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A growing number of patients seeking plastic surgical procedures in the authors’ practice are first-degree relatives of previous surgical patients. Three possibilities for procedural coalescence within a family unit include (1) similar morphologic and anatomical patterns within relatives; (2) a captive “audience” (family members) appreciates firsthand the surgical result and positive difference, be it functional or aesthetic; or (3) the rapport established between surgeon and patient leads that patient to recommend his or her surgeon to others. The purpose of this study was to identify the authors’ recent cohort of family members undergoing similar or related procedures performed by the same surgeon (D.M.S.), and understand the diagnoses, factors, and rationale for “passing the torch” to other family members to undergo surgery. Survey responses from 17 members of 10 families who sought elective procedures after an index family member indicated that both the result of the first operation and rapport with the surgeon were important factors in their decision to undergo surgery (mean Likert response ± SD, 4.94 ± 0.24). Ninety-four percent of family members (16 of 17) indicated that the result of the original procedure was the most important factor in their decision to undergo subsequent procedures performed by the same surgeon. Eighty-eight percent of family members (15 of 17) seeking subsequent procedures were not considering undergoing surgery before observing the result of the first index procedure. The data demonstrate the importance of achieving an excellent surgical result in earning the trust of patients and establishing strong family referral patterns.