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The internet has become a great resource for the consumer to research products and services in the privacy of their own home, and at their convenience. Groceries, electronic equipment, exotic vacations and a new car are often available with a click of the mouse. This faster/easier/more convenient means of researching and getting a product or service has stretched out and into the medical world, predominantly in cosmetic and plastic surgery.
Buyer beware. The internet offers a platform for patients to either applaud or harshly criticize their physician and/or plastic surgeon and no one is monitoring whether this information is true, accurate or completely false and if that person is actually a patient of said physician. Unfortunately, physicians and plastic surgeons cannot disclose any information in disagreement or not because of Federal and State privacy regulations protecting a patient’s medical history. This regulation is called the HIPPA laws.
What does this mean? Anyone can make statements about a physician and surgeons that are not true in an attempt to defame that physician unjustly. Physicians are helpless to rebut or protect themselves from often slanderous and untrue accounts of their patients’ experiences or that of anyone who claims to have been a patient. Ludicrous and manic statements of one individual should not deter patients from seeking a plastic surgeon with highest qualifications and a spotless record.
Do your homework the right way. An educated consumer should use the internet as a first step to learn about the surgeon, see unaltered before and after photos and make inquiries to that Dr. and his/her office via email. They may read postings or ratings on websites that post patient comments about surgeons, but what you read there should be taken what with a grain of salt. As we said before, no one is monitoring whether this information is true, accurate or completely false and if that person is actually a patient of said physician. As rateMDS states in their FAQ section, “it is not possible for us to verify which raters had which doctors, so always take the ratings with a grain of salt. Remember, we have no way of knowing who is doing the rating - the doctor, other doctors, patients, dogs, cats, etc.“
What is paramount when researching a physician? Credentials are absolutely critical when selecting a surgeon. Following is the minimal patients should look for:
- Graduation from an accepted and known medical school
- Medical residency completion
- License as a surgeon in the state where he/she practices
- Board certification
- Fellowship training (the most specialized) in the surgeon’s specific specialty
- Hospital privileges
- No malpractice lawsuits
Serious patients should always meet with the surgeon and staff one on one, consult with the surgeon as many times as needed, request to and speak with other patients of the doctor who have undergone the same or similar procedure and make their own judgment after using all the resources available to them, including the internet.
What are the reasons for defaming statements of physicians on the internet in the first place? The typical reasons for patients to defame and make untrue statements about their physicians include: breakdown of doctor – patient relationship, unrealistic expectations of the surgical outcome, inability to create personal relationships with others in their own life as well as a host of other psychological /emotional instabilities. A busy plastic surgeon that sees thousands of patients may sometimes not recognize an emotionally unstable patient that may need psychiatric care rather than a cosmetic procedure to cure his/her personal issues. It is true that on occasion, a plastic surgeon may require a patient to undergo psychiatric evaluation prior to undergoing a surgical procedure. Occasionally however, plastic surgeons, with best intentions in mind, oversee patients that need psychological counseling and take them as operative candidates. A face lift, for instance, cannot change a patient’s internal landscape and magically transform their life. After surgery, the patient’s feelings may revert to disappointment, frustration and anger.
Face lifts are performed for 2 main reasons:
- To improve jowling and neck sagging which returns youth to the face.
- To tighten loose skin in the cheek area that may be a result of acne scarring or other skin disorders that loosen the skin prematurely.
Some medical causes for premature aging include: smoking, sun exposure, hypothyroidism, Downs syndrome, Progeria, Acrogeria, Cockayne syndrome, De Barsys syndrome, Geroderma syndrome, Hutchison-Gilford progeria syndrome, Lisone syndrome, Werners syndrome Wiedemanns-Rautenstrauch syndrome and Xylosylprotein 4-beta-galactosyltransferase deficiency.
Age is not so much a factor in determining whether a patient is a candidate for a facelift. We have all seen people that look young in their 50’s and 60’s . In contrast, some patients age prematurely and can be candidates for cosmetic procedures in their 20’s.
Why do you think you need surgery? There are a myriad of reasons why people want to change or enhance their appearance. During the patient/surgeon consultation, the patient is evaluating the surgeon and the surgeon is doing the same with the prospective patient. Why does the patient want to have surgery? What does the patient want to see changed? It is a surgeon’s job to decipher the right versus the wrong reasons for seeking cosmetic surgery. When is a patient not a good candidate for a face lift, for instance? Some of the wrong reasons include when he/ she is looking to change their looks for someone else’s approval, improve his/her social life, right after a divorce or serious relationship break-up and recent job loss. Such a patient is looking for surgery to solve their problems. The surgery will most likely be followed by disappointment. This patient has unrealistic expectations that can never be met, and they unfortunately tend to gloss over or ignore what the realistic outcome will be, ignore the risks of surgery and potential complications in their desire or zeal to be transformed. Surgery will not magically create emotional happiness and well being. The desire for improvement in our lives, should come from within.
What are the possible complications of face lift surgery? Face lift surgery includes a wide range of potential complications. It is routine in our practice to talk about these complications during office consultations that can last 45 minutes to an hour. In many instances, patients’ consultation are done 2 or 3 times prior to surgery to make sure the patient understands the potential risk. This necessary process is called informed consent and is documented in a patient’s chart. Consents that patient sign prior to surgery whether on the day of surgery or days prior is a routine matter mandated by law that provides acknowledgement that the patient understands the risk, benefits and alternatives and is allowing the surgeon to operate on them. Otherwise the surgeon can be accused of assault and battery on the patient.
Facelift incisions can take time to heal and on occasion, less than 1% of the time can form hypertrophic scarring. These scars can be treated with conservative management, such as mild steroid injections or with excisions of scars. The healing process can take several months to a year. This time may be very difficult for the patient and doctor during the healing process, however 99.9% of the time the scars improve to the point where they cannot be seen. Most of the time, as seen in the photos below, face lift incisions heal extremely well.
If patients have emotional issues prior to surgery, which do not manifest during the consultation phase, those emotional issues can be projected on the surgeon if there is a slight complication or sometimes no complication at all. The emotionally disturbed patient now has an easy target to blame the surgeon for his/her problems. As this situation unfolds the doctor – patient relationship breaks down. The patient can turn on the surgeon in many different ways: slander, attempts of defamation, verbal abuse of surgeon and staff, legal action and even attempts to physically harm the surgeon and/or the staff.
In these situations surgeons are helpless, because of HIPPA regulations, to defend their position. It is true that the best offense is a good defense. In other words, to be wary of emotionally disturbed patients and not to operate on them.
In my practice, I encourage every patient to speak to at least 3 of my patients to get a first hand account of their experiences with their surgery with me. I also encourage my patients to seek a second and even third opinion prior to making a decision on which surgeon is best for them.
The bottom line is that even “the best surgeons” have complications and have patients that they wished they never operated on because of underlying psychological issues. However, a busy surgeon may mistakenly overlook patients with emotional issues.
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Review of 1,000 consecutive short-scar rhytidectomies.
Dermatol Surg. 2008 Feb;34(2):196-202; discussion 202-3. Epub 2007 Dec 17.
PMID: 18093201 [PubMed - indexed for MEDLINE]
Complications after superficial plane cervicofacial rhytidectomy: a retrospective analysis of 178 consecutive facelifts and review of the literature.
J Oral Maxillofac Surg. 2007 Nov;65(11):2227-34. Review.
PMID: 17954318 [PubMed - indexed for MEDLINE]
| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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| Scar around ear following mini facelift by Dr. Oleh Slupchynskyj |
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