Managing Patient Expectation

Managing patient expectation is a critical aspect of aesthetic plastic surgery. Patients often have specific goals and desires, and it is the surgeon’s responsibility to ensure that these expectations are realistic. It’s very clear having carried out aesthetic and reconstructive surgery for many years that we all look at outcomes or results differently, so I thought that I would share some observations and advice about this in my blog.

When patients come for their final check, I occasionally have a little surge of apprehension before they are called into the consultation room. This is not because I am expecting a bad result, but because I can sometimes be caught out by an unexpectedly disappointed patient. This is because patient satisfaction does not always correlate with the objective quality of the result.

So I have seen some patients who have a truly perfect result, yet they are unhappy and others in whom I think “well that perhaps could look better”, who are over the moon with delight at how good their body looks.

Why then does patient satisfaction not clearly relate to the quality of the surgical result? For the main part this is about patient expectation before the surgery. Here are a few tips for managing your expectations when considering aesthetic surgery.

Have an open and honest conversation with your surgeon: Before the surgery, the surgeon should try to understand what the patient is hoping to achieve. I often say to patients “we need to understand what a good outcome would be in your eyes”. I then try to explain what can be realistically achieved and how this compares with the patient’s ideal or perfect outcome. This helps set realistic goals and can prevent any misunderstandings or disappointments later on.

Some things that I might say during the consultation to help manage expectations include:

“It’s not about producing a particular result that you have seen on the internet, it’s about applying the tools and techniques I have to the best of my ability on your body, to produce as a good as a result as we can. This may fall short of your ideal result.”

“The biggest determinant of outcome is the starting point and your natural body or breast shape will therefore affect the result that we can achieve.”

“There are no guaranteed outcomes or specific results. We should make things much better but the results will not be perfect. I can guarantee that I will take great care of you and work hard to produce the best result I can.”

“We should not necessarily carry out the operation that you want, we should consider everything properly and do what we think will work best for you.”

“Ultimately, this is not just about treating your breasts, it is about you as a person, your confidence, your self-esteem, and how you feel about yourself”

Consider all the information given to you very carefully: The surgeon should always provide detailed information about the procedure, including risks, benefits, and recovery time. I do this during the initial consultation and it is followed up with a summary in my detailed and individualised letter to every patient. This information is reinforced at additional consultations and from the standard procedure information sheets given to all patients.

Consider before and after photographs: It’s clear from my social media and website publications, that I am not a fan of multiple before and after photographs. These can be manipulated and they do not apply to every patient. Indeed, I think these advertising techniques lead to unrealistic expectations for many patients. During the consultation however, I do show many untouched before and after photographs of my own patients. I have a collection of photos from patients who have agreed to have their images shared. I then try to match the patient body type and procedure to give a realistic expectation of outcome. I show both very good and not so good outcomes pointing out the deficiencies, such as bad scarring, when present. This helps set realistic expectations and gives patients an idea of what can be achieved for them.

Follow up after the procedure: Regular follow up visits are essential to ensure patients heal properly and that we, as a team, are meeting their expectations. I also show patients their own before-surgery photographs and we always take a post-operative set at around three months. We can then compare the change and see the benefits. Comparing post-operative photos to pre-operative photos allows patients to easily see the gains.

In aesthetic plastic surgery, the overwhelming majority of patients are extremely happy they chose to go through with their operation. This can be seen from the many positive reviews and testimonials published on various review sites. Patient satisfaction is, however, not just about achieving a particular result that looks good in a photograph.

It’s about, setting realistic goals and being looked after in a sensitive and supportive manner together with the surgical skills to achieve the best result possible.

By Paul Harris | Managing patient expectation | Date of Publishing