Everything we say before surgery is information. Everything we say afterward is an explanation.
For a long time, I have wanted to share some of my insights and opinions regarding certain aspects and challenges of plastic surgery. One of these—something that has concerned me for years—is the doctor-patient relationship during consultation, around the time of surgery, and throughout the post-operative period.
Several years ago—and occasionally since then—I was told that according to some reviews and forum discussions, I appear distant, reserved, or even unfriendly toward my patients. This is likely because I firmly believe that a doctor’s primary duty is to provide an objective and detailed explanation of the materials used, the surgical process, possible complications, and their potential consequences.
After examining the patient and understanding their expectations, I inform them about what can realistically be achieved given their individual anatomy and which surgical method is best suited for them. Once they have all the facts and answers to their questions, they should take time to consider their decision.
I strongly believe that a doctor should never influence a patient’s decision regarding surgery. My role is not to persuade or dissuade anyone but to present all relevant information in an impartial, almost detached manner. This is not a fabric shop where the seller’s job is to showcase as many colorful ribbons and buttons as possible, using personal charm to boost sales.
For this reason, I never answer when patients ask what cosmetic procedure I think they should undergo. It is not my role to decide. A person must be fully aware of what bothers them enough to consider a surgical solution.
A real-life example:
A woman enters the consultation room, introduces herself, and the doctor immediately reassures her: "Madam, we will create beautiful little ears from those large, protruding ones."
The shocked response: "Doctor, my ears do not bother me at all. I came in for breast surgery."
Another common question: "Would you place an implant in your own daughter or close relative?"
This is difficult for me to answer for two reasons. First, it is upsetting to think that someone assumes I perform surgeries I would not consider for my own loved ones. Second, if I respond that, of course, I would—and in fact, have done so with excellent results—this could be interpreted as encouragement or persuasion.
Unrealistic expectations can also pose a challenge.
Sometimes, patients do not understand that possibilities are limited and heavily dependent on individual body type, anatomical structure, and personal characteristics.
For instance, a 155 cm tall, 50 kg woman requested breast augmentation and insisted that her friend recommended nothing smaller than a 300cc implant. However, upon examination, it was clear that her narrow chest and naturally proportionate breasts would not accommodate such an implant. The only way to fit a 300cc implant would be with a very high-profile model, creating an unnatural, "half-ball" appearance.
Further discussion revealed that her friend was 185 cm tall, weighed 80 kg, and had almost no natural breast tissue—making the 300cc implant a logical choice for her.
It is crucial to set realistic expectations because otherwise, even before surgery begins, failure is inevitable if expectations exceed what is physically possible.
