The patient Patient's primer


That patients entrust their health, aesthetic ideals and hopes to us, the providers of cosmetic surgery, never ceases to amaze and daily remind me that we should under promise and over deliver. Cosmetic surgery after all involves the suspension of disbelief, as a basically healthy individual is made temporarily worse, because both patient and physician believe we can achieve something better. Occasionally "bumps" or complications occur along the road: pain, delayed wound healing, unsatisfactory outcomes; these can occur absent errors of omission or commission. The physician's directive is to communicate their assessment and contingency plans.  The patient's obligation is to participate in their care by attending appointments, notifying the practice of deviations of their trajectory and following instructions.  Problems occur when either party defaults on their part and the therapeutic alliance disintegrates.

Pain inevitably accompanies many of the procedures.  Apart from anesthesia services, we can offer pain relievers, biofeedback techniques, and most importantly outline the certainty that pain will resolve.  Our protocol for Ultherapy includes patient selection to determine the compatibility of the patient's anatomy to the procedure, as well as review their pain history and tolerance.  Typically the patient is offered premedication with a variety of anxiolytics, analgesics as well as nonsteroidal anti-inflammatories, provided they can schedule a driver. The area to be treated is liberally coated with analgesic cream, approximately an hour prior to the procedure.  Thirdly, the patient is provided a variety of "distracting" devices, which they can utilize during the treatment.  Lastly, we interact with the patient, permitting them breaks from the treatment and acknowledging that their pain is real, will be short lived and a necessary prequel to their desired results. We have found uniformly that as the Ulthera results unfold, our patients' enthusiasm eclipses their memory of pain.  

Ultimately, "patient" is both an adjective and a role.  A patient's fitness depends on a variety of factors: physical, psychological and emotional health, support systems, prior experience and expectation as well as belief in their provider.  While physicians cannot abandon patients, patients can and do quit a practice, usually when they get impatient with less than satisfactory results.  

Article by
Orange County Plastic Surgeon