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Your very own reality show

Article-Your very own reality show

Key iconKeypoints:

  • Dramatic cinematic or television treatments of medicine are unrecognizable
  • Although media presentations of cosmetic surgery may be unrealistic, it creates interest in cosmetic procedures and possibilities
  • The cosmetic surgeon's challenge is to convert a program-inspired viewer into a well-informed and realistic patient

There isn't much I recognize about most dramatic cinematic or television treatments of medicine. The characters seem improbably young and attractive, with a surfeit of hair and a paucity of sag. The stories are wrought with tense intrigue, and rarely does one hear the line "that pressure sore looks a little smaller, let's put the VAC back on for another couple weeks." Rather than Lamborghini I have Honda, my nurses are grandmothers, and the only beautiful young women I have climbing on me are teenager daughters with an agenda.

I am a "Mellow Makeover" practitioner, working in Billings, Montana, yet I feel that I, as well as my patients, have benefited from all the various media presentations of cosmetic surgery. This content, even if it is silly, creates interest. I really don't care what crazy ideas patients bring with them to my office — it is the knowledge they leave with that really matters. The conversion of a program-inspired viewer entering our office to a well-informed and realistic patient is the challenge presented us as cosmetic surgeons in an era of heightened media interest in our specialty.

The mantra of "realistic expectations" might be more effectively retooled to "specific expectations." A patient drawn to our office by a "makeover" program might be globally unhappy with their appearance. The skillful interviewer walks the patient through the various elements of facial analysis, gradually bringing into focus some specific, achievable goals. I avoid telling patients they will look "younger," or "better." I do tell them I will reduce their jowls, decrease the excess skin in the neck, or soften the lines between their nose and cheek. My goal is to convert the patient drawn to my office by a program suggesting a younger, happier self, to a well-educated patient who understands that if I surgically reduce the bone and cartilage on top of their nose that they won't have a hump in their nose. I let the patient decide if the absence of the hump in their nose is a good thing. Converting the passive patient wanting to be "made over" to the educated, active patient who chooses to have a specific anatomic alteration is the successful culmination of a process begun on the TV couch.

Providing value to our patients is critical. Value is the product obtained when you divide what you get by what you pay. A patient may be drawn to our practice after viewing a program on miracle "noninvasive" procedures, but won't come back if she feels she spent a bunch of money on something that really didn't make that much difference. A patient may say, "I saw the most amazing thing on TV they did with a laser, do you do that?" You may, in fact, have the laser sitting in your office, and the patient may be rubbing her money in your face, but if you don't think such a result is realistic, don't yield to the temptation. Perhaps the truest test of a professional is to advocate for the patient's interest when it is in contradiction to your own interest.

We have been provided the boon of free, albeit undifferentiated, advertising for our profession. Incumbent in this largesse is the responsibility of converting nonspecific "makeover" fairy tales to educated, focused and reasonable patient requests. In this unique collision of popular culture and professionalism, both the patient and the practitioner can be winners.

For more information
Alan Muskett, M.D.
[email protected]

Alan Muskett, M.D. Guest Columnist
Dr. Muskett was born in Missoula, Montana, and received an English Literature degree from Montana State University. An Alpha Omega Alpha honors graduate of the University of Washington Medical School, he was trained and certified in general surgery at the University of Utah. He then completed a fellowship in cardiothoracic surgery at Washington University in St. Louis, and was certified in thoracic surgery in 1992. After 12 years of cardiac and thoracic surgical practice in Billings, Mont., he returned to training in 2003, completing a plastic surgery residency at the University of Mississippi in 2005. He was certified by the American Board of Plastic Surgery in 2006. Alan and his wife Pam have three children, and have returned to practice at Billings Plastic Surgery in Billings, Mont. Dr. Muskett has written numerous scientific articles and has made editorial contributions to both thoracic and plastic surgery journals, as well as regular contributions to the local newspaper. He strongly desires not to take any more board exams.
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