Teaching Patients What To Expect After Surgery
Part of pre-surgical teaching, and incorporated into all initial consultations, is some concepts about what to expect after your plastic surgery procedure(s). This is probably the weakest part of any surgeon-patient connection. While all patients will ask questions like…How much swelling will I have?….when can I go back to work?…..when will it look good and when can I see the final result?……no patient can have a true understanding of the postoperative healing process or prepare for seeing their body parts swollen, bruised, and temporarily distorted…..unless they have had prior surgery that was a similar procedure. And, unfortunately, most consultations with your plastic surgeon generally occur once, during the first meeting, and you do not see the doctor again until the day of surgery. While I encourage all patients to come back and see me again for the second time prior to their surgery to answer any questions or concerns, it is very rare that they actually do. I would say it occurs in less than 10% of all new surgery patients. Does that mean because they didn’t they have a perfect understanding about all aspects of their procedure….or my explanation of everything was so profound that everything was perfectly clear (I have come to realize that less than half of what I say to a patient in a consultation is actually remembered)…..no…….I think they try and get those questions which arise after the initial meeting clarified with the doctor’s staff by phone or e-mail, what is said on the mailed paperwork, and in talking to friends and other patients. Only the rare patient who is confused or concerned about a major point will make time to come back and actually speak to me.
When I talk to patients about what to expect after surgery, I divide their recovery into three phases: the day after, the first week after, and a month later. These time periods can also be called: the pain and agony (the day after), I’m starting to feel human again (the first week after), and It’s all worth it now (a month later) . While the type of plastic surgery procedure may be better or worse than these time periods (for example, breast augmentation is great in a week, full facial rejuvenation will take a full month), these are good average assessments at these time periods. I have long learned that it is far better to overestimate the amount of recovery, physical or social, than it is to fall short. Most patients don’t have realistic recovery expectations (why would they) and already think it will be faster than it will likely be. Doctors are famous for saying…you will have a little swelling and bruising, for example…..when from the patient’s perspective it is a horrible amount of swelling and bruising. It’s always different when you are the one actually having the experience than projecting what it will be like for someone else.
The most important, and occasionally problematic, expectation to manage is the long-term one or the final result. While I routinuely do some computer imaging (particularly on faces), what you do in surgery is not as precise. Plastic surgery is not as simple or predictable as morphing a digital image or manipulating images on Photoshop. Many variables affect the final result, particularly how tissues heal. No procedure is ever exactly the same on both sides, whether it be eyes, ears, a face, or two breasts. Some of that has to so with the fact that they weren’t the same before and some of it has to with how the body responds to surgical manipulation. That is why I caution patients…..perfection and perfect symmetry is not possible…..even though it may sometimes be obtained. Occasionally patients confuse paying a fee as a guarantee of optimal results. (even though they sign paperwork which states otherwise) What a patient pays for is the plastic surgeon’s best effort based on his skill and experience. And for the vast majority of patients that is fair enough regardless of the outcome.
Dr Barry Eppley
Indianapolis, Indiana