One of the most frustrating aspects of cosmetic plastic surgery is dealing with patients’ expectations. It’s Surgery, Not Magic. Despite the fact that most plastic surgeons will (or should) spend time with their prospective patients explaining the procedure, showing before and after photographs, answering questions, pointing out where the scars of the surgery will be and so on, many patients remain perplexed after the surgery as to why they do not have the result they wanted. This is where the problem is: “the result they wanted.”

During the initial and pre-op consultations, most board-certified plastic surgeons will have explained all the major points of the surgery as well as the expected cosmetic results based on the procedure and their experiences with it. For example, I tell my tummy tuck patients where they will have a scar, how long the swelling will last, how long before the wrinkly skin flattens out, etc. Plastic surgery patients, like other patients, may hear what the surgeon says, but, studies have shown, comprehend only about 20% of it!

The excitement of the situation, the unfamiliarity of the journey and the emotional baggage the patient brings to the surgery all combine to cloud the situation and lower understanding to a minimum. On the other hand, the expectation of the surgical result soars far above realistic goals. Patients come to think that they will look like exactly what they want, not like what is possible.

Patient information

To pre-empt this confusion, I routinely give my patients a booklet of information to read about the surgery as well as an explanation of the emotional responses we are prone to as patients. Still, even if the patient reads it all, the “want” wins.

For example, last week I had two such experiences. let me preface this by saying that both patients are intelligent people who now understand their initial confusion.

The first patient I had performed a tummy tuck and liposuction on 72 hours beforehand. These were her questions:
Q: Why do I have a scar?
A: A tummy tuck requires removal of excess skin by cutting, leaving a scar. I showed you the scars on 20 patients’ photos. We discussed where it would be and how it would hide under the panties.

Q: Will my cellulite be gone?
A: No. We did a liposuction to remove fat from under the skin. There is no current treatment for cellulite, which is caused by bands of fascia holding the skin to the muscle layer. We discussed that liposuction does not help cellulite.

Q: Why am I swollen?
A: Swelling is a normal body response to injury. Any surgery is an injury, and swelling is necessary for proper healing. With time, the swelling decreases, though it may takes months or even years in some cases to fully dissipate.

The other patient complained of deep lines remaining in her face despite injections of dermal fillers. We had had a long discussion of how the lines were so deep that a facelift would be the best treatment for her, but she was adamant for a quick fix. I told her (and wrote in the chart) that this would be a minor and temporary improvement; what she really wanted was the unattainable look of a facelift with only dermal skin injections.

Communication is not understanding

Naturally, the confusion between plastic surgeon and cosmetic patient can sour the relationship between the two. In its rawest form, the patient feels hoodwinked by the plastic surgeon and the cosmetic surgeon feels they are being taken advantage of by the unhappy and belligerent patient demanding repeat procedures or their money back!

In this age of information and open dialogue where all your questions are answered by everyone and everything, including the computer, it turns out that there is still a lack of communication when emotions are involved. Whether it’s talking with your loved one about the grocery bill or with your plastic surgeon about your surgery, emotional involvement decreases communication and understanding. You only hear what you want to hear, not what is actually being said. The information was available and transmitted; it was not received.

So what to do? Not much other than trusting that your surgeon is really acting in your best interest.

Here is something on the subject i have written in the past.

Surprised after surgery?