Cosmetic Surgery and the Importance of Communication

Clear communication between the patient and surgeon is vital.


  • The role of the surgeon during the consultation is to help synthesize an individual’s desires.
  • Manipulated photos, images of other individuals with desired traits, and a review of actual before and after photos can be helpful references.
  • Open communication and realistic expectations are key to patient satisfaction.

With increased on-camera time during COVID-19, many people are conceivably spending more time analyzing their faces and contemplating nonsurgical and surgical means to enhance their facial features. While deciding to undergo any cosmetic surgery to change the appearance of one’s face is a very personal decision, it is often not done alone. During the pandemic, facial plastic surgeons have seen a dramatic increase in the number of consultations, which has been attributed to several features, including the ease of telehealth appointments and relative ease of downtime given the current work-from-home trend. For those that do seek consultation with a facial plastic surgeon, engaging with appearance manipulation apps, seeking real-world examples of desired features, and reviewing publicly available before and after pictures ahead of time can help effectively communicate one’s appearance goals.

The influences of social media and online self-exposure have increasingly led individuals to seek cosmetic procedures. For example, “morphing apps” that are intrinsic to these social media apps have led to phenomena such as “Snapchat dysmorphia” or “digitized dysmorphia,” where patients seek to appear like their “enhanced” or “morphed” version. While there has been concern that sharing digitized or morphed images may distort expected outcomes, they provide a great way for patients to visually express their desires. It allows prospective patients to drive the discussion on what they are hoping to achieve as opposed to the traditional approach where surgeons share their suggestions to drive the discussion. Therefore, spending time prior to consultations making their own changes allows for the patient and surgeon to engage in shared decision-making strategies.

How patients and surgeons get on the same page about cosmetic surgery

Prior to the growth of social media platforms, the most common way for patients to communicate their desired appearance goals was to share pictures of real-world examples. This often included pictures of celebrities with desirable facial features. Interestingly, one study by Swami et al. found that people who have higher ratings of celebrity acceptance are also more accepting of cosmetic surgery, such that those with more intense personal celebrity worship are more likely to pursue these procedures. While only having one specific example for surgeons to use may be counterproductive and raise concerns, providing images from different real-world examples can help provide better data points to use as reference.

When compared to other generations, millennials, for example, often take a more active role in their health and have a “trust but verify” approach to medical professionals. Prior generations took a paternalistic view of physicians, whereas millennials view their health care providers as partners or equals. Interestingly, it is becoming more commonplace for individuals to consult with Google or RealSelf before seeking cosmetic consultation. This trend highlights the importance of reviewing before and after photos, which are typically found on a surgeon’s website or even from social media.

Analyzing the results of surgeons can help future patients gauge their aesthetic preferences to determine if the surgeon would be able to deliver the results one is looking for. This practice helps to give a jumping-off point to discuss desires and expectations for the outcome. It is also very common for surgeons to review their own before and after photos during a cosmetic consultation to help set better expectations.

The role of the surgeon during the consultation is to help synthesize an individual’s desires based on their own manipulated photos, images of other individuals with desired traits, and a review of actual before and after photos. Most experienced plastic surgeons will also assess each patient for the possibility of body dysmorphic disorder or other mood and personality disorders that may negatively impact surgical outcomes. These visual and verbal communication tools will give the best chance of establishing realistic expectations, which directly correlates with the highest likelihood of a satisfied patient.


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