Fools rush in where angels fear to tread, so the saying goes. And, if you are about to forge ahead recklessly with an aesthetic procedure – no matter how minimally invasive – without due care and attention, then stop now and read this.
Dr Fulvio Urso-Baiarda is a consultant plastic, reconstructive and aesthetic surgeon with a Berkshire practice.
He shares his thoughts and insight into why waiting a little longer to ensure a safe path to treatments will reaps benefits in the long run…
3 ways time matters when it comes to cosmetic surgery?
Patient should have the chance to answer all their questions and really understand the implications of the choices they are given. Sometimes, there is too much information to process all in one go, and it may be necessary to return to the clinic twice or even three times before surgery. It is always time well spent. It’s infinitely better to identify and correct any misunderstandings before a procedure than afterwards.
You should be ready for your operation, physically and psychologically. This means no snap decisions after a divorce and no yo-yo dieting. If you smoke, you have to stop, and stay stopped, for a few weeks before and after. Forever would be even better!
A patient who sees a clinician for cosmetic surgery is placing a lot of trust in him or her, and it should go without saying that the surgeon should never feel stressed because of a lack of time. So, it is important to know that your surgeon is able to control their own operating list and how densely it is packed. Surprisingly, that may not be the case in every institution.
Should clinicians give patients plenty of time to consider all options?
Absolutely so! The recommendation is for a two-week cooling-off period for cosmetic surgery. Often, the really probing questions come after the patient has gone home, had a think and chatted with friends, family or looked online, and it’s not uncommon for the answers to those questions to have an impact on the operative plan.
Do you encourage patients to discuss their choices with loved ones?
If the patient feels comfortable doing this, then they definitely should. Many people want to keep cosmetic surgery private, but most do bounce their ideas off at least one other person before surgery. If anything, it’s more important to have that support afterwards, and I'm a bit concerned if I learn a patient will have no emotional support at home.
Do you turn away patients?
Yes, for many reasons. Some people are simply not fit enough to justify non-essential surgery. Others are physically healthy but have unrealistic expectations of the outcome - if so, cosmetic surgery will ultimately not make them happy.
Occasionally, patients have a reasonable understanding of the effect that surgery will have on their appearance but think it will transform their lives in other ways – a better job, finding a partner, earning more money, having a better social life… If those things cannot be cleared up, then it is better not to go ahead. Finally, and I know this sounds vague, when it comes to a cosmetic procedure, the patient and surgeon actually need to get along because you’ll be spending a lot of time together!
We live in a fast-paced world – has this altered patient expectations when it comes to the time it takes from consultation to procedure? And even time it takes to see results?
There is a general sense that patients are visiting us younger, looking for quicker results with less downtime. That has fuelled a trend towards medical rather than surgical cosmetics, by which I mean Botox, fillers, threads, peels, lasers and so on. Many patients will accept less of a result, more often but with less downtime each time. These days many patients have been down the non-surgical road before reaching an operating theatre.
How do you sift out those patients with psychological body issues from those who simply have high expectations?
One is essentially an extension of the other, so drawing the line is difficult, but there are screening tools (questionnaires) that help. Mind you, I think they are a bit out of date: one screening question asks how often you look at yourself in the mirror, whereas I think these days it’s more relevant to ask how many selfies you need to take before you’re happy to post it.
Is it sometimes safer NOT to treat?
Absolutely. This is non-essential surgery – the reason we are doing it is to improve somebody’s self body image. It’s about the only instance I can think of where patient happiness is the actual primary surgical outcome. If the patient is not psychologically ready to be happy with their appearance, however good it is, or if their happiness will be determined by things outside of my control – like a promotion or a new partner – then you’re better off parting company. Thankfully, the majority of patients I meet are having surgery for the right reasons – for themselves – and have sensible expectations. For the right patient, it is the most rewarding job there is!
Ask our Expert Fulvio Urso-Baiarda a question