Minority Representation in Before and After Photographs on the American Society of Plastic Surgeons Website
Year: 2025
Type: article
Abstract: The racial demographics of patients pursuing cosmetic procedures (CPs) in the United States are diverse.1 However, racial minorities tend to undergo disproportionately fewer CPs than their White counterparts.1 This discrepancy is likely due to a variety of confounding factors including cultural and socioeconomic differences. This underrepresentation also represents a potentially unserved patient population and an opportunity for plastic and reconstructive surgeons to grow their patient base. In addition to these factors, the representation of advertised CPs may also play a role in the disproportionately fewer CPs seen in non-White patients. The American Society of Plastic Surgeons (ASPS) website contains a “Before & After” (BA) section of popular CPs.2 Members of the ASPS with patient consent have the ability to upload their patients’ BA photographs, effectively advertising their work directly to the public and managing potential patient expectations of anticipated results. As authors, we were interested in further investigating the degree of racial representation on the BA section of the ASPS website. On August 23, 2024, 2 authors of this article (F.B. and A.H.) independently reviewed the racial distribution of patients’ BA photographs in 5 of the most popular CPs (liposuction, breast augmentation, abdominoplasty, rhinoplasty, and blepharoplasty).1,3 BA photographs were limited to the first 100 patients under each procedure. Because race is a social construct that is difficult to quantify through visual observation and analysis, fair versus dark skin was utilized as a proxy for White versus non-White patients. The findings on the BA section of the ASPS website were then compared with the demographic information of plastic surgery procedures released by the ASPS.1 Figure 1 shows that White patients are overrepresented on the ASPS website in every CP investigated. The greatest discrepancy between ASPS representation and the actual number of minorities receiving CPs is seen in liposuction. These results may be due in part to greater acceptance of cosmetic surgery among White patients and, therefore, an increased willingness to provide consent to display their procedural results. It may also be suggestive of an underlying bias among plastic and reconstructive surgeons, favoring the display of results from their White patients over their minority counterparts.Fig. 1.: Racial demographics of popular cosmetic surgery vs ASPS website representation.The purpose here is to draw attention to the underrepresentation of minority patients on the ASPS website as this is likely a public resource utilized by patients from all demographics to better understand the potential benefits of CPs. Although the photographs uploaded to the BA section on the ASPS website are done so by members, rather than the organization itself, the overrepresentation of White patients may be influenced by member demographics as plastic surgeons as a whole are disproportionately White.4 The lack of CP results for non-White patients on the ASPS website likely makes it more difficult for minority patients to self-visualize the results of various CPs. This lack of representation could contribute in part to the underutilization of CPs by these groups. Members of the ASPS should take note of these findings and consider intentionally increasing their efforts to upload BAs of minority patients so the ASPS website is more reflective of the diverse patient population that cosmetic surgeons serve. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.
Authors: Forrest Bohler, Ava Harvey, Caleb North
Institutions: Oakland University, Montana State University
Language: English
Subfield: Gender Studies
Field: Social Sciences
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,195
OpenAlex ID: W4407388910