An important part of the plastic surgery consultation is for the surgeon to determine why the patient wants to make a change in their appearance. Patients often fail to appreciate that while they are interviewing or screening the surgeon, so too is the surgeon screening the patient. Is this patient a good anatomic candidate? Can I get a good result? Is he emotionally stable? Does she have a healthy reason for making such a change?

Most patients do have good reasons for having surgery. Some healthy motivations are personal (“I’m doing it for me. It’s always bothered me.”). Some, especially in the entertainment industry, are work related (“I would like to extend my career for a few years.”). On the other hand, I have met many people over the years who believe that the sole reason for their failing relationship, their failing career and their unhappiness in general was a single unattractive feature, a bump on their nose or a weak chin. No matter how technically perfect and esthetically well the outcome of their surgery might be, the process is destined for failure. Loving relationships and career fulfillment are not likely to ensue.

The relationship between the patient’s emotional concern about the feature in question and the extent of the physical problem itself is a helpful guide for plastic surgeons to decide whether to proceed. Minimal “anxiety” with a considerable “deformity” (“Doctor, I’m curious, is there anything that can be done about my very large nose?”) is a green light situation for the cosmetic surgeon. Conversely, high anxiety over a minimal deformity (My husband doesn’t love me because of my ears stick out”) is a red flag.

Equally important in the consultation is an evaluation of the patient’s expectations. The surgeon must be asking himself or herself, “Do I think I can please her”? Most people realize that changing the way they look is not going to garner them a three-picture deal or find the love of their life. Yet, strangely, once and a while someone does! It is very important, however, that it not be the sole motivating factor in proceeding with cosmetic surgery.

Bear in mind that when you go to see the plastic surgeon, be prepared to tell him or her not only what bothers you about your appearance, but also why you want to have the surgery and what you expect of the outcome. And realize that just as you are deciding “Is this the surgeon for me?”, the doctor has a responsibility to ask, “Is this a patient for me?”. The plastic surgery consultation is very often fraught with such anxiety on the part of the patient that the experience can be diluted. Your knowing what to expect will assist both you and the doctor in getting the most of your time together.