Most patients see a few plastic surgeons before they decide who will do their procedure, especially if the patient is interested in a surgical procedure like liposuction or a tummy tuck. One of the things new patients often say to Dr. Burnett is “I chose you because you listened to me”, because we reviewed so many different aspects of their expectations before they made a final decision. So what I want to explain here is how we go about the process of insuring that each patient is:
- Clear in their own minds about their goals
- Understands what exactly can be accomplished in a plastic surgery procedure
- Understands post-op healing and recovery considerations
You might think ‘gee this is a lot to accomplish during an initial consultation’, and you’re correct. That’s why our consultations last an hour or more, and why we consider the consultation the first step in the surgical process. Our patients learn a great deal during a consult, and leave with a better understanding of whether or not their expectations can be met at our practice. We won’t overpromise, and we don’t like surprises; we want our patients to be fully prepared on what is involved to achieve their goals. The majority of this education and assessment is accomplished at our initial consultation.
This approach to consults is very different from most other practices, that may limit the time to a quarter-hour and advertise free consults. That’s fine: you get what you pay for.
WHAT BROUGHT YOU HERE TODAY?
Most patients have a pretty good idea of what they want when they come in; either she will say it’s a specific procedure or describe how she would like to look after the procedure. First off we dive into the reason for the consultation – what bothers the patient the most, what is most important to her – and our fine-tuning of her expectations begins right away. Is the patient being realistic about their expectations? Can their goals be addressed successfully?
A woman came in not too long ago, interested in breast enhancement. Dr Burnett showed sample silicone inserts and discussed her size expectations. When the 4’11” woman demonstrated her goals by placing two large inserts over one breast, Dr Burnett knew the patient was considering a procedure that would cause pain to her back and make walking uncomfortable. He explained the serious and uncomfortable side effects, so that she could adjust her expectations accordingly. If a patient is unable to tolerate possible complications to a desired procedure, we will not recommend that procedure.
Though most people come in with an open mind, and have done some homework. We can spend time evaluating how to approach their goal, and how to improve the aspect of appearance that is unsatisfactory.
WHAT IS THE BEST WAY TO ACCOMPLISH YOUR GOALS?
A patient inquired about the “vampire face lift” recently, after seeing something about it on TV. This trendy procedure re-injects the patient’s own blood to remove wrinkles. Ultimately what she wanted was to smooth out her face for an upcoming wedding. Dr Burnett and the patient wound up switching gears and used Botox, an FDA approved injectable, to accomplish her goals. He advises patients to be very wary about trendy procedures that are not sufficiently researched for FDA approval. The more evidence there is to predict a desired outcome without undesirable complications, the better. In general we operate with a high consciousness for safety, which usually makes me avoid experimental procedures.
Many times a patient needs to see options before a pathway to their goals can be determined. Dr, Burnett likes to show patients three examples of tummy flatness, for example, asking which picture is closest to their desired appearance. This not only shows concretely what the patients have in mind, but provides a means to evaluate how realistic their goals are. So many things need to be considered – how much fat is involved, skin elasticity, stretch marks, the strength of the patient’s muscle walls. It may turn out that liposuction would be sufficient for one patient; while a tummy tuck combined with liposuction is indicated for a different patient.
So we hope you are starting to see how many ways a patient’s going-in expectations need to be examined before a plan of action is determined. For serious patients we encourage follow-up consultations, involving significant others, to give the patient all the confidence he or she deserves prior to receiving a surgical procedure.
While we save the discussion of surgery preparations for another time, there are a number of post-op realities that may influence a decision to do the surgery in the first place. Pain, for example: people interested in a tummy tuck need to expect a certain amount of pain after surgery due to the amount of repair under the skin. We neither minimize nor exaggerate the pain factor during a consultation; it is simply treated like another facet of the decision process. Scarring is another: it is an unavoidable complication in many procedures. Patients should be aware, ahead-of-time, of how much or little scarring to expect and evaluate their tolerance for that outcome. Perhaps intolerance to inevitable pain or scarring will cause a patient to re-evaluate their initial expectations. Either way,it is important that the patient has realistic expectations so that he or she is most likely to be satisfied with the outcome of their plastic surgery procedure.