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Impact Of Perceived Physician Attractiveness On Cosmetic Plastic Surgeon Selection
Darya Fadavi, BS, Helen Xun, BS, Pooja Yesantharao, MS, Justin M. Sacks, MD, MBA, FACS.
Johns Hopkins School of Medicine, Department of Plastic and Reconstructive Surgery, Baltimore, MD, USA.

Purpose: Patients have a wide range of resources to consult when choosing a plastic surgeon. While a surgeon's training, years in practice, and patient outcomes are important factors in the decision-making process, personal bias about performance independent factors, such as the surgeon's appearance and attractiveness, may influence patient decision making. Physical appearance can be particularly influential in the cosmetic surgical field, and thus may impact which surgeon a patient would prefer to see. Only the influence of physician gender has been looked at in the field of plastic and reconstructive surgery, so this study aims to analyze the effect of physician attractiveness on cosmetic surgeon selection. We also analyze whether modifiable factors, such as degree of makeup applied in women, can mitigate preference among female surgeons.

Methods: In an IRB exempt study, surveys were distributed through mechanical Turks and data was collected through Qualtrics. Participants were shown literature validated computer generated images of an individual altered to be very attractive, average, and very unattractive, and asked to rank the likelihood that they would see this surgeon for a cosmetic surgical procedure. Participants were also shown faces of two individuals (one white and one black) with varying degrees of makeup (none, minimal, and moderate), and again asked to rank the likelihood that they would see this surgeon for a cosmetic surgical procedure.

Results: 328 respondents consisted of 202 females (61.6%), 123 Males, and 3 Non-binary individuals, with a mean age of 36.9 12.6 years. Compared to the average and very unattractive surgeon, the very attractive surgeon had the highest likelihood of being seen by the surveyors for a cosmetic surgical procedure (p<0.001) (Table 1). When asked to rank images of faces with makeup (from 1 to 6), the image of the white woman with minimal makeup was ranked highest (1.9, p<0.001) and the image of the black woman with no makeup was ranked lowest (5.2, p<0.001) (Table 1).

Conclusions: Our study demonstrates a positive correlation between attractiveness of cosmetic surgeons and increased likelihood of being selected by a patient. This linear association applied to natural appearance, however, and wasn't directly linked to an increasing preference with an increasing amount of makeup. Of the six images of levels of makeup, the most preferred was the white image with minimal makeup. This could imply that participants did not correlate a moderate level of makeup as more attractive than a minimal amount. However, we cannot discount the possibility that more makeup is not preferred for an alternate reason, such as decreased perceived professionalism. While the use of makeup can to some degree compensate for natural appearance, surgeon appearance has a significant effect on the degree of patient preference, which has implications for a surgeon's professional success. These findings can better help inform both patient and provider when attempting to reach an informed decision for cosmetic reconstruction.

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