When you attend for a consultation it’s not just about the lines. We are all unique and our understanding, perception and expectations are all different. The wisdom of life’s experiences is reflected in our face and body. Some we cherish and others we would rather forget or ignore.
A good consultation should include why the patient seeks consultation and what has prompted their attendance now. It is important to establish what the patient is expecting from the doctor in order to provide patient-centred care. As the information available to the general public varies greatly, patients might be under illusions about the type of treatments and achievable outcomes. The time frame of treatment versus expected results also varies from one treatment to another. It is important to establish what the patient is aware of and educate accordingly so that they can have realistic goals.
The consulting room website https://www.consultingroom.com/ contains information about treatments and clinics for cosmetic treatments.
Medical and drug history
It is the doctor’s responsibility to check if they have any medical conditions that may make them unsuitable or at increased risk of complications when having a cosmetic treatment. The cosmetic treatment would also have an impact on their general health and social circumstances especially post-procedure. Allergies and medication details are also important for safe practice.
How we look has a huge psychological impact. Therefore, it is important to check their psychological well-being. It may be necessary to decline to treat a vulnerable individual in order to protect them from further distress and refer them for appropriate care.
There is a higher incidence of Body Dysmorphic Disorder in those seeking cosmetic treatments. If someone suffers from this mental health condition, they have a disproportionately high level of worry about one or more features of their body. This feature may not be noticeable to others and the person may spend a lot of time checking the mirror and concealing this feature. Having cosmetic treatment is likely to do more harm than good in this situation. It may also be associated with other mental health conditions such as depression, anxiety or obsessive-compulsive disorder.
Social media puts a lot of pressure for all of us to look ‘selfie-ready’ at all times. Having a high level of our images on public view risks self-scrutiny and excessive focus on our imperfections. Social media is easily accessible and serves as constant entertainment or distraction. Celebrity endorsements and ‘influencers’ make it a powerful influencer on our decision making. There is constantly new material thanks to hashtags we are encouraged to follow and this repeated exposure to corrections of imperfections can normalise cosmetic procedures making it trivial and acceptable. This is not helpful in anyone who is feeling vulnerable or dissatisfied with their personal appearance.
Images captured on cameras are often distorted and filters don’t help. There is a fear of ‘Snapchat Dysmorphia’ where it is thought that people are seeking cosmetic procedures to replicate their filtered faces without the filter.
The facial assessment and treatment planning
The facial assessment should be methodical and systematic. It is very rewarding to explain facial and skin ageing to a patient and hear them say ‘no one has explained it like that to me before’. It ensures that the patient and doctor are on the same page when it comes to what they are hoping to achieve with treatment. The treatment plan can then be individualised to that patient on a timeframe appropriate for them. The patient should be made aware of the cost of treatment and what is included in the cost.
In cosmetic medicine, consent is not just simply informing the patient about what to expect during and after treatment. Cosmetic medicine is not ‘necessary or essential’ therefore patients have to give ‘informed consent’. There should be a frank discussion of all the treatment options including those not offered by the doctor as well as ‘no treatment’ options. The options offered should be based on the patient’s welfare and not for financial gain.
The patient should then be able to weigh up the pros and cons of all the options before making a decision. This requires the patient to have adequate capacity. It is good medical practice to allow time for this and I usually offer a ‘cooling-off’ period before treatment is carried out.
Aftercare is discussed including any social downtime required post-treatment. This enables effective treatment planning around holidays, social events, etc. Contact details should be readily available for any queries or concerns the patient may have.
Post-procedure, clear, written aftercare, as well as verbal instructions, ensures that the patient understands and follows the advice and reports any adverse effects promptly and accordingly.
It can take a person many years to actually book a consultation for a cosmetic treatment. Therefore, it is important that this is a thorough and rewarding experience for both the doctor and the patient.