title: Female plastic surgery patients prefer mirror-reversed photographs of themselves: A prospective study.
abstract: BACKGROUND
  The use of a patient's image in plastic surgery is common today. Thus, plastic surgeons should master the use of the image and be aware of the implications of the patients' perception of themselves. The mere-exposure effect is a psychological phenomenon in which a person tends to rate things more positively merely because (s)he is familiar with them. Faces are asymmetric, so faces in photos are different from those observed in mirrors. The main objective of this study was to assess whether patients within a plastic surgery population, particularly those undergoing facial aesthetic surgery, preferred standard photographs or mirror-reversed photographs of themselves.
  
  
  METHODS
  A prospective study was conducted in a plastic surgery department, which included women who were admitted to the hospital the day before their procedures. The patients were separated into the following two groups: Group 1 was composed of patients who were undergoing facial aesthetic surgeries, and Group 2 consisted of other patients who presented to the plastic surgery department for surgery. The patients were required to rate their appreciation of their own faces and to choose between standard and mirror-reversed photos of themselves.
  
  
  RESULTS
  A total of 214 patients participated. The median age was 47.9 years (interquartile range (IQR): 36.4-60.6), and the median face appreciation was 5 (IQR: 5-7). The preference for the mirror-reversed photograph was significantly different from chance (p < 0.001, binomial (214, 156, 0.5)); 73% of the patients preferred the mirror-reversed photographs. The proportions of patients who preferred the mirror-reversed photograph differed significantly (p = 0.047) between Groups 1 (84%) and 2 (70%).
  
  
  CONCLUSIONS
  Plastic surgery patients have a significant preference for mirror-reversed photographs of themselves over standard photographs. This preference is even more pronounced among patients who are undergoing facial aesthetic surgery.
  
  
  METHODS
  III.
authors.affiliation: Plastic, Reconstructive and Cosmetic and Burn Surgery Unit, Hôpital Saint Louis, Paris, France; EA 7299, ETHOS, Faculté de Médecine, Université de Lorraine, Nancy, France. Electronic address: aderunz@gmail.com.
authors.forename: Antoine
authors.initials: A
authors.lastname: de Runz
authors.affiliation: Plastic, Reconstructive and Cosmetic and Burn Surgery Unit, Hôpital Saint Louis, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Boccara
authors.affiliation: Plastic, Reconstructive and Cosmetic and Burn Surgery Unit, Hôpital Saint Louis, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Chaouat
authors.affiliation: Plastic, Reconstructive and Cosmetic and Burn Surgery Unit, Hôpital Saint Louis, Paris, France; Centre de Recherches Psychanalyse, Médecine et Société, EA 3522, Université Paris Diderot 7, UFR d'Etudes Psychanalytique, Paris, France.
authors.forename: Katia
authors.initials: K
authors.lastname: Locatelli
authors.affiliation: Hopital Sud, Department of Plastic and Reconstructive Surgery, CHU Rennes, 35200 Rennes, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bertheuil
authors.affiliation: EA 7299, ETHOS, Faculté de Médecine, Université de Lorraine, Nancy, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Claudot
authors.affiliation: Plastic, Reconstructive and Cosmetic and Burn Surgery Unit, Hôpital Saint Louis, Paris, France.
authors.forename: Farid
authors.initials: F
authors.lastname: Bekara
authors.affiliation: Plastic, Reconstructive and Cosmetic and Burn Surgery Unit, Hôpital Saint Louis, Paris, France.
authors.forename: Maurice
authors.initials: M
authors.lastname: Mimoun
mesh_terms: D000328:Adult; D004644:Emotions; D005149:Facial Expression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010781:Photography; D011446:Prospective Studies; D021641:Recognition, Psychology / Q000502:physiology*; D015361:Rhytidoplasty / Q000379:methods* / Q000523:psychology*
keywords: Facial asymmetry; Facies; Outcome studies; Photography; Self-assessment