When One Surgery Turns Into Two

The decision to have cosmetic surgery is a big step for my patients. Actually, having surgery of any kind is a big event in anyone’s life. Cosmetic surgery has an added element of complexity as a result of the financial commitment patients make. Most patients feel that although the procedures are expensive they will be happier with their self image post operatively and therefore the cost is justifiable.

What happens if the result isn’t what was expected? Did the surgery result in a complication or were the expectations not in line with the technical possibilities of the situation? Does it matter?

Unfortunately revision surgery is a complicated situation. I always try to be more critical of my results than my patients will be so that we can maintain open lines of communication about the outcomes. Sometimes despite what seems like a perfectly executed initial surgery, the results are less than perfect. The question then becomes whether more surgery will improve the situation or just make it different in an equally unsatisfying way. As the saying goes, perfect is the enemy of good.

Part of what I love about doing cosmetic surgery is that the end point of “beautiful” isn’t one thing. There is no greater challenge than identifying the goals for a specific patient based on their desires and their anatomy and then enacting a plan to get them to their ideal. A big part of this is helping the patient understand the unpredictability of the way their body will respond to the surgery. I spend a considerable amount of time pre operatively discussing these concepts with my patients. I will always do my best for them but we will both have to accept an element of unpredictability. Revisionary surgery is sometimes necessary, and establishing rapport between patient and surgeon will help to ensure that at the end of the day, the patient is satisfied with their choices.