by Vartan Mardirossian MD FACS, Double Board Certified Facial Plastic and Reconstructive Surgeon

Throughout the years of my career as a facial plastic surgeon there are essentially two types of patient that I have encountered. The first type: the luckily more predominant one, are the patients whose exterior appearance does not correspond to their interior perception of themselves. These are 95% of my patients – they feel that their nose is too big for what they would like, that their jawline is too wide or that their cheeks are too sunken compared to the inner image of themselves. These patients, for the most part, are happy after the procedure as they observe their facial features, now transform to match what their idea of their own appearance was. These are the good ones.

The other type is the patient who desires a facial plastic surgery procedure unfortunately without the clear understanding of what the “much desired” final result will be. And this is after all of the hours of consultations, detailed explanations and risks and benefits descriptions. Surprisingly, after the procedure(s) are completed, these patients remain unhappy – not because the goals were not achieved, but rather because they have literally not “caught up” with their new appearance. In other words, their own idea of themselves has not yet matched what they have desired and what they have received. This is a “dangerous” group of patients as this mismatch may understandably cause serious emotional distress. But are there ways to avoid the second group from getting surgery or from getting it too prematurely? Is extensive pre-op counseling enough?

There are many reasons why patients come to us looking for facial plastic procedures and most of them have valid and reasonable reasons for it. I often say that my role is basically the one of a mitigator: I often have to “mitigate” between what the patient thinks they are going to be looking best and what would really look aesthetically pleasing for the people around them; I have to often reconcile what their needs are and what they have in mind; but most of all, my role is helping them achieve the result they want while keeping them safe and happy. I believe that facial plastic surgery is an investment in your own self, more than a luxury good expense. That is what makes it so special and different from the other things we want to have. It is something that stays with you and even more, becomes a part of you. Facial plastic procedures should be carefully weighed and “filtered” before proceeding. Here are some of the reasons that raise a red flag in my evaluation:

1. To look like a celebrity

Celebrities rise and fall sometimes within a year. Your face stays with you all your life. Why not enhance its own unique beauty? Why do you want to be someone else? Understanding the answer may start from inside-out…

2. To fight depression

Plastic surgery may increase self-confidence but should not be the only pillar upon which confidence is built. Once the depression is gone, then improving your appearance may “bolster” your victory.

      3. To please your significant other

A big red flag there! If they love you they will love you the way you are. Why did they fall in love in the first place?

4. To get a job

This is a tricky one but it all depends on the job. Many patients want plastic surgery to look younger and to keep their current job.

5. To get revenge or make jealous

This is a spin-off of #3. If a story is over it is over. As they say in my country: “God closes one door and opens hundreds more.”

Of course there are many other “red flags” and situations that may undermine the good patient-physician relationship. To filter these out it is important to see the patient through a human lens even before we start talking about the intervention they would like. Because I deeply believe that to be a good facial plastic surgeon, someone should first be a good physician and even before that, a good person.

Dr. Vartan Mardirossian is an Assistant Professor of Facial Plastic and Reconstructive Surgery and Otolaryngology at the Florida Atlantic University and a consultant of Facial plastic and Head and Neck Surgery at Jupiter Medical Center. He is double Board-certified in both Facial Plastic surgery and Head and Neck Surgery and has authored many studies on pivotal topics within the realm of Facial plastic surgery. http://palmbeachplastics.com/