested in having plastic surgery?” (B) Responses to the question, “Which of the following is the principal reason you would NOT have plastic surgery?” Downloaded from August 2022 Galanis et al 589 finding that 1 of the primary considerations for respondents in selecting a plastic surgeon was board certification. These findings seem dichotomous. If respondents felt that board certification was important, that would seem to highlight the recognition that not all cosmetic surgeons were boardcertified, which should in turn indicate a distinction between a cosmetic surgeon and a plastic surgeon. These results suggest a major deficit in public understanding of what it means to be a board-certified plastic surgeon and what it means to be a cosmetic surgeon, which is consistent with previous findings by Kim et al4 and Dunkin et al,5 who also demonstrated the public’s general lack of understanding about which procedures a plastic surgeon is qualified to perform. As suggested by previous studies on public perception, it is imperative that the plastic surgery community educates the general public on this distinction, thereby ensuring that only properly trained practitioners are treating this growing population. The most important factor for patients in selecting their plastic surgeon was surgeon reputation. The factors creating and constituting “reputation” are, of course, subject
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