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Managing Patient Expectations

Are you making patients more attractive, or just making them think that they are?

In a recent small study, 50 people were asked to rate the appearance of people who had undergone facial surgery. The bottom-line: Surgical intervention shaved a few years off perceived age but did almost nothing to boost patients’ overall attractiveness.  

What’s at issue is patients’ expectations, said study lead author Dr. Joshua Zimm, an attending surgeon at Lenox Hill Hospital and Manhattan Eye, Ear and Throat Institute of North Shore-LIJ Health System in New York City.

“When we’re doing this kind of surgery I’m telling patients that they’ll look fresher, more energetic and less tired, and we have some data in the literature that indicates you will look younger, as we found,” Zimm said. “But clearly I cannot say that they will look more attractive.”

Clarifying why someone elects to have cosmetic surgery is as important for the physician as it is for the patient. “The best motivation for cosmetic surgery is a healthy sense of vanity—emphasis on the word healthy,” says Timothy A. Miller, M.D., chief of the Division of Plastic and Reconstructive Surgery at UCLA. “There is nothing wrong with vanity, but when it becomes obsessive or the patient sees it as an avenue to changing the direction of his or her life, it can be a problem.” 

What patient doesn’t want to look their best? Most patients have very realistic expectations. But some patient expectations can stretch beyond reason. “If you expect cosmetic surgery to turn you into a movie star, you’re bound to be disappointed,” Dr. Miller says. “Also don’t count on surgery to save a rocky relationship, gain a promotion or improve your social life.” 

Maybe physicians in this space should refer to the hairstylists adage, “We use scissors, not magic wands.”

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