ML Kreidstein, HG Thomson, PC Neligan. Influence of specialist title on perceived surgical ability. Can J Plast Surg 1994;2(4):149-154. This study was conducted to test the hypothesis that patients associate specialist titles with superior surgical ability, and that operative results are viewed more favorably if believed to be the handiwork of a specialist. Subjects (n=130) were randomly selected from among patients at a medical walk-in clinic. All subjects were presented with an identical set of ‘before and after’ photographs depicting six unrelated facial operations. However, each set of photographs was attributed at random to one of the following surgeons: plastic surgeon, plastic surgery resident, aesthetic plastic surgeon, facial plastic surgeon, ear nose and throat/ head and neck surgeon, cosmetic surgeon. Subjects completed a questionnaire evaluating the quality of the result from each operation, and then for each operation indicated which of the above surgeons was likely to achieve the best operative result. The attribution of identical operative results to the different surgeons resulted in evaluations that were not statistically different (P>0.05). Cosmetic surgeons were chosen most frequently as the type of surgeon likely to perform the best quality rhytidectomy or rhinoplasty, and facial plastic surgeons were chosen most frequently as best for repairs of facial lacerations or removal of skin tumours on the face (P<0.00l). Plastic surgeons and ear nose and throat surgeons received intermediate ratings, and aesthetic plastic surgeons and plastic surgery residents received low ratings. As hypothesized, specialist titles were associated with superior surgical ability, with cosmetic surgeons thought to provide the best cosmetic procedures, and facial plastic surgeons thought to provide the best reconstructive procedures. Despite this bias, evaluations of the operative results were not influenced by the type of surgeon credited with the operation, refuting the hypothesis of a placebo-type effect.