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Plastic Surgery: The First Step

Dr. Heather Furnas is evaluating a patient's face.

Dr. Heather Furnas evaluating a patient

The Plastic Surgeon’s Responsibility

A plastic surgeon bears a lot of responsibility, from planning the operation and educating the patient to providing a safe facility with excellent staff, performing the surgery well, and caring for the patient afterward. But if the patient wants the best outcome, she has to take on some responsibility herself. Of course, she can’t do her own surgery, but there’s a lot she can do.

The Patient’s Responsibility

If you (or perhaps a loved one) are thinking of having plastic surgery, your first step towards the best outcome is to articulate what bothers you and why. If you don’t explain what your goals are, you leave the surgeon as commander of the ship with no compass.

Be specific, be complete, and be realistic. The more clearly you explain the changes you want, the better your plastic surgeon can plan your surgery. Or if there are uncontrollable constraints, he or she can tell you your goal just isn’t possible.

Let’s say you want a breast reduction. What size bra do you wear now, and what cup size would you like to become? A thin, athletic patient might want to be a B-cup size, but a more generously proportioned woman might want to be no smaller than a D-cup.

Broken Hearted after Breast Reduction

Years ago, when I still a training in plastic surgery, I performed a breast reduction on a woman with F-cup breasts. Her heavy breasts weighed down on her neck and upper back, causing constant pain. A C-cup size sounded good to her, and that’s what she ended up with.

But afterwards, she was broken hearted. Her smaller breasts no longer covered her large abdomen, and her husband berated her daily. Her pain was gone, but now she had a different problem. Later she had a tummy tuck, which made both the husband and my patient very happy.

After that I realized my job wasn’t just to listen to the patient’s desires but to try to anticipate the impact of surgery, both positive (“No more neck pain!”) and negative (“Your abdomen may protrude more than your breasts at that size.”)

How Patients Can Help the Plastic Surgeon

Patients interested in having a breast augmentation vary greatly, and I listen to what they say, look at photos they like, and note down their rice test results. The following patient comments have helped me figure out what patients want:

“I want to look like Bay Watch.”

“I don’t want to look like Bay Watch.”

“I want to look natural.”

“I want to look fake.”

“I’m not insecure or trying to please a man, but I can’t find dresses that fit. I want to feel like a woman instead of a boy! I just want to be a normal B.”

Plastic Surgery Communication Flows Both Ways

Some patients come in wanting something I can’t deliver, like women with hanging tummy skin who want to get rid of it with liposuction or CoolSculpting. I explain that the only way I can remove the loose skin is with a tummy tuck. Liposuction results would only make them unhappy.If they aren’t interested in a tummy tuck, then I do nothing.

Whether patients are interested in a facelift, nose reshaping, an arm lift, or anything else, communication is the first step towards satisfaction with the results.

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