An Analysis of Racial Diversity in the Breast Reconstruction and Aesthetic Surgery Literature

Chawla, Sahil; Shihadeh, Hanaa; Patel, Ashit

doi:10.1097/gox.0000000000004487

Cited by 6 publications

(14 citation statements)

References 26 publications

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“…Many studies used Fitzpatrick skin types judged from photographs obtained on the Internet 16,18,38,77,126 . Most investigators recognize that skin type does not correlate well with race 23,86,128 .…”

Section: Discussionmentioning

confidence: 99%

“…Many studies used Fitzpatrick skin types judged from photographs obtained on the Internet. 16,18,38,77,126 Most investigators recognize that skin type does not correlate well with race. 23,86,128 Some Blacks have type IV skin types, and many Indian Americans have skin types (V and VI) that are similar to Blacks.…”

Section: Fitzpatrick Skin Typesmentioning

confidence: 99%

“…142 The recent emphasis on diversity coincides with the introduction of new terminology. In addition to diversity, equity, and inclusion, new catchwords and phrases include antiracism, 19,60 implicit bias, 19,59,77,128 race concordance, 10,27,28,47,79,86,118,124,125 cultural competency, 10,14,18,19,61,77,89,90,110,117 cultural humility, 19 intersectionality, 11,41,53,114 microaggressions, 19,23,62,69,79,83 White privilege, 19 allyship, 19 toxic mentorship, 67 and hypermasculinity. 67 The word "merit" infrequently appears.…”

Section: Language Of Diversitymentioning

confidence: 99%

“…Race is not a biological category, but rather a social construct. 23,77 Massie et al 16 provocatively conclude, "Skin tone does not define race. Ancestry does not define race.…”

Section: Fitzpatrick Skin Typesmentioning

confidence: 99%

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Diversity, Equity, and Inclusion in Plastic Surgery

Swanson

2024

Ann Plast Surg

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Background The number of publications on the subject of diversity, equity, and inclusion has surged in the last 5 years. However, a systematic review of this topic has not been published. Method Six top plastic surgery journals were queried from 2018 to 2023 using the search term “diversity.” Methods, conclusions, and recommendations were tabulated. Results A total of 138 publications were identified; 68 studies presented data suitable for analysis. All studies were retrospective. Currently, over 40% of plastic surgery residency applicants are women. The proportion of women in integrated plastic surgery residents is now 43%. In 2021 and 2022, the percentage of female first-year residents exceeded men. The percentage of female presenters at meetings (34%) is double the number in the workforce (17%). Twenty-five percent of academic faculty positions and 22% of program director positions are now held by women. Underrepresented minorities account for fewer than 10% of applicants to integrated plastic surgery residencies. Discussion The proportion of Black and Hispanic applicants to integrated plastic surgery residencies (6% and 8%, respectively) mirrors the proportion of Black and Hispanic medical students (7% and 6%, respectively). Numerous recommendations have been made to increase the proportion of underrepresented minorities in plastic surgery programs. Conclusions The representation of women in plastic surgery has increased dramatically. A lack of Hispanics and Blacks reflects a small pool of applicants, as opposed to a “leaky pipeline.”

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Section: Discussionmentioning

confidence: 99%

Section: Fitzpatrick Skin Typesmentioning

confidence: 99%

Section: Language Of Diversitymentioning

confidence: 99%

“…Race is not a biological category, but rather a social construct. 23,77 Massie et al 16 provocatively conclude, "Skin tone does not define race. Ancestry does not define race.…”

Section: Fitzpatrick Skin Typesmentioning

confidence: 99%

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Diversity, Equity, and Inclusion in Plastic Surgery

Swanson

2024

Ann Plast Surg

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“…Current medical research and education lacks a robust understanding of skin color as an objective variable, making it difficult to quantify its impact as both a social and physical determinant of health. 1–4 Physical colorimeters or spectrophotometers are the current gold standard to objectively quantify skin color independently from race or ethnicity. 5–7 These tools, however, must be used in person with the patient present.…”

Section: The App: the Skin Analyzermentioning

confidence: 99%

A Novel Method to Determine Patient Skin Type: The Skin Analyzer

Mohamed,

Koussayer,

Randolph

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Measuring skin color for medical research in an objective and nonbiased manner usually requires expensive equipment such as spectrophotometry and requires the subject to be present in person. We present a novel method to measure skin color from photographs using the Skin Analyzer application as a more effective, accessible, and efficient alternative. A desktop application, the Skin Analyzer, was developed to convert skin samples collected from digital images to the L*a*b color space and uses those values to calculate an individual typology angle that correlates to a Fitzpatrick skin type. To assess accuracy in variable lighting, six known colors representing the six Fitzpatrick skin types were printed and photographed in 15 separate locations within the hospital. To account for user variability in sample selection, interrater reliability was calculated with data generated by 13 untrained users testing the app on six subjects. The accuracy of measuring known values, which is the classification accuracy, was calculated to be 80%. Krippendorff alpha test was used to evaluate interrater reliability. The obtained alpha of 0.84 indicates a high interrater reliability. The high accuracy and reliability make the Skin Analyzer a suitable method of objectively determining Fitzpatrick skin type from images. The app may be used to investigate the effects of skin tone in various areas of interest, especially in retrospective studies where skin colorimeters cannot be used.

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Anatomy's missing faces: An assessment of representation gaps in atlas and textbook imagery

Beresheim,

Zepeda,

Pharel

et al. 2024

Anatomical Sciences Ed

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Previous research suggests that underrepresentation in medical curricula perpetuates inequities in healthcare. This study aimed to quantify the prevalence of human phenotypic diversity (e.g., skin tone, sex, body size, and age) across 11 commonly used anatomy atlases and textbooks in pre‐clerkship medical education, published from 2015 to 2020. A systematic visual content analysis was conducted on 5001 images in which at least one phenotypic attribute was quantifiable. Anatomy images most prevalently portrayed light skin tones, males, persons with intermediate body sizes, and young to middle‐aged adults. Of the 3883 images in which there was a codable skin tone, 81.2% (n = 3154) depicted light, 14.3% (n = 554) depicted intermediate, and 4.5% (n = 175) depicted dark skin tones. Of the 2384 images that could be categorized into a sex binary, 38.4% (n = 915) depicted females and 61.6% (n = 1469) depicted males. A male bias persisted across all whole‐body and regional‐body images, including those showing sex organs or those showing characteristics commonly associated with a specific sex (e.g. for males, facial hair and/or muscle hypertrophy). Within sex‐specific contexts, darker skin was underrepresented, but male depictions displayed greater overall skin tone variation. Although most images could not be assigned to a body size or age category, when codable, these images overwhelmingly depicted adults (85.0%; 482 of 567) with smaller (34.7%; 93 of 268) or intermediate (64.6%; 173 of 268) body sizes. Ultimately, these outcomes provide reference metrics for monitoring ongoing and future efforts to address representation inequalities portrayed in anatomical imagery.

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An Analysis of Racial Diversity in the Breast Reconstruction and Aesthetic Surgery Literature

Cited by 6 publications

References 26 publications

Diversity, Equity, and Inclusion in Plastic Surgery

Diversity, Equity, and Inclusion in Plastic Surgery

A Novel Method to Determine Patient Skin Type: The Skin Analyzer

Anatomy's missing faces: An assessment of representation gaps in atlas and textbook imagery

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