Do I need to like my plastic surgeon?


If you have ever considered having a nip or tuck, you will no doubt have trawled the internet in search of an appropriate surgeon to deliver the cosmetic treatment you desire.

But when it comes to finding that perfect clinician, do we have to like him or her in order for the outcome to be successful?

And, just as importantly, do they have to like us?

The consensus suggests that there is indeed a need for a patient and clinician to ‘click’ in order to achieve much-desired aesthetic results.

Fulvio Urso-Baiarda is a consultant plastic, reconstructive and aesthetic surgeon and he strongly believes we need to feel comfortable with our surgeon – not just as a trusted and proficient professional, but as an honest and likeable person, too.

He explains: ‘For any cosmetic procedure, the patient should like the plastic surgeon and the plastic surgeon should like the patient – or, at least, they should not dislike each other.
‘This is distinct from any other doctor-patient relationship I know where all that matters is the medical outcome.’

With any cosmetic procedure, of course, the medical outcome is reliant on achieving patient happiness by successfully enhancing an area of the body to make it more attractive. 

And, because there is no universal definition of what constitutes ‘attractive’, the surgeon relies solely on getting inside the patient’s head to understand – and then manage – expectations.

Fulvio says: ‘Really, the only thing that matters is what that patient considers to be attractive, so the surgeon can try to reproduce it. This requires an unusual amount of psychological engagement between the surgeon and the patient and I think this would be really hard to achieve if they don’t actually get on with each other – even a little bit.’    

So, what should we look for in our surgeon beyond their experience and qualifications?

Fulvio, a leading authority on plastic surgery and’s resident ‘facelift’ expert, says: ‘A lot. The way they run their whole practice is important. Do they and their team respond to your enquiry attentively? Are they welcoming? Are they polite – to you and to clinic staff? Will they follow you up post-surgery and how long for? What aspects of aftercare will be included in the cost? Can they explain what treatment they do and don’t recommend?’

Interestingly, the surgeon may also be looking for a lot of those soft signs in you, too. 

He explains: ‘I always walk from my office to call patients from the waiting room myself so I can see how they interact with their companions or staff members. We are both assessing each other’s suitability.’

In which case, do patient and surgeon need to be able to communicate well with each other?

Fulvio is unequivocal. ‘Absolutely. I need to understand the patient’s motivation for surgery to have an idea of whether it is achievable. Wanting to fit into a certain dress size may be achievable through surgery; wanting to look younger so you get a promotion at work, or enhancing your figure so your partner to love you more, probably wouldn’t be.’

Honesty is, therefore, key. He says: ‘A major reason for me to decline a patient is when parts of the story fail to add up. This often relates to surgery that has not quite gone right before, and I think patients are embarrassed about discussing disputes with other surgeons. Really that’s fine, but not being open about it isn’t – for me, at least.’

Clinicians are not our ‘saviour’ – keeping the aim very defined and focused (‘bigger breasts’ not ‘a better career in the media’) will ensure this is understood from the outset.

And surgeons aren’t magicians either, and only ever have whatever we give them to work with. 

Surgical instruments not wands

Fulvio says: ‘For instance, during a liposuction consultation, I show patients a picture of a series of silhouettes increasing from underweight to overweight, and ask them to tell me which is most like their own body. As well as showing me how much insight they have about their own appearance, this gives me a way of showing patients that liposuction will (only) make them one to two sizes thinner. 

‘If that’s not enough for them, then they shouldn’t go ahead; if they manage to lose weight first, they will get a better result. But always, the surgeon wields instruments, not a magic wand.'  

So, if a surgeon refuse to offer us treatment, does this mean our relationship has failed?

‘It’s a possibility,' says Fulvio. 'Or, it could mean that the patient cannot be improved much – either because the starting point is too good or too bad. Alternatively, the technique we need may be outside the surgeon’s breadth of practice or a patient may not be physically or psychologically not quite ready to go ahead.'  

Whatever the treatment you are considering, make sure you do your homework.

You can browse clinicians and their area of expertise on this website. Good luck!

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