Polydactyly is one of the most frequently encountered congenital anomalies of the hand. Surgery for the duplicate thumb has progressed from a concept of simple ablation [10] to complex reconstruction. Ablative procedures commonly result in complications that include narrowed first web space, scar contracture, thumb angular deformity, and joint stiffness or instability. Wassel in 1969 stated that “ablation of a supernumerary digit can create problems resulting in deformation and functional limitation” [22]. More recently, surgeons have utilized soft tissue spare parts such as tendons and ligaments from the removed component to augment the function of the reconstructed thumb with improved outcomes [1–5, 7, 14, 16, 18]. Unfortunately, unfavorable functional and esthetic outcomes can still occur and secondary corrective procedures are often performed [11]. Only a few published studies assess the surgical outcomes with emphasis on subjective and objective parameters that evaluate the patient’s or family’s perception of the reconstructed thumb [1, 5, 6, 8, 12, 13, 19]. Objective evaluation is typically based upon certain measurable parameters such as thumb length, girth, angulation, and nail properties, characteristics dictated by the investigating surgeon. There is a potential disparity in objective assessments and the parent’s or patient’s perception of the outcome and progress after polydactyly surgery. The purpose of this study was to assess the postoperative functional and esthetic outcomes of the reconstructed duplicate thumb in our own series with emphasis on the subjective perception from the parent’s or patient’s perspective.