FEAR FIXATION Many of us downplay all the possible problems that can occur from our proposed procedures because we fear that we'll talk the patient out of having surgery. Another problem stems from the malpractice atmosphere we live in, which results in patients perceiving problems from surgery as mistakes and wanting restitution. And lastly, we deal with a certain segment of the population who are "crazy" and have expectations that never can be met. Many also obsess over problems from their surgery — even those that are very minor — and are unable to let go of this fixation.
TAKING ACTION So what do we do? First, give patients a true analysis of their cosmetic issues and an over-explanation of probable complications so that their expectations are greatly reduced. Second, let the patient know that no matter how skillfully we perform their surgery, problems can occur and they might need secondary touch-up surgery. We must be aware of the "crazy" patient who has had multiple previous procedures that he or she finds unacceptable and who fixates on cosmetic issues that they perceive as a "ten" when we see them as a "one" or "two." Lastly, it is important that we own up to our complications and stand by our unhappy patients by seeing them more frequently and empathizing with their distress, rather than running away from them for our comfort. Cosmetic oculofacial plastic surgery is "a battle against complications and unhappy patients." Many of my colleagues are falling victim to this battle by retiring or threatening to quit. It is our challenge to be victorious, peaceful warriors.Dr. Putterman, professor of ophthalmology and chief of oculoplastic surgery at the University of Illinois College of Medicine and chief of ophthalmology and director of oculoplastic plastic surgery at Michael Reese Hospital, has been in private practice for more than 35 years. He has published over 300 scientific papers and has contributed to more than 50 textbooks, recently publishing the 4th edition of his definitive textbook, Cosmetic Oculoplastic Surgery.
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