Dr. Vijay SharmaDr. Vijay SharmaPresidentPresident

Federation of Restorative and Cosmetic SurgeryFederation of Restorative and Cosmetic SurgeryMumbai, INDIAMumbai, INDIA

How to Consult a Patient

The art and science of Cosmetic Surgery is to go into the depth of emotional requirement.

Reach up to hopes and expectations.

Match this with the limitation of the surgery.

Choose the right reason. Right time and right operative procedure on

right patients.

Deliver what is committed and commit what can be delivered.

To Choose the right reason for Cosmetic SurgeryWhat then would be the right-reasons to go in for cosmetic

surgery?

You’ve successfully used diet and exercise strategies to lose weight — except for some stubborn fat on your thighs. Liposuction (fat removal) can help.

Your five-year-old is the butt of taunt and ridicule by his school friends because of his protruding ‘bat’ ears, setting the stage for a severe and lifelong inferiority complex. Otoplasty (ear surgery) can nip this psychological damage in the bud.

You have a large, bulbous nose and feel it compromises your otherwise hugely handsome looks. Rhinoplasty can get you closer to the Apollian ideal.

Is career improvement a valid motivation for cosmetic surgery? Could be. Not because your boss is going to think, “What a wonderful new nose Krishnan has acquired, let’s promote him”, but because the improvement in appearance can enhance your self-confidence, causing you to interact more positively, more assertively with others, which in turn produces positive feedback, giving you that vital edge that could eventually lead to, yes, a promotion.

But remember that the bottomline is that cosmetic surgery changes appearance, not personality. A face-lift may, as rewarding fallout, boost your self-esteem, but there are no guarantees about this. Psychological tests on some patients in the U.S. have shown that about 40 per cent get “measurable emotional improvement” — but that the majority gets no such improvement. After all, the transformation has been wrought on an operating table, not a Freudian couch. In fact, if your decision to have cosmetic surgery is based on factors other than improving your appearance, the operation could leave you psychologically worse off than before.

Avoid wrong Motivation.Just as there is a right and a wrong motivation for electing to undergo

cosmetic surgery, there is a right and a wrong time. Wrong times

include:

When you are experiencing a personal crisis, such as an impending divorce.

When you are going through a time of grieving or severe depression.

The reason, in both the above instances, is that, during such times a person does not have the emotional reserves to go through elective surgery. And a cosmetic operation does require emotional preparedness: for one thing, you’ve got to be ready to look worse before you look better, (To imagine the immediate aftermath of eyelid surgery, for example, imagine going a few rounds with; Mike Tyson, only he’s using a scalpel instead of gloved fists).

Practical considerations can also dictate when the time is wrong for cosmetic surgery: for instance, if you have a family wedding coming up in a fortnight, it would be unwise for you to schedule a dermabrasion session before that, unless you want to grace the function looking like a protagonist in a Ramsay horror film. All cosmetic surgery has a recovery period that’s more often an extended one: from several days to several months. If you’re thinking you’ll be able to get back to work a few days after the surgery, you’d better rent a Frankenstein cassette and think some more. Cosmetic surgery is the only medical discipline that takes people who are well and makes them ‘sick’ — you’ll be bruised, you’ll be swollen, you’ll hurt, and you’ll feel worse before you look better. Like the Boy Scouts, your motto should be to be prepared.

How to choose the right doctor.Okay, so you’re prepared. Right motivation, right time, right

emotional state. What next?

It’s time to look for the right cosmetic surgeon. You’ll need to

check him out at two levels. First, his surgical competence. After

all, he’s going to take his scalpel to places no man has gone

before — your inner places. And you’ve got to feel secure about

entrusting your scalp, face, breasts, abdomen, whatever to him.

How do you find Dr. Right?

Dont's Don’t go to your friendly neighborhood beautician for

procedures like chemoabrasion or dermabrasion. Many of them do offer these “services”, but both are potentially risky procedures and the risks are naturally heightened in inexpert hands. The last thing you want is for an aesthetic procedure to leave you looking more than imperfect you started out.

