The first point of contact for a patient to ask post-surgical questions should be the surgeon who performed said surgery. The trend seems to be in exactly the opposite direction.

I've noticed a concerning trend. I participate in websites like RealSelf.com that connect plastic surgery patients and cosmetic surgeons. These sites are allowing patients to have near immediate access to expert plastic surgeons from across the nation and plastic surgeons to interact with potential patients.

In the past few months an increasing number of patients in the early post-operative period (some with dressings still in place!) have posed questions to “online surgeons” seemingly before seeking follow-up with the plastic surgeon who just performed the procedure. It is concerning that a patient would seek advice from a surgeon they do not have a doctor-patient relationship with and who is unfamiliar with the specifics of the surgery that they've recently undergone. Patients have even gone so far as to inquire about where to seek second opinions and whether revision surgery will be necessary all within the first post-operative week.

The early post-operative timing of this phenomenon is most concerning. This is the period in which we need to reassure our patients that bruising and swelling will resolve, dressings and sutures will be removed and that they truly will look great once they’ve healed. This period can cause patients significant distress and many require a lot of hand holding at this point.

We’re obviously failing some of our patients if they're reaching out online during this period instead of calling our offices and dropping in to be evaluated. I agree that second opinions are highly valuable and would not hesitate to arrange such for a concerned patient. However, a patient-initiated second opinion from an unfamiliar, online surgeon who has an incomplete picture of the patient's history is problematic at any time point let alone while the compression dressing is still in place!

What could possibly be responsible for this trend? As cosmetic surgeons are we so difficult to reach that our patients need to seek online advice from others? As we become more amenable to interacting with potential patients online are we failing to care for those who have already made a trip to our operating room? Is it simply easier for our patients to log onto a website rather than call the doctor's office? What can we do to direct those online inquires back to our own practices rather than into the digital ether?

As a Facial Plastic Surgery practice, my entire team is in the business of building relationships. If a patient has a professional, responsible and ethical plastic surgeon, the first point of contact to ask post-surgical questions should be the surgeon who performed said surgery. This trend seems about as far astray of that goal as one could imagine.

Has anybody else noticed this trend online? Have you experienced this with one of your own patients? What you have done to prevent this from happening in your practice? Please contribute your thoughts.