As more and more people have become aware of the range of treatments available, so too has the general public’s expectations increased to such a degree that there is a danger of losing touch with realistic outcomes.
These unrealistic expectations have been fuelled by ever present advertisements and television programmes. With some pushy commercial outlets, pre-operative consultation with patients may be less than adequate. Should this result in an unsatisfactory outcome, the disgruntled patient may argue that he or she did not give full and proper informed consent. Did they even speak to the surgeon involved?
Potential risks must be explained to the patient and preferably a very detailed note kept by the commercial outlet. In the case of cosmetic surgery the preparation of sketched diagrams, for example showing potential outcomes and even scarring, can be a wise step. After all, a patient’s expectations will, as stated, be high.
Whilst pre-printed pamphlets and information can be helpful, a personalised letter to the patient outlining potential risks goes one step further.
Pre-surgical advice may extend to other risk factors such as cigarette smoking. Avoidance of smoking and even nicotine substitutes reduces the risk of major healing complications e.g. nipple necrosis or gangrene.
The operation may be sub-standard itself such as contour irregularity following liposuction. Equally poor planning can, for example, impair blood supply and this may or may not be revealed by the operative notes.
Post-operatively, if there is a delay in diagnosis then secondary complications may occur e.g. peritonitis caused by accidental perforation of the intestines. Nursing notes may also reveal lack of after care in this regard.
Carefully planned scar revision surgery may be of benefit. However red and lumpy scarring may not always be avoidable.