How to Marry a Plastic Surgeon

robinpbhps on 3 May 2009 at 12:16pm

First you have to meet one, perhaps on an internet dating service, at the local gym, or in the vegetable section of your organic food store. Or, you can examine your face or body and decide to undergo elective cosmetic surgery; the process of engaging a plastic surgeon is very similar to that of matrimonial commitment.

Or, as I tell my patients, a trip through an operating room door is like a walk down the aisle.

While patients can stumble unto a good plastic surgeon and might end up with a good result by luck, it is not a very reliable formula for a successful mature relationship between doctor and patient in as serious an endeavor as cosmetic surgery. Some people will fall in love at first sight and head straight for the altar that same night - but not many, and not if they are sane.

Yet patients routinely sign up for surgery after one consultation, maybe spending as little as ten minutes with the person with a sharp scalpel in his hands before handing a deposit over to a surgical consultant who is not even a doctor and who is often referred to as the ‘closer’ for obvious reasons. If the doctor or ‘closer’ seems too eager to ask for a deposit on the first visit, think of it as a person requesting sex on the first date, and slow down. Better yet, run out of the office.

A patient should first think of establishing a solid relationship with a plastic surgeon and less of just getting a procedure performed. Once blood is drawn, you are stuck with each other until someone files for divorce.

Any relationship that will last and endure the trials and tribulations of marriage or the potential complications of major cosmetic surgery requires the 3 C’s: Communication, Compromise, and Commitment. Is this starting to sound familiar?

A person who doesn’t fall in love at first sight will end up “dating” multiple prospects just as a patient might visit with many surgeons. But once smitten, both dater and patient will return to their ”match.” The process of deciding on a monogamous relationship is very personal; a patient may chose their surgeon based on credentials (i.e. how they look “on paper” or in web pixels), by the recommendations of a trusted confidant (i.e. a girlfriend, family member, or personal physician who is “in the know”), by simple gut instincts, or all of the above. No matter how the lucky couple is paired, I always recommend discussing one’s desires on more than one heart-to-heart occasion: a dater might choose a quiet dinner at a sushi restaurant, a boat-ride on a moonlit lake, or maybe just on iChat while the patient communicates in the clinical setting of the doctor’s office.

Communication is a two-way street traveled together. Both patient and surgeon must communicate with each other what their “dreams” and desires are, what is potentially obtainable, what is unobtainable, and what pitfalls or imperfections are possible. Neither the patient nor the surgeon should be dictating treatment to the other. Imagine the household where there is only one voice dominating the other and you’ll understand what I mean. Power struggles, resentment, loss of self, and blame for failures may ensue. Instead, there should be a “meeting of the minds” whereby mutual goals are agreed upon and there is a sense of commitment to these goals and to each other. If your conversations aren’t satisfying, if your voice isn’t being heard, or if your needs are consistently being ignored, walk out of the office like you would walk out of a relationship.

Both parties must be willing to make compromises and each must be ready to accept things that are unavoidable whether it be anatomical scars or personality flaws. Patients need to accept the reality that surgery, like a relationship, is an imperfect endeavor. Side effects, shortcomings, and risk of complications are the prices you pay. The real challenge is to minimize, and be able to live with, the imperfections that one decides to accept.

Both patient and doctor should not be afraid to test each other, to probe their ideas or opinions in earnest dialogue. But they must also be able to respect the other’s point of view. That is the only way the relationship can be stable and survive a misstep. The paternalism of a traditional physician’s role is not that useful in the practice of elective cosmetic surgery designed to enhance the quality of an individual’s unique life. True cosmetic surgery patients are not sick in the usual medical sense. They just want something and their plastic surgeon should help facilitate, not dictate, their goals.

At some point in a mature relationship, the two parties will establish an immutable trust, but not one based on blindness. Rather, knowledge of a person and how they think, how they will act, and what they believe in, will require less

When I was a kid playing baseball, my favorite position was pitcher. I didn’t progress much beyond Little League and the junior high team, but I always loved the game and had an appreciation for the interaction between the pitcher and the catcher. There has to be a high level of trust of each other. The pitcher trusts the catcher to call the right pitch at the right time and the catcher trusts the pitcher to execute what he calls. It is true teamwork. But the trust is built on the experience of prior successful execution. They’ve been through these pitches and situations before. Each knows the other’s strengths and weaknesses. It becomes quite a different matter when the pitcher and catcher know very little about the other. Then it is mostly guessing and hoping.
In an ideal relationship, a surgeon will know what you want and how you will react so there is less guessing.

A simple example occurs in breast augmentation when there may be a range of implants options that might be acceptable. I always ask the patient whether they would be more disappointed if they came out bigger or smaller than they desired. The answer she gives allows me more confidence in choosing the appropriate implant size during the operation. For some patients I upsize, but for others, I downsize. Likewise, a patient will know what a surgeon is thinking, why he answers questions the way he does, and what he is capable of, without hoping he’ll do his best. That is the kind of relationship I usually like to see.

I always tell my patient that I do not worry when things go right because then everyone is happy. When everything is great, life is wonderful. With good planning, surgical success is probable. Instead, I worry about the time when things might go wrong. The same with relationships; when money is low, the kids are acting out, the business is sour, and someone is sick, that is when the belief in each other has to be strong. Too often I have heard from unhappy patients that they did not have a good feeling about their surgeon, or didn’t like his personality, or didn’t get a particular question answered. But they still went through with the surgery!

The same is true from the surgeon’s side where every surgeon has that case they regretted doing but failed to heed the discomfort in their relationship with the patient. Listen to the rustling of red flags. If things go wrong, and they can, you want a patient and surgeon relationship that is a solid as a lifelong marriage.

Recently, a patient called me out of blue about two years after her augmentation-mastopexy to enlarge and lift her breasts. Tragic death during plastic surgery was the topic of numerous national television news and talk shows so I handled the call with much anxiety silently wondering if I was going to get an earful of complaints. Instead, she had called to thank me for putting her through the pre-operative “ordeal” of numerous consultations, questions, and discussion. “I feel blessed, Dr. Yuan,” she gushed. “I am so happy.”

There is no magic to a solid and successful relationship with a plastic surgeon. It takes time and effort, but when you achieve it, it is magical and, as opposed some surgeries themselves, it can last a lifetime. Anybody ready for marriage?Dr. Yuan, a plastic surgeon practicing in Beverly Hills, California

Guest Post by Robin T. W. Yuan, MD, Beverly Hills Plastic Surgeon