The Bold Surgeon Syndrome: Contemporary Analysis of Overconfidence, Training Gaps, and Patient Safety in Plastic...

The "bold surgeon syndrome" describes a growing phenomenon in modern plastic surgery, in which technical confidence surpasses clinical maturity and self-criticism. This study aims to characterize its cognitive, educational, social, and institutional determinants, analyzing how overconfidence, rapid training models, and social media exposure may compromise patient safety.

An integrative analytical review was performed, combining scientific evidence from psychology, surgical education, ethics, and patient safety. Articles published between 2000 and 2025 were selected from PubMed and Scopus using terms such as overconfidence, Dunning-Kruger, surgical learning curve, mentorship, and social media in plastic surgery. Thematic synthesis was organized into 5 domains: cognitive, formative, social, institutional, and ethical.

Findings demonstrate that early-career surgeons frequently overestimate their competence, a pattern consistent with the Dunning-Kruger effect. Short commercial training courses and the absence of structured mentorship reinforce premature autonomy. Social media amplifies the pursuit of recognition over prudence, whereas institutional systems often fail to provide continuous supervision. In contrast, structured checklists and safety cultures significantly reduce errors derived from impulsive decision-making.

The bold surgeon syndrome arises from an imbalance between technical skill and reflective judgment. Its prevention requires integrating mentorship, formal evaluation of competence, adherence to safety protocols, and ethical responsibility in digital communication. Recognizing this behavioral pattern is essential to protect patients, sustain surgical integrity, and guide the next generation toward mature and safe practice.