“The Impact of Race, Age, Gender, Income, and Level of Education on Motivations to Pursue Cosmetic Surgery and Surgeon Selection at an Academic Institution”
Cassandra A. Ligh, M.D. Lanair A. Lett, M.B. Robyn B. Broach, Ph.D. Fabiola A. Enriquez, B.A. Atasha Jordan, M.D., M.B.A. Ivona Percec, M.D., Ph.D. Joseph M. Serletti, M.D. Paris D. Butler, M.D., M.P.H. Division of Plastic and Reconstructive Surgery 800 Walnut Street, 19th Floor Penn Medicine Washington Square Philadelphia, Pa. 19107
Full article here: https://pubmed.ncbi.nlm.nih.gov/32332533
We’ve touched on the highlights of this paper, but it has significant depth so we recommend reading it in full.
There are misconceptions about the type of patients who seek plastic and reconstructive surgery. Relying on assumptions means that practices will miss significant opportunities.
Consciously or unconsciously, inaccurate beliefs about who and why a patient seeks plastic surgery will drive business decisions for surgical practices. It also impacts professionals entering the field and the experience of patients whose lives are improved by aesthetic surgery.
Bear in mind that there are limitations. The paper reviewed survey responses from 172 patients at an academic institution In Pennsylvania. It is a limited sample of a specific population, so use caution before generalizing to broader groups. However, there were some features of this study that make their findings even more interesting.
The majority of the findings were represented in tables with odds ratios and 95% confidence intervals. To make the data more visually appealing, we converted the data to forest plots, where the vertical line crossing intersecting at “1” represents no effect. Any data point to the left of this line represents an idea that the respondent was less likely to agree with; if to the right, an idea that the respondent was more likely to agree with. The horizontal line through each data point represents the 95% confidence interval. If this line crosses the vertical line at “1”, then the data point is not statistically significant. Latino and Asian groups were not included in our analysis due to the small sample size.
The data shows that race/ethnicity, gender, education, and income affect views on plastic surgery.
African American patients were 2.31 times more likely than Caucasians to “think that a plastic surgeon that shares the same race/ethnicity as me can better address my concerns and provide me with a more desired result.” They were 2.37 times more likely to “actively” search for a surgeon who was of the same race or ethnicity.
African American patients were 2.41 times more likely to “believe that people of different races have different attitudes regarding cosmetic surgery.” Congruent with that idea, African Americans were 7.36 times more likely to rate the hips and buttocks as the most important feature in attractiveness, and only one quarter as likely as Caucasians to rate the face as the most important area.
These beliefs are powerful enough to drive action.
The research team found that African American patients were much more likely to travel to see their preferred surgeon. They were 3.41 times more likely than Caucasian patients to be willing to travel more than 100 miles to see a surgeon that shares their same gender or race/ethnicity, and 4.92 times more likely to “have considered going to international plastic surgeons to achieve my cosmetic surgery goals.”
Income has an interesting effect, regardless of race. Patients who earned more than $125,000 annually were compared to patients earning less than $125,000. Higher earners were 2.91 times more likely to believe that “a surgeon that shares the same gender as me can better address my concerns and provide me with a more desired result.” They were 2.21 times more likely to say that “Societal standards have influenced my decision to have plastic surgery.” They were 4.97 times more likely to say that the face was the most defining feature of beauty.
These findings are in contrast to the reports based on race alone.
The authors of the study went further with the analysis to determine if combining race and income looked the same as when they were analyzed separately. The authors controlled for age, sex, education, and marital status to be as precise as possible. Many responses still paralleled race and ethnicity preferences.
African American patients were 4.33 times more likely to “have considered going to an international surgeon,” 3.11 times more likely to “have actively sought out a plastic surgeon” of the same race or ethnicity, and 2.9 times more likely to think a plastic surgeon of their race or ethnicity would address concerns and provide better results. They were 3.31 times more likely to be willing to travel 100 miles or more to see a surgeon of their race or ethnicity. They were also 5.78 times more likely to find the buttocks and hips the most attractive feature.
Some results from race/ethnicity-focused analysis washed out when income was considered. In the initial analysis, African Americans were more likely to believe that people of different races had different attitudes toward cosmetic surgery and to believe that a surgeon of their gender would provide more satisfactory work. They also reported that cost had been a barrier to pursuing cosmetic surgery.
There is notable concordance between race/ethnicity-based preferences and the preferences seen when race and income were considered jointly.
Survey responses imply that patients had strong feelings about identifying with their surgeon’s race or ethnicity. In competitive environments, a viable future may hinge on how well a practice honors patient preference.
The entire profession could be stunted by a lack of diversity. African American patients were 4.33 times more likely to consider international travel for their procedure if they thought it would help them get their desired result.
Garnes Society is committed to helping minority plastic surgeons succeed on their professional path. Plastic and reconstructive surgery needs greater diversity to serve our patients and remain viable in a global economy. Mentorship, support systems, and professional equity are critical.
Garnes Society is developing relationships, gathering information, and promoting minority representation in plastic surgery. Leadership is not a destination. It’s a path. We invite you to walk with us.
Ligh CA, Lett E, Broach RB, Enriquez FA, Jordan A, Percec I, Serletti JM, Butler PD. The Impact of Race, Age, Gender, Income, and Level of Education on Motivations to Pursue Cosmetic Surgery and Surgeon Selection at an Academic Institution. Plast Reconstr Surg. 2020 May;145(5):932e-939e. doi: 10.1097/PRS.0000000000006734. PMID: 32332533.
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