Tuesday, November 9, 2010

Making Wise Decisions in Aesthetic Care

Having developed the opinion that the mixed (and often irresponsible) messages in many advertising and media stories about Plastic Surgery (Lose 3 gallons of fat in an hour!) have unfortunately complicated the doctor-patient relationship on which safety and successful treatment depends, I think it would be valuable to describe a healthy and productive experience more likely to result in a safe and positive outcome.


Of note, I will not describe how to verify a surgeon's credentials, as I have covered this in other posts (see "Choosing a Plastic Surgeon").

I think it is worthwhile to emphasize that in engaging a Board Certified Plastic Surgeon, you are in fact hiring a highly educated and trained professional to intervene on your behalf- this part is no different than hiring an attorney or architect.

The major difference is that, because the work product of the Plastic Surgeon often involves surgery, your happiness and safety will depend on your choices and on you doing your part to achieve the best outcome and maintain a healthy working relationship with the professional you choose.

Step 1:  Spend some time and energy learning everything you can about the enhancement you may be interested in.

  • Learn about the options, the outcomes, and the postoperative experience- realizing that your individual experience will greatly depend on your individual goals, the details of your procedure, and your surgeon's preferences.
  • I would recommend against taking anything you read too much to heart at this stage- the best way to digest this kind of information is to take it all in and formulate an opinion based on all of it only after meeting with a professional for the proper perspective.
  • Don't worry too much about making decisions at this stage either- it would be a mistake to commit to any particular way of doing things until you've gotten the advice of your Board Certified Plastic Surgeon (whether it is which liposuction machine is to be used or which breast implant might look best in you).
  • Early in the process, I would also recommend a careful examination of your motivations and goals for the procedure...
    • The happiest patients are those that are committed to the experience and who's goals are reasonable. They are not interested in looking better to please someone else.
    • There's no such thing as "drive through" plastic surgery... Your aesthetic improvement should be thought of as a process, with necessary preparation and careful adherence to your surgeon's instructions and restrictions in order to achieve your best and safest outcome. Understand that without your cooperation, even the best surgeons would be limited in the outcome possible, and your chances of being happy are compromised.
Step 2: Having decided that the enhancement you've been considering might be right for you, I would then recommend researching the surgeons available to you. Keys to understanding meaningful differences include:
  • The surgeon's education (medical school)
  • Their training 
  • Are they Board Certified by The American Board of Plastic Surgery? (If not, run away)
  • What do their outcomes look like? 
    • Don't worry that their outcomes may not look exactly like what you are hoping to achieve, but do ask yourself if they are attractive, consistently shapely outcomes... or do they just look funny?
  • What do their prior patients say about them? Again- you'll want to digest this information as a whole... Read all of the reviews. 
    • Don't be fazed if a surgeon has one or two negative reviews- even the very best among us might not be able to make every single patient happy (and some of this dissatisfaction may have something to do with unreasonable expectations on the part of the patient, or failure to follow postoperative instructions...).
    • In other words, look for a pattern, not for individual experiences. 
Okay- so now you've decided you are interested in pursuing improvement, have educated yourself about the alternatives available, and have a few surgeons in mind... You're ready to schedule a consultation or two. 

What should you expect, and what do you need to do (and not do) to ensure the most productive communication?
  • Have a firm grasp of your goals. Remember that no one will be able to achieve your goals if you do not understand exactly what you are hoping to achieve or are unable to communicate them. 
  • Don't worry that you'll need to be super-articulate or able to draw a picture of what you want- experienced and well-qualified surgeons will be adept at interpreting your goals and re-stating them so you know they understand.
  • Do not prematurely commit to the details. If your research led you to believe that a certain technique might work for you, but the professional you meet with believes a different technique would be better (after a careful examination and understanding of your goals), in almost all cases you would be best off following their recommendation. Remember that, while this is your first experience with the procedure, they have performed (hopefully) a great many of them and will have a better understanding of what would work best in your situation.
  • Listen carefully to the surgeon.
    • Pay attention to the way he talks to you and answers your questions. Do you think this is someone you can trust with your safety and happiness? Do you think the two of you will get along well through the course of treatment? This is an important relationship, and you will want to be as careful entering into it as with any other...
    • Pay attention to the outcome he believes is reasonable for you and any limitations on the outcome that may or may not exist in your case. Ask if your goals are reasonable to expect, understanding that no responsible physician would give you a guarantee of outcome (if they do- again, run away).
    • Pay close attention to the anticipated recovery and postoperative limitations, as well as the potential risks involved
      • Plastic Surgery is real surgery. 
      • If you are in good health and make smart decisions regarding who you let operate on you, where it occurs, and who is taking care of you from an anesthesia standpoint, the risks are very low... 
      • If you let an eye doctor or ER doctor do liposuction on you in his office without a qualified anesthesia provider present (and yes, liposuction IS surgery), then all bets are off.
  • This is another opportunity to review the surgeon's work, as most will show you before and after photos of prior patients.
    • Be sure to ask if the photos being shown to you are of patients who were actually treated by the surgeon you are seeing, and whether they had the exact procedure you are interested in.
      • Amazingly, some doctors show photos of patients operated on by someone else
      • Equally amazing, it is now very common for you to be shown photos of patients who had one operation in order to "sell" you an another... For example- you would be shown a photo of a woman who had a Tummy Tuck (amazing outcome) and told she had SmartLipo... Hmmm...
      • There's no two ways about it- this is fraud... but it does happen- although this is much less likely if you are dealing with a Board Certified Plastic Surgeon.
    • Ask yourself about the quality of the outcomes you are shown, realizing that they represent the surgeon's best work (that's why they're showing them to you, right?)
  • Ask to speak with a few prior patients. Most reputable surgeons will be able to put you in touch with a few patients who had the same procedure with them that you are considering.
  • Pay attention to the staff- many of your interactions with the surgeon's office will be with his staff- friendly, courteous and professional demeanor and attention to their own appearance would indicate a productive and positive work environment, respect for their employer (the surgeon) and for the practice's patients.
So by now you should have all the information you need to make the decisions that are best for you... Remember- your part in the relationship is important if you want to be safe and achieve the best outcome- keep all of your appointments and follow your surgeon's instructions carefully.

For more information about how to verify the surgeon's, facility's, or anesthesia provider's credentials, email me or see our prior posts on "Choosing a Plastic Surgeon".


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