Don’t pick out the first name listed in the yellow pages, or the one that’s nearest your residence. You need to put more serious effort into finding your surgeon.

Don’t go to a practitioner from a medical system that doesn't include surgery in its curriculum — for instance, acupuncture or homeopathy. An M. D. or an M. S. should be the basic qualification you look for.

Dos Do consult your family physician. Tell him the technique you're looking

to get done; and listen to his advice and recommendations: he knows the men in the field. He may have seen many of them at work; he knows who’s a technical wiz, who overcharges, and who rejects candidates from time to time — a good sign in a cosmetic surgeon. (You’ll learn why in a later chapter).

Do speak to others, who you know, have undergone the same procedure — by no means an easy thing since cosmetic surgery is one of the best-kept secrets of men and women. But if you’re lucky to be able to talk to such persons, you’ll get first-hand reports of different surgeons’ skills — which goes far beyond just their qualifications on paper.

Do contact a professional body, such as the American Academy of Cosmetic Surgery or the Indian Association of Cosmetic Surgery, for recommendations. Membership in this body is a good sign because it offers board certification. Unqualified and unethical practitioners are automatically weeded out. The Association has its offices in big cities.

CONSULTATION REPORT

Consultation Date: 6th -7th –June ,2003.

Ref.By: Colleagues and Doctors Hospital Nursing Home Clinic Self imagination TV programme Magazine Newspaper Beauty Parlour

Patients Details:

Name: Dr. Nikolay P. Serdev

11, "20th April" Street,

BG-1606 Sofia, Bulgaria

Date of Birth: 18 Mar 19--

Email: nserdev@infocom.bg

Tel: +359 888 02004

Sex: Male

Patients GP:-

Name: Melvin Shiffman

Procedure/Interest:

1. How can I help you

2. Which part Specifically

3. Since how long you have been thinking to improve upon

History of Present Complaint:

1. Since how long you are aware

2. Number of years

Previous Surgery and Medical Illness:

1. Long hospital stay

2. Major ailment, operation, accident.

Previous Mental Problems:

1. Tension

2. Depression

3. Stress

4. Obsession

5. Anything else

Husband/Wife:

1. Married

2. Unmarried

3. Separated

4. Divorced or Live-in Relation

Children: Number and age

Work:

1. Business

2. Office Executive

3. Manager

4. Proffessional

Social:

1. How Active

2. Do like meeting people

Family/Friends:

1. What do they think

2. Do you mix with them well

Patients Hopes and Expectations:

Why would you be interested

• To please people around you

• Getting pushed or advised by others

• Purely for self

General History:-

1. Do you smoke,….. Cigarette, Cigar, Biddy, Chewing Tobacco

2. How many per day

Drinking:-

Do you drink, how often?

Pill: Contraceptive

Drugs / Medication: Do you have any kind of medicine

Previous Anaesthetic:

1. Head Injury

2. Epilepsy

3. Complications of Anesthesia

Allergies: To any medicine

Examination and General Description:

1. Height

2. Weight

3. Built, Average, Large small

Special Description of Relevant Areas:

1. Nose

2. Face

3. Breast

4. Body

General Examination:

B.P.------ H.R.------ Pulse------ CVS--------

Chest:

Cough, Asthma

Abdomen:

1. Constipation

2. Diarrhea

3. Irregular Menstruation.

My Opinion / Comments:______________________________

Patients is: (A) Good Candidate

(B) Suitable with Reservations

(C) Poor Candidate and surgery not Indicated

Operation Recommended:Clinic:______________________ No.of Nights_______________

Type Anaesthetic:_____________ Date_____________________

Time of Report_______________ Last Food/ Liquid___________

Special Instruction to patient________________________________

Signature_______________

I agreed your contacting my GP and for him to provide you with details of my medical history.

Signed________________Date_______________________

I do not wish you to contact my GP

Signed__________________________

Date____________________________

Thank youThank youDr. Vijay Sharma, M.D.Mumbai, INDIA