How can doctors perform major surgery on patients they've never seen before, until the day of surgery?

I'm researching and reading that skype consultations and sending in pictures is normal for some surgical practices. And that some surgeons don't even look at the wish pics or self body pics sent in until the day of surgery. This seems like a red flag, but it seems like the norm for certain doctors. Should I be concerned? I want a body lift, w/BBL and breast augmentation. I loss 100 pounds. Shouldn't a doctor see me in person way in advance of surgery and not the day of?

Doctor Answers 9

Body lift, BBL and breast augmentation after massive weight loss

Thank you for asking about your lowe body lift, liposuction, BBL and breast augmentation.
  • You have a very good point.
  • At a minimum, for out of town surgery, you would need a detailed Skype consultation, a full set of photos sent to your surgeon, clearance by your regular doctor for surgery and to arrive in town two days before surgery -
  • You would be seen when you arrive and any additional testing and planning done the day before surgery
  • Finally you should plan to stay 2 - 3 weeks after surgery.
  • You would need at least one over-night stay and surgery ideally would be in a center linked to a hospital.
  • Your surgery is a very great deal for one session and requires thorough discussion and planning.
  • It may not be advisable to try to do it all in the safe surgical limit of 6 hours.
  • This cannot be done the day of surgery. 
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

How can doctors perform major surgery on patients they've never seen before, until the day of surgery?

Call me old fashioned, but I don't believe in operating on someone who I have not seen before surgery, especially someone having fairly extensive procedures like the ones you describe. Weight loss patients often have other medical problems and potential nutritional deficiencies that can affect your surgery, recovery and wound healing. I would recommend that you find a surgeon who will spend the time to explain the procedures, expected outcomes and limitations what the procedures will accomplish for your body type, as well as, go over the potential complications and recovery process.

Skype consultations

I agree with you.  Technology has advanced the cause of medicine in many ways but I still think there is no substitute for a good old-fashioned in-person consultation and examination.  It gives the patient a chance to get to know the surgeon performing his/her operation, ask questions, and develop a rapport with the surgeon and his staff.  It also gives the surgeon a chance to examine the patient in person and to review options and alternatives with the patient.  Pictures are nice but not as good as seeing someone in person.  While skype consultations may work for some doctors and patients, I think I will stick with the old personal approach.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 24 reviews

Body lift

Skype consultations, internet consultations are and should be considered as informal opinions.To perform any surgery, there should be an exhaustive in person consultation and evaluation for suitability of the surgery and thorough understanding of the procedure and the expected outcomes.Discussion of the potential risks, and complications and making decisions as to the position of the scars, and the type, shape, size and position of the implants. Short term and long term consequences.In my practice this would require at least two  in person consultation may be three. Each consultation may take an hour or two.Evaluation pre-operatively, medical clearance and lab tests to assure patient safety.Where the procedure is being done? office based surgery, is it accredited? is the surgeon and anesthesia provide Board Certified?Surgery is not a production line. Surgery is customized to the individual anatomy and patient desires.Post-operative care, by whom? availability of the surgeon? Only face to face consultation would tell you if the surgeon choice is appropriate to you.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

In Person Consultation is the GOLD STANDARD

Hi and thanks for posting your question on Real Self!
You have good reason to be skeptical of remote/Skype consultation practices. There really isn't a better way to connect with your surgeon, have a thorough examination, and have surgical recommendations made than with a real LIVE consultation. 
Some very high volume surgeons who have established centers of excellence may be employing this method. I would certainly vet the surgeons and opt for in person consultations.
Best of Luck finding your surgeon!

Rachel Streu, MD
Portland Plastic Surgeon
5.0 out of 5 stars 15 reviews

How can doctors perform major surgery on patients they've never seen before, until the day of surgery?

Doing major surgery on someone I have not seen before is generally not a good idea.. However, occasionally a patient can come in the day before for the consultation and history and physical, providing the case is not too complicated and involved. This would have to be in special situation, however. I have had patients from far away, such as other countries, and they have to come in a few days before surgery and remain in the area for several days, according to the procedure.
The PS would have to see photos, know the vital statistics, weight, height and had a consultation on Skype or something similar. The patient would also have to be cleared by her local physician as to her or his health. Still even with all of that, it's best to see the PS for a personal consultation.

Virtual Consultations Only Prior to Surgery?

There certainly is a place within today's plastic surgery practices for virtual consultations. Virtual consultations can be a great starting point in developing a doctor-patient relationship, especially for patients that are considering whether or not to travel a significant distance to see that doctor. 
Virtual consultations, however, can not provide the surgeon with anywhere as near as much information as a formal consultation wherein a physical exam can be performed. For me, the physical exam is paramount. Each patient has different physical attributes that may be better addressed with one technique over another. The better plan you and your surgeon have prior to surgery, the more comfortable you will likely both feel about achieving the desired results.

Ashley B. Robey, MD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 25 reviews

Body lift

Hi - if you are going to invest in surgery as extensive as you are considering then you should insist on seeing your surgeon prior to surgery. I would always see my patients before surgery as you need to establish a relationship with your surgeon. It is not possible to do this using photos or even over Skype. Some surgeons may do initial short consultations over Skype, particularly for patients who live far away but you should certainly meet your surgeon in person before the day of surgery.

Seeing patients pre op

I agree with you that under best of conditions you should have a live consult with your surgeon well in advance of the surgery. Both of you need time to think about your plan and prepare. I have had a small number of patients who are out of town or out of the country, but will be in the same city as me for their surgery and post op recovery. I so a consult with really good photos and get a plan. I still see them the day before surgery to make sure we do not need a change in the final plan. I would avoid the surgery mill you seem to be describing. After a 100 lb weight loss you need a well thought out surgical plan. Good luck.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.