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Expectations and desires - At the beginning of my consultation, I always ask the patient the following:
1)' What part of your body concerns and bothers you and how? How do you want it changed?'
2)'What are your expectations at the end of the surgery and what results will make you happy and satisfied?'
The answer to these questions helps the surgeon understand the problem from a patient's perspective. This is extremely crucial, as people have different desires. Many patients still expect the surgeon to 'tell them' what they need doing. If so, I always say that cosmetic surgery is not done to treat a disease process. It is being performed to meet the patient desire. Hence, it is important for me to understand what they want. This approach has two major advantages.
First, it involves the patient in decision making and exposes their understanding or lacks thereof, of their own wants and desires. Second, it helps the surgeon understand what the patient wants. Take for example, a patient asking for a breast enlargement. While one patient may seek natural looking, fuller breasts, the other may want significantly larger breasts. If such a patient were to say to me that 'they want to look normal', my reply is that there is no fixed, absolute normal.
Subjective nature of cosmetic surgery - It is extremely important to explain to the prospective patient that the results of the surgery vary from one patient to another and people react differently to surgery. I have found that most patients understand and accept these facts. In certain cases, it is important to get the parents and/or partners involved and also provide a second consultation. It is standard in our practice that the consent forms are sent to the patients two weeks before the surgery.
These form reiterate these points. It also allows the patients time to understand what they are consenting for and raise any questions. A classic example is of a 42 year old, male patient, who sought consultation because he was extremely selfconscious about his 'large earlobes'.
He informed me that he had always kept his hair long to cover his ears and although he was 42, he has never had a stable relationship. He consulted three times and I took all sorts of measures to reassure him that his earlobes were 'not large'. At the third consultation, he brought his GP's letter, which emphasised his concerns and requested if I could help him out. I performed a bilateral earlobe reduction.
The procedure took half an hour and his earlobes were reduced by a few millimeters. The healing was uneventful and the patient was thrilled with the results. I received a letter thanking me for changing his life. I then saw him after a few months for a check up. He had a short haircut and was accompanied by a girlfriend!
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