I have come to learn over the years of a patient phenomenon of what I call…the unrecognizeable problem. While it is not quite that common in major surgery, it has become more evident in minor plastic surgery procedures and, in particular, with all of the new injectable treatments that now exist. It is when the patient points out some issue on their face and I, quite honestly, can’t seen it. I don’t claim to have microscopic vision but my macroscopic vision is still really quite good in both eyes.

When I was younger I would look hard and even if I could not see the facial problem, I would often say I could….just to make the patient happy. That may sound deceptive, and I was not trying to be deliberately so, but I figured if the patient sees it it must be real. Not that I am older, I have come to realize that if I don’t see it, just say so. Even if the patient and I disagree, as unpleasant as that can be with some patients. And the reason is….patients always then want something done to it or a little ‘extra’ tweak to these areas and what we effectively have is……chasing a moving target. It is hard to correct something that I can not see very well or something that I don’t even agree is there. Plus, agreeing with the patients always leads to more treatment as they search for the perfect result. Quite frankly, not every result can be perfect and many results will fall into the category of ….improved….or better than it was.

Being too agreeable at times can encourage a patient to try and improve their result even further….and not every result can or should be improved. I have learned that I usually know best as to when to stop…not the patient.

Dr. Barry Eppley

Indianapolis