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cosmetic surgery market has become increasingly competitive, motivating more physicians of all specialties to perform cashbased cosmetic procedures.31 To steer prospective patients to their members, competing professional organizations have created online patient guides and surgeon search forms.32-34 Individual surgeons’ websites often include content that may be seen as attractive or reassuring to prospective patients, such as a surgeon’s biography, years of practice experience, board-certification, area(s) of surgical Figure 2. Distribution of interests among 200 inquiring patients. Of those patients, 180 had a single interest, and 20 had two interests, with 131 interested in breast, 41 interested in body, 29 interested in face, and 19 interested in genital surgery. Figure 3. Distribution of surgical interests by inquiring patients’ surgeon gender request. The horizontal axis indicates the inquiring patients’ surgeon gender preference (male; female; no preference; request by name for the female surgeon; request by name for the male surgeon). Surgical interests were categorized as breast (blue), body (red), face (green), and genital (purple). The vertical axis indicates the number of patients interested in each category. Huis in ’t Veld et al 469 interest, before-and-after photos, and quotes from happy patients. In addition, women plastic surgeons sometimes include their gender as a positive attribute. While patient gender preferences have been studied in other medical and surgical specialties, similar studies among plastic surgery patients have been primarily anecdotal.20 The purpose of this study was to determine whether a plastic surgeon’s gender matters in patient choice. The results indicated that nearly half of patients surveyed had no preference regarding the gender of their surgeon. If we consider only those patients who did not request a specific doctor, nearly two-thirds (63.01%) had no gender preference. Among those who did, 35.61% of all patients preferred a female doctor, and just 1.37% preferred a male. This was statistically significant. However, of those requesting a specific doctor, slightly more patients requested FLC, the male surgeon, than requested HJF, the female, a difference that wasn’t statistically significant. Patients considering body surgery cared least about their surgeon’s gender, with nearly two-thirds (65.85%) having no gender preference and only 16.67% requesting a female doctor. Nearly a quarter of those interested in breast and face preferred a female surgeon, possibly indicating the greater privacy associated with breasts and a greater preference for gender concordance among older women. Among patients with a genital interest, no one requested either a male surgeon or FLC, while half preferred a female and 16% requested HJF. Just as primary care patients preferred female doctors the more intimate their concern,18,19 plastic surgery patients considering female genital procedures may have a greater preference for a female surgeon for the same reason. All patients in this study were women, mirroring the nationwide statistic that 90% of cosmetic surgical procedures are performed on women.1 Most patients with a gender preference requested a female doctor. Although the patients surveyed were not asked to provide a reason for their preference, based on studies indicating patient preference for gender concordance,17,22 it is possible that these female patients sought a same-gender doctor rather than any perceived superiority in the skills or qualities of female surgeons.17,22 At the time of this writing, just 14% of plastic surgeons are women, but they make up 37% of trainees.35 Female patients for whom gender concordance is important may welcome the growing choice of female plastic surgeons. Nonetheless, our study reflects the results of other studies showing that the surgeon’s gender doesn’t matter to most patients.9-13,19,21 Instead, studies have shown that other qualities matter, like demeanor, thoroughness, and humanity.10,30 When choosing a thoracic surgeon, patients prefer someone assertive and independent, but for a breast surgeon, they prefer a more communicative doctor.10 In our study, gender preferences disappeared when patients knew enough about a doctor to request him or her by name, a finding aligned with these other studies showing that a surgeon’s personal qualities matter more to patients than does gender. A patient who doesn’t know of a surgeon’s personal qualities may base surgeon choice on qualities generally associated more with one gender more than the other. Rather than ranking one gender as better or worse than the other, these qualities may simply indicate a difference. Among primary care and urology patients, most women preferred a female doctor, and most men preferred a male doctor,17 which suggests a search for gender concordance. Bertakis et al speculated that traditional male-female relationship dynamics may make an encounter between a female physician and male patient less comfortable for both partners than one between a male physician and a female patient or one in which the genders are the same.22 In this study, 26% of patients preferred a female doctor and 1% preferred a male. Given our female patient population, this finding may indicate a search for
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