The role of the plastic surgeon during the pre-operative consultation Introduction The first step to take when considering plastic surgery to enhance the appearance of your body is to schedule a consultation with the plastic surgeon you have chosen to play out the procedure. There are many roles that the pre-operative consultation needs to fulfill, and having an experienced plastic surgeon to go with you over the details and performing the medical examination is crucial for the success of your procedure. Patients should be aware of undergoing plastic surgery that they schedule through email or over the phone, and this practice is common when thinking about plastic surgery abroad and it comes with a host of potential complications that could occur. In this article, we will discuss what happens during the initial consultation for plastic surgery and what is the role of the plastic surgeon during the pre-operative consultation. Outline of the pre-operative consultation The pre-operative consultation is not just a rule of the health system, but also a crucial time when the plastic surgeon has to assess the health condition of the patient, the reasons and motivations for undergoing surgery, and the emotional condition. Most patients don’t know what to expect when it comes to the initial meeting with the plastic surgeon. However, the initial consultation is the first step towards achieving your aesthetic goals with the help of plastic surgery. There is a certain level of preparation that the patient needs to bring into the initial meeting with the plastic surgeon. Before anything else, the patient needs to clearly have in his head what he wants to achieve with the procedure he wants to undergo. This means that all types of details can come in handy, including pictures of patients showing similar results they are trying to achieve. It can also help to write down questions or concerns you have about the procedure to make sure you don’t forget bringing them up when discussing with the plastic surgeon. Also, it is crucial to make sure that your plastic surgeon is board-certified, experienced and well-versed in the procedure you want to have so he will be able to guide you through this process. After the pre-operative consultation, you should know all the details associated with the procedure and what is the best surgical approach to help you achieve your goals. You should also know whether you are a good candidate, when would be a good time to schedule the procedure, and what to expect during the recovery period. In a vast majority of cases, one pre-operative consultation is enough to set straight all the details of the procedure. Performing the medical examination and recommending the surgical approach Evaluating the medical condition of the patient is essential before the procedure. This medical evaluation is as important as the diagnosis in itself as all the data from the medical history of the patient together with the desires of the patient and the physical characteristics are cumulated and analyzed. The plastic surgeon has the role of performing exact measurements to be able to determine the best course of action and a suitable surgical plan. The surgeon will also ask questions about your medical history, allergies, current medication, and health conditions to make sure there are no contraindications to the procedure. Even if the procedure you want to undergo is something as simple as abdominal liposuction, the plastic surgeon will have to measure your weight and height and check the condition of the tissues in the areas to be treated during surgery. Also, he will ask about previous surgical procedures performed for aesthetic purposes or not as he will want to check the appearance of the scars. Some patients might have a predisposition towards abnormal scarring, and it is important to know this before scheduling the procedure. After the medical examination has been performed and the patient has described his goals and expectations from the procedure, the plastic surgeon will elaborate on the surgical plan. In some cases, the surgical plan can be different from what patients expect. For example, there are women coming to the pre-operative consultation for breast implant surgery only to find out that they actually need a breast lift with or without implants. The plastic surgeon will recommend the optimal surgical approach that can help the patient achieve his aesthetic goals. Giving the patient all the details about the surgical plan After the medical examination and informing the patient about the suitable surgical plan to be followed, the plastic surgeon should give the patient all the details associated with the surgery. He should discuss both the complications of the procedure but also the benefits so that the patient can have a clear understanding of what to expect during and after the procedure. Important information that should be discussed during this time is associated with the placement of the incisions, how the procedure is performed in extreme detail, the recovery time frame, side effects that can normally occur after the procedure, potential risks and complications, and when they can develop. Also, there are other important details that should be mentioned such as the need to undergo additional procedures in the future. For example, in the case of a very complex breast reduction procedure, the plastic surgeon might estimate that two procedures would be needed to achieve spectacular results, or that breast implant surgery will need to be revised later on if complications such as capsular contracture or implant rupture occurs. The details of the anesthesia to be used for the procedure are also discussed at this point, and the plastic surgeon will also tell you about the consultation that you will have with the anesthetist a day or two before the procedure is performed. Recommending tests to be performed and the pre-operative instructions Any type of surgical procedure should only be performed after the patient has done routine tests such as blood tests (glycemia, coagulation, etc.) but also more specific tests such as a breast echography or mammogram for breast enhancement procedures, EKG and so on. The plastic surgeon will also recommend a pregnancy test as we need to rule out the possibility of the patient being pregnant before the procedure is performed. Keep in mind that a responsible plastic surgeon will recommend as many tests as he considers necessary. This is not just a formality, but it is for the well-being of the patient. Preparing the patient for the surgery from an emotional point of view Before any plastic surgery procedure, the patient should also be emotionally prepared for what will follow. By this, we mean both the recovery period and the final results of the procedure. An experienced plastic surgeon is aware of the struggles and will tell the future patient what to expect. An important thing to discuss is the recovery period and the visibility of the results. It is often the case that the final results of the procedure take months to be fully visible. This means that the patient needs to have patience and understand that the appearance of the body might be different during the recovery period. For example, after breast implant surgery, many patients are surprised to notice that the implants are very high on the chest wall and they have the appearance of a bodybuilder. It is very important to understand that this is just a temporary side effect and the implants will descend and settle in time. Knowing exactly what can happen during the recovery period and how and when the final results will transpire can help the patient be more prepared and also reduce the post-operative stress. The plastic surgeon also has the role to discuss pain management and give the patient instructions on how to minimize the discomfort and pain after surgery. Conclusion The plastic surgeon has a very important role during the pre-operative consultation, maybe just as important as during the operation proper. The initial meeting with the plastic surgeon is the time when the patient is asked to talk about his aesthetic goals, medical history, and health conditions to help the plastic surgeon elaborate the optimal surgical plan that will deliver the results expected. The plastic surgeon has the role of explaining the details of the procedure to be performed, to recommend medical tests to be taken before the procedure, and teach the patient how to prepare both physically and emotionally. It is important to understand that it is only an experienced, board-certified plastic surgeon who can efficiently guide you in the process of enhancing your physical appearance with the help of plastic surgery. The knowledge and experience of the plastic surgeon are also crucial in helping you avoiding complications that could occur during or after the procedure.