Houston — In a perfect world, every patient's concerns and expectations about breast augmentation would be completely taken care of, all of their wants and needs would be ideally met and lawsuits would be a thing of the past.
According to Neal Reisman, M.D., J.D., clinical professor, plastic surgery, Baylor College of Medicine in Houston, cosmetic surgeons who employ a process of interaction with their breast augmentation patients are able to get a much better idea about those patients' expectations and then can more effectively manage those expectations. This, in turn, can result in happier patients who are much less likely to sue.Dr. Reisman uses a number of approaches to help understand, manage and better meet a woman's expectations.
A major role of the physician is asking and listening, according to Dr. Reisman.
"We need to ask questions, listen to find out what their goals are, look at past history and medical problems, and then determine which goals are realistic and which are not," Dr. Reisman, who is also associate chief of plastic surgery at St. Luke's Episcopal Hospital in Houston, says.
"The more we can educate a patient about all of her options, the better she is able to focus on her expectations. I think that's critical for planning for any operation, but especially for breast augmentation. Sometimes, this takes more than one office visit.
"I'll ask where she would like to be; what size, what shape. I use a number of visual aids to help them understand what might be best for them. I tell them how the surgery is done, and discuss the options, potential problems, and the likelihood of inherent risks and complications — then I listen to the patient," he says.
"I like to involve significant others, but am leery about boyfriends who might be here today and gone tomorrow. The doctor should be able to get a better idea about all of these things through careful interaction."
Web pros and cons
Today, women have very specific ideas about shape and size of the implants they want. The Internet provides a tremendous opportunity for women considering breast augmentation to hone their expectations.
They view myriad photos of breast shapes and sizes, chat with other women about the procedure and do research to learn about factors specific to their concerns or issues. (See related story.) According to Dr. Reisman, the worldwide Web is a mixed bag.
"The pictures can be misleading and they can misrepresent what is the norm," he says. "But whether we like it or not, this is a visual age and women will seek out sites in order to understand their options and create their expectations."
While it has disadvantages, the Web can also be an asset.
Dr. Reisman uses a powerful Web-based patient satisfaction and risk management tool called Emmi (Expectation Management and Medical Information) Augmentation module (Inamed, Rightfield Solutions). Emmi helps patients get the information they need to better understand what to anticipate before, during and after their breast augmentation surgeries.