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We consider the question of when the operation of contact surgery with positive surgery coefficient, along a knot $K$in a contact 3-manifold $Y$, gives rise to a weakly fillable contact structure. We show that this happens if and only if $Y$itself is weakly fillable, and $K$is isotopic to the boundary of a properly embedded symplectic disk inside a filling of $Y$. Moreover, if $Y^{\prime }$is a contact manifold arising from positive contact surgery along $K$, then any filling of $Y^{\prime }$is symplectomorphic to the complement of a suitable neighborhood of such a disk in a filling of $Y$. Using this result we deduce several necessary conditions for a knot in the standard 3-sphere to admit a fillable positive surgery, such as quasipositivity and equality between the slice genus and the 4-dimensional clasp number, and we give a characterization of such knots in terms of a quasipositive braid expression. We show that knots arising as the closure of a positive braid always admit a fillable positive surgery, as do knots that have lens space surgeries, and suitable satellites of such knots. In fact the majority of quasipositive knots with up to 10 crossings admit a fillable positive surgery. On the other hand, in general, (strong) quasipositivity, positivity, or Lagrangian fillability need not imply a knot admits a fillable positive contact surgery. 

From a handle-theoretic perspective, the simplest contractible 4-manifolds, other than the 4-ball, are Mazur manifolds. We produce the first pairs of Mazur manifolds that are homeomorphic but not diffeomorphic. Our diffeomorphism obstruction comes from our proof that the knot Floer homology concordance invariant ν is an invariant of the trace of a knot, i.e. the smooth 4-manifold obtained by attaching a 2-handle to the 4-ball along K. This provides a computable, integer-valued diffeomorphism invariant that is effective at distinguishing exotic smooth structures on knot traces and other simple 4-manifolds, including when other adjunction-type obstructions are ineffective. We also show that the concordance invariants τ and ϵ are not knot trace invariants. As a corollary to the existence of exotic Mazur manifolds, we produce integer homology 3-spheres admitting two distinct surgeries to $$S^1 \times S^2$$, resolving a question from Problem 1.16 in Kirby's list.