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Books/Facial Aesthetics: The Anatomy of Natural Results/Patient Consultation: The Architecture of a Good Aesthetic Decision
Chapter 189 min read

Patient Consultation: The Architecture of a Good Aesthetic Decision

A good aesthetic decision begins with a good consultation. This section explains what questions should be asked during a consultation, expectation management, and that saying "no" is also part of aesthetics.

Main ideas in this chapter

  • A good consultation should last 30-45 minutes; a healthy decision cannot be made from a 10-minute consultation.
  • Understanding patient expectations is more crucial than the treatment technique.
  • A physician who can say "no" in the case of a wrong indication is the safest choice in the long run.

Stages of Consultation

A good consultation includes the following steps: (1) understanding the patient's expectations and motivation; (2) detailed assessment of facial anatomy; (3) creating photographic documentation; (4) presenting possible options and alternatives; (5) explaining the risks, benefits, and costs of each option; (6) allowing time for decision-making (no pressure for same-day procedures).

Points to Understand About the Patient

"Why now?" — Is there a social event, or is it a chronic condition?

"Who influenced you?" — A celebrity photo, a friend's result, or your own photo?

"How much time and money are you willing to commit?" — The reality of maintenance should be discussed.

"What have you had done before?" — Previous interventions, their results, and satisfaction level.

"Health status" — Autoimmune diseases, allergies, medication use, pregnancy/breastfeeding.

Expectation Management

Are the patient's expectations realistic? Is the desired outcome possible with their anatomy? A patient might ask for "lips like celebrity X"; however, if their mouth bone structure is very different, this result might not look natural. In this case, either the expectation becomes realistic, or the treatment does not proceed.

Saying "No"

A good physician does not say "yes" to every request. Situations where "no" should be said: (1) the expectation is anatomically impossible; (2) the patient is making a decision during an emotional crisis; (3) they haven't seen the results of a previous procedure yet; (4) their health condition is not suitable; (5) the patient's expectation is inconsistent with the physician's value system (desire for excessively exaggerated results).

These "no's" lead to short-term disappointment for the patient but long-term protection. In my clinic, I end 15-20 consultations a year by saying "I don't recommend it" — this is approximately 5% of all consultations.