Nearly all of my patients seeking facial improvement want a “natural look”. But what does that really mean? One look through the popular magazines, or a walk through your upscale department store, and it’s easy to find a lot of un-natural results. Isn’t there a “norm” that all surgeons should follow? Well, the simple answer is “No”. “Natural” can mean different things to different patients and doctors. “Natural” is a popular catch word to market a surgeon’s work. “Natural” is an easy thing to talk about during a consultation but not always an easy thing to deliver.
In my opinion, the quality of a surgeon’s results depends on three things, the surgeon’s technical expertise, the patient’s particular problems and anatomy, and, probably the most important, the surgeon’s judgement in selecting the right procedures to achieve the desired results. Let’s face it, not all surgeons are created equally. They all have a basic level of skills that should make them safe and competent, but some are just better able to cut, suture, and handle tissues better than others. It’s not just a matter of “how many have you done” but “how good are the ones that you have done”. Of course experience does come into play since most surgeons will continue to learn from each of their patients in order to continue to improve to give the very best results possible. Yet, there will always be certain surgeons that simply have a “gift” which sets them apart.
Patients are also not all built the same. Differences in anatomy, aging, effects of the environment, just to name a few, make each patient unique. Mix that with the patient’s own ideas of what they want and what they are, or are not willing to sacrifice, make for an infinite number of variables that present themselves to the surgeon. High cheeks, low cheeks, loose skin, saggy skin, strong chin, weak chin, baggy eyelids, deep set eyes, recovery time, cost ……… you get the idea. So the patient plays a large part in the result. After all, the patient is really the canvas.
Finally, it is only after the surgeon and patient meet that the path towards the final result begins. Communication is key. The patient needs to be clear in what they want, their fears and concerns. But it is ultimately up to the surgeon to pick the right “tools” from the toolbox to best help the patient. The surgeon has many tools available but his/her ability to choose the right one(s) is paramount. The best surgeons will recognize that they may not actually have the right tool and refer the patient to the surgeon that does have it. If the surgeon is not able to recognize the limitations of the patient as well as him/herself than the result is doomed. Simply following popular fads or clever marketing will not make for consistent or reliable results. Treating all patients the same, or following cookie cutter procedures will not work. Sometimes doing “less” is more, even though it may not be as popular. Sometimes it takes “more” to keep someone’s face in balance and avoid the telltale signs of the “bad facelift”.
At the end of the day it is the match between the patient and surgeon that makes the result. Patients should take the time to research their surgeons carefully. They should not base their decisions on the best ad or marketing campaign. They should feel comfortable discussing their concerns and issues with the surgeon. They should understand the recommendations by the surgeon and the expected results. Surgeons should be responsive and responsible. They should be able to explain their recommendations and their expected results. They should be honest with their abilities and whether or not their abilities will satisfy the patient. The “natural” result really begins long before the patient goes into the operating room. It really begins on the day of the consultation.