Does Surgeon Gender Matter for Aesthetic Patients?

BACKGROUND: Plastic surgery patients have expectations for an ideal practice to visit. However, patients' preferences regarding their plastic surgeon are still being described. OBJECTIVES: The aim of this study was to investigate if elective cosmetic plastic surgery patients exhibit gender preference in their plastic surgeon when making online inquiries. METHODS: A retrospective, single-practice review of all online inquiries for elective plastic surgery and nonsurgical injectable treatment from June 2019 to June 2020 was performed. The study was based on a private practice located in Houston, TX. The practice surgeons were a married couple, 1 female and 1 male, with identical training, age, and post-residency experience. Patients submitted an online inquiry for their procedure of interest and surgeon preference via the practice website. RESULTS: The private practice received 873 online inquiries during the year-long study period. The majority of patients were female, 855 (97.9%), and the remaining 18 (2.1%) were male. Of the female patients, 476 (55.7%) preferred a female surgeon and 138 (16.1%) preferred a male surgeon; 241 (28.2%) female patients expressed no surgeon preference. Regardless of surgeon preference, the majority of procedures inquired about were breast and body contouring. CONCLUSIONS: This cohort of female patients prefers the female surgeon for breast procedures or multiple procedures involving the breast, and the male surgeon for injectable procedures and facial procedures. There is no preference for the male or female surgeon for body procedures. Female plastic surgery patients may be influenced by surgeon gender in choosing their surgeon, depending on their surgery of interest.

Aesthetic subunit of the breast: an analysis of women's preference and clinical implications.

Patient satisfaction in breast surgery is dependent on achieving a balance among all aesthetic subunits. The purpose of this study is to identify which subunit of the breast women consider important and correlate this clinically to improve patient satisfaction following breast surgery. A total of 313 subjects (ages, 20-80) were surveyed using a 25-point survey instrument collected via a telemedicine form. The data was analyzed to determine clinical significance. Of the subjects, 63% selected the upper inner quadrant as the most important subunit. Furthermore, 66% of the subjects indicated defects located in this region would lead them to seek operative intervention and this was consistent for all subgroups. Based on these results, defects in the upper inner quadrant of the breast are more likely to cause patient dissatisfaction. Patient outcomes following surgery can be enhanced by restoring volume and minimizing scars in this upper medial subunit of the breast.

An Analysis of Female Plastic Surgery Authorship: Where Are We Today?

BACKGROUND: Authorship in a peer-reviewed journal is highly regarded in both the academic and private sectors of plastic surgery. Recently, several articles have cited an increased contribution from women in the plastic surgery literature; however, none to date has analyzed the demographic trends of these female authors. The purpose of this study was to conduct an analysis of female authors in three well-known plastic surgery journals. METHODS: Articles published in Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and Aesthetic Surgery Journal between January of 2015 and December of 2015 were reviewed. Supplemental journal, review, and CME articles were excluded. First, second, and last authors from the United States were reviewed and stratified by a number of categories, including sex, geographic location, and title. RESULTS: Two-thousand fifty authors were reviewed. Of these, 20 percent of first authors, 24 percent of second authors, and 15 percent of last authors were women. Female representation was fairly equal among the journals, and 39 percent of women authors were international. Overall, 16 percent of fully trained plastic surgeon authors and 25 percent of resident authors were women, as compared to 15 percent female fully trained plastic surgeons and 36.2 percent female residents represented in the overall community. CONCLUSIONS: Faculty are on par with national percentages of women plastic surgeons; however, women residents have lower representation in the literature than in the community as a whole. Residents and faculty must promote productivity of the younger generation of women plastic surgeons to continue increasing contributions of women to the specialty.

Inset of Unilateral Dual Microvascular Breast Reconstruction Using Nonabdominal Free Tissue Transfer.

BACKGROUND: Large breasted patients are difficult to reconstruct using free tissue transfer after mastectomy when abdominal tissue is inadequate. For these, two unilateral free flaps may be required. This study reviews the authors' experience using transverse upper gracilis and profunda artery perforator flaps. METHODS: Through retrospective chart review, subjects were divided into three groups based on vascular anastomotic orientation: group 1, thoracodorsal and internal mammary; group 2, noncrossed internal mammary; and group 3, crossed internal mammary. Statistical comparison determined differences between groups for peri-operative "take-backs" and flap survival. RESULTS: Twenty-one subjects underwent 42 free tissue transfers for unilateral breast reconstruction. Perioperative complications requiring return to the operating room occurred as follows for each group: group 1, two of four flaps (50 percent); group 2, two of two flaps (100 percent); and group 3, two of 36 flaps (5.5 percent). Long-term flap survival was as follows: group 1, three of four flaps (75 percent); group 2, zero of two flaps (0 percent); and group 3, 36 of 36 flaps (100 percent). Both the incidence of perioperative complications (p = 0.0011) and flap survival (p = 0.0008) were statistically significant in the three groups. CONCLUSIONS: Use of double free tissue transfer consisting of transverse upper gracilis or profunda artery perforator flaps is a feasible option for unilateral autologous breast reconstruction. In the authors' experience, horizontal inset with crossed pedicles to the internal mammary system is the safest and most reliable technique for flap and pedicle inset.

The dorsal metacarpal artery perforator flap: a case report utilizing a quaba flap harvested from a previously skin-grafted area for dorsal 5th digit coverage.

Burns to the hand are common in burn victims. These burns often leave complex wounds that require local flaps for coverage. Local flaps are often excluded because they lie within the zone of thermal injury. The purpose of this case report is to report the successful use of a Quaba flap harvested from a previously burned and skin-grafted area. The patient's medical record including pre-operative, intra-operative, and post-operative photographs were reviewed and utilized as sources of data. The patient tolerated the procedure well and was able to return to his previous hand therapy regimen without adverse event and with an acceptable cosmetic result. The Quaba flap can be a safe and effective option for local hand coverage even in previously burned and skin-grafted areas.