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Introduction

CHAPTER 55 The Cosmetic

Consultation

Kathryn J. Tan Heidi A. Waldorf

SUMMARY

The demand for cosmetic procedures, both invasive and noninvasive, is

increasing dramatically.

A thorough consultation is invaluable for patient education and comfort.

Patients vary widely in their desires and expectations, and the consultation is the

ideal time to tease out a patientโ€™s individual preferences.

Beginner Pearls

The interaction with the front desk sets the stage for everything that follows.

Etiquette for a physicianโ€™s office staff must be similar to that seen in high-level hotels

or retail stores.

Expert Pearls

A cosmetic interest questionnaire that lists problems and procedures the patient wants

to discuss helps to streamline the consultation.

Use a variant of responsive listeningโ€”repeating back to the patient what he or she

expressed to the nurse or assistant in the preliminary interview.

Donโ€™t Forget!

The appearance of the reception area is particularly important when treating cosmetic

patients.

The public generally does not understand that surgery may be less expensive than the

combination of nonsurgical procedures necessary to produce desirable results.

Pitfalls and Cautions

Patient expectations must be set by the physician with both clinical and financial

boundaries: the patient who expects to pay for one syringe of a filler but requires at least six syringes to attain the desired result will not be satisfied.

Body dysmorphic disorder is the most common psychiatric condition seen in patients

seeking cosmetic procedures.

Patient Education Points

Be clear that nonsurgical procedures can provide excellent, but still not surgical,

results.

A physician must say โ€œnoโ€ to any treatment they believe is medically or aesthetically

inadvisable.

Billing Pearls

Do not automatically write off procedure fees or offer reimbursement without checking

with your malpractice carrier; returning money to a patient prior to discussion with your carrier could negate your insurance coverage if the incident is litigated.

CHAPTER 55 The Cosmetic