Your’e not the expert in cosmetic surgery

In days gone by, your cosmetic plastic surgeon would have gone to college, medical school, five years of surgery training and two to three years of plastic surgery training before being allowed to start a plastic surgery practice. After two years in practice, they would take an oral examination given by senior plastic surgeons, and if they passed (30% did not), they would be able to call themselves a “board-certified plastic surgeon.”
Patients would seek their expertise in wound surgery, reconstruction and cosmetic surgeries. Options for treatment would be offered and the patient may even have been referred to a particular specialist in the field if the problem was too complex for the surgeon to handle. Patients would choose their plastic surgeon, have the surgery and trust their surgeon to take care of them. After all, they had just trusted the surgeon to perform surgery on them with sharp instruments—and that takes a lot of trust.
It’s not like that anymore…

Cosmetic patients play at being surgeon

With the 1980s “empowerment  of the patient” movement, surgery has changed significantly—and not always for the best. Before then it was the era of your being diagnosed with a fatal disease and doctors deciding not to tell you of your imminent demise for fear of upsetting you. They would tell your family instead. Obviously, this was not such a good idea, and a change in the doctor-patient relationship was needed for a more equitable sharing of responsibilities and commitments.

The pendulum has now swung to the opposite pole. Now it’s the patients who decide what they want done and dictate their treatment to the surgeon. If they don’t like what they hear, they ignore the surgeon’s years of training and experience and shop around to find the answer they want to hear or the one they read about on the internet.  There is no trusting of the cosmetic plastic surgeon.

Wrong choices by cosmetic patients

Case 1

A youngish woman has a tummy tuck, and a few weeks later, after not wearing her binder, gets swollen; a small 1-inch wound opens in her lower abdomen. Common enough. She is instructed to clean and pack it, and given an appointment to come to have it re-sutured in five days. She didn’t like that plan. She made up a story about being on vacation, went to a wound clinic where she was fitted  with a “Woundvac” (the only thing a wound clinic can do— a Woundvac is a suction apparatus you have to walk around with 24 hours a day for 3 weeks) before the wound closed. She still has not been back to see the cosmetic plastic surgeon, despite the fact that  plastic surgeons are THE WOUND SPECIALISTS!!!!

Case 2

A middle-aged woman has a tummy tuck but is slow to get up and around, getting swollen in the belly area. Common enough. She is seen at a clinic and reassured that everything with the abdominoplasty is going fine and that healing is progressing normally. She didn’t want to hear that so she spent the following evening in an emergency room to be seen by a doctor who has no idea what an abdominoplasty is, just to have them call me to be told that everything is fine!

Case 3
Another lady is recovering after a tummy tuck she had two weeks ago. She is doing fine but decides to go to the emergency room to get checked out—instead of coming to her appointment with her cosmetic plastic surgeon!

Trusting your plastic surgeon

As a patient contemplating cosmetic surgery, you should see several surgeons, get as much information about the surgery as possible and choose your plastic surgeon based on his or her abilities and techniques, personal rapport, reputation, credentials and board certification. Then you will be paying lots of money to have your surgery performed and for post-operative care. Your surgeon has performed surgery on many thousands of other patients—why wouldn’t you want to avail yourself of the expertise of this highly trained individual you have engaged to provide surgical services to you, and whom very recently you trusted to cut you with a knife?
It makes no sense to me!

Granted, if the plastic surgeon ignores your calls, cancels your appointments, has no system for coverage by other surgeons, etc., you should seek surgical help elsewhere. But for goodness’ sake, trust your surgeon and know that they are doing the best for you; an emergency-room doctor is not a substitute for your surgeon, and internet information is an even poorer substitute. Cosmetic plastic surgeons really do care a lot more than you think.

Add to the mix Dr. Google and we now really have a big mess of confused and frightened plastic surgery patients. Just call your surgeons and trust them.

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