The formal plastic surgery experience begins with the in-person consultation. The formal plastic surgery consultation accomplishes several prerequisites before performing any plastic surgery procedure. The first and most important is the professional relationship between the plastic surgeon and the patient. This relationship is of primary importance because the physician-patient relationship is the basis of open communication, which is the foundation of every plastic surgery procedure.

There are elements of the in-person plastic surgery consultation that occur at every medical visit. The starting point is a medical history. Following the medical history, the patient will get a physical exam. In a plastic surgery office, the physical exam may be “focused,” meaning the anatomical area of concern is examined and discussed in great detail. The focused plastic surgery exam helps the patient understand their anatomy and helps determine the options for surgery.

Following these two steps the options for surgery are discussed with the patient in detail. In some patients there is a single procedure that is clearly indicated. In other patients, there may be multiple procedures that are reasonable. As an example, when considering re-contouring of the abdomen, some patients are good candidates for tummy tuck surgery but not good candidates for liposuction (alone), while other patients are good candidates for liposuction (alone) but not abdominoplasty.

There is a third category of patient that is not a perfect candidate for abdominoplasty and is not a perfect candidate for liposuction (alone). This category of patient may be a reasonable candidate for abdominoplasty or liposuction (alone), depending on her/his goals. Because progress in plastic surgery has advanced dramatically in the last thirty years, there are many more options available to patients now that were not available then. The advances in plastic surgery and the multiple options for patients available today highlights the importance of the in-person plastic surgery consultation.

Following the discussion of procedure options, which is partly guided by the patient’s goals, documents explaining the procedure are provided to the patient. There is a lot of information online regarding plastic surgery procedures, and the documents provided at the in-person consultation act as a supplement. The patient has the opportunity (with no time limit) to review the information during the in-person consultation if so desired, review the information at home, or both. The patient is encouraged to review the information more than once to help ensure comprehension. The patient is given unlimited time to ask questions about anything related to the procedure. The questions from patients usually center around options for surgery, anesthesia for the procedure, and recovery time. A large percentage of patients will think of additional questions after the initial in-person consultation, and there is ample opportunity to ask additional questions before the procedure is scheduled.

Some patients seek more information about a procedure than is provided at the initial consultation that is “lay public-friendly.” When patients request more detailed scientific peer reviewed information (peer-reviewed literature) this is also provided. Scientific peer-reviewed literature can be difficult to understand for the lay public, so when provided it is “translated” to an understandable language for the patient.

Because elective surgery (not an emergency) can be performed at any time, there is an unlimited amount of time for the patient to become “informed” before making a decision to proceed with surgery. In many circumstances, the patient’s preconceived opinions are changed after obtaining more information at the in-person consultation.

Some time is required to assimilate the information learned at the consultation. This is why the consultation and surgery (except in a small procedure, e.g. skin lesion excision) are not scheduled the same day without sufficient time to understand the information. Spouses and other family members are welcome and encouraged to attend the consultation if so desired by the patient.