Background:In the patient-driven market of aesthetic surgery, an understanding of the factors that patients consider in their choice of surgeon can inform the individual plastic surgeon’s marketing strategy. Previous studies have investigated patient gender preferences for physicians in other specialties, but none has investigated whether patients consider gender when choosing a plastic surgeon.Objectives:The purpose of this study is to determine the impact of a plastic surgeon’s gender on patient choice.Methods:A prospective study was conducted in a single private practice of two plastic surgeons, one male and one female, both closely matched in training, experience, and reputation. Two hundred consecutive patients calling for a consultation were asked if they preferred a male or female doctor; their preference, age, and area(s) of interest were recorded.Results:All patients were women. Nearly half (46%) had no gender preference, 26% requested a female surgeon, and 1% requested a male. Preference for a female surgeon was significant (Binomial-test: P < 0.001). The remaining 27% requested a specific doctor, with slightly more requesting (53.7%) the male surgeon by name, than requested the female surgeon by name (46.3%), a difference that was not statistically significant (P = 0.683).Conclusions:Most female patients interested in aesthetic surgery have no gender preference. Of those who do, nearly all requested a female plastic surgeon. More important than a plastic surgeon’s gender, however, is a plastic surgeon’s reputation.

BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma for which clinical examination up to 10 years is recommended. The objective of this study was to identify prognostic factors for recurrences and metastases that can be used to evaluate the validity of follow-up schedules after treatment for DFSP. METHODS: Patients with DFSP who received treatment between 1991 and 2016 at 3 tertiary centers were included. Cox regression analyses were conducted to identify variables associated with the primary endpoints. RESULTS: In total 357 patients were included, with a median age of 38 years (age range, 2-87 years) and a median follow-up of 60 months (interquartile range, 24-115 months). Eighty-one patients developed recurrent disease (22.7%), and the median time to recurrence was 55.5 months (interquartile range, 20-90 months). Of these, 50 tumors (61.7%) were identified by patient self-examination, whereas 3 recurrences (3.7%) were identified at clinical surveillance. For the remaining 28 tumors, no information was available on how the recurrences were identified (34.6%). Fibrosarcomatous change (hazard ratio, 21.865; P < .001), and positive resection margins (hazard ratio, 14.645; P < .001), were independent prognostic factors for recurrence. Metastases occurred in 4 patients (1.1%). All tumors were identified by imaging after patients presented with symptomatic metastases. Fibrosarcomatous change (P < .001) and tumor size >5 cm (P = .014) were associated with the development of metastases. CONCLUSIONS: Disease recurrence after resection of DFSP remains a significant issue, whereas metastases are uncommon. The majority of recurrences are identified by patient self-examination. Consideration should be given to individualized follow-up schedules based on risk factors for recurrences and metastases. Cancer 2019;125:735-741.

Delayed-immediate autologous reconstruction should be considered as an option for patients wanting autologous reconstruction when the need for RT remains unknown. Delayed-immediate autologous reconstruction demonstrates better breast contour/size/position and overall aesthetic outcome.