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Thorne, Charles H. M.D.

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Plastic and Reconstructive Surgery: August 2010 - Volume 126 - Issue 2 - p 688
doi: 10.1097/PRS.0b013e3181de1a45
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The authors have corrected my mistakes regarding interpretation of their statistics. I thank them for that and I apologize for my statistical naiveté.

They have in their discussion, however, admitted an important bias in a way that is more clear, and more alarming, than I could ever articulate in a Discussion. They state, “This study was based on an idea that most women to a certain degree are dissatisfied with their appearance, but although some would be interested in a surgical fix, others would aim at different and perhaps more healthy solutions to their dissatisfaction, such as to develop strategies to accept their appearance as it is, or to change their body through physical exercise.”

In other words, the authors admit that they began their study with the belief that cosmetic surgery was a less healthy solution to dissatisfaction with appearance than other methods. Unfortunately, this reveals more than a bias, it reveals a lack of understanding about cosmetic surgery. If the authors understood that cosmetic surgery is not indicated for any problem that can be remedied by exercise, they might have approached their study differently.

Obviously, I have a bias in favor of plastic surgery as an option for some patients, and the authors of this article have a bias against it. We will not solve that here. I would only hope the authors would be more informed about a subject before writing about it.

Charles H. Thorne, M.D.

812 Park Avenue

New York, N.Y. 10021

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