Avoiding patient dissatisfaction

The practice of medicine has always been a balance of the latest scientific advances, and a less well-defined ‘art’ of patient care. Much of this ‘art’ is good communication. In cosmetic surgery, advances in anatomical and scientific knowledge have allowed plastic surgeons to enhance youthful beauty to a level never thought possible in the past. Technical success does not, however, equate with patient satisfaction. All surgeons will have the occasional patient who is unhappy with a result that the surgeon feels is reasonable. It is likely that something was missed in the patient preparation for surgery, possibly a psychological condition that was overlooked. Cosmetic surgery patients are, by definition, dissatisfied with their body image. This dissatisfaction could be understandable and reasonable, or it may be excessive and abnormal. Within the cosmetic surgery patient spectrum there will be patients with body dysmorphic disorder or other problems that will place both patient and surgeon at risk of an unhappy outcome even though there has been a good surgical result. Plastic surgeons must have insight into the psychology of body image dissatisfaction. Subspecialization in modern medicine means that today’s plastic surgeons may need the help of psychologists to assist in the identification of these patients.