This document provides guidance on properly consulting with patients considering cosmetic surgery. It outlines important steps like determining the patient's motivation, assessing their emotional state, examining relevant areas, and recommending the right procedure or surgeon. The key aspects are choosing a qualified surgeon, making sure the timing is appropriate, matching expectations with limitations, and committing only to what can realistically be delivered to achieve the best outcome.

1. Dr. Vijay SharmaDr. Vijay Sharma
PresidentPresident
Federation of Restorative and Cosmetic SurgeryFederation of Restorative and Cosmetic Surgery
Mumbai, INDIAMumbai, INDIA
How to Consult a Patient

2.  The art and science of Cosmetic Surgery is to
go into the depth of emotional requirement.
 Reach up to hopes and expectations.
 Match this with the limitation of the surgery.
 Choose the right reason.
 Right time and right operative procedure on
right patients.
 Deliver what is committed and commit what
can be delivered.

3. To Choose the right reason for Cosmetic Surgery
What then would be the right-reasons to go in for cosmetic
surgery?
 You’ve successfully used diet and exercise strategies to lose
weight — except for some stubborn fat on your thighs.
Liposuction (fat removal) can help.
 Your five-year-old is the butt of taunt and ridicule by his
school friends because of his protruding ‘bat’ ears, setting the
stage for a severe and lifelong inferiority complex. Otoplasty
(ear surgery) can nip this psychological damage in the bud.
 You have a large, bulbous nose and feel it compromises your
otherwise hugely handsome looks. Rhinoplasty can get you
closer to the Apollian ideal.

4. Is career improvement a valid motivation for cosmetic surgery? Could
be. Not because your boss is going to think, “What a wonderful new
nose Krishnan has acquired, let’s promote him”, but because the
improvement in appearance can enhance your self-confidence, causing
you to interact more positively, more assertively with others, which in
turn produces positive feedback, giving you that vital edge that could
eventually lead to, yes, a promotion.
But remember that the bottomline is that cosmetic surgery changes
appearance, not personality. A face-lift may, as rewarding fallout,
boost your self-esteem, but there are no guarantees about this.
Psychological tests on some patients in the U.S. have shown that
about 40 per cent get “measurable emotional improvement” — but that
the majority gets no such improvement. After all, the transformation
has been wrought on an operating table, not a Freudian couch. In fact,
if your decision to have cosmetic surgery is based on factors other than
improving your appearance, the operation could leave you
psychologically worse off than before.

5. Avoid wrong Motivation.
Just as there is a right and a wrong motivation for electing to undergo
cosmetic surgery, there is a right and a wrong time. Wrong times
include:
 When you are experiencing a personal crisis, such as an impending
divorce.
 When you are going through a time of grieving or severe
depression.
 The reason, in both the above instances, is that, during such times
a person does not have the emotional reserves to go through
elective surgery. And a cosmetic operation does require emotional
preparedness: for one thing, you’ve got to be ready to look worse
before you look better, (To imagine the immediate aftermath of
eyelid surgery, for example, imagine going a few rounds with; Mike
Tyson, only he’s using a scalpel instead of gloved fists).

6. Practical considerations can also dictate when the time is wrong
for cosmetic surgery: for instance, if you have a family wedding
coming up in a fortnight, it would be unwise for you to schedule a
dermabrasion session before that, unless you want to grace the
function looking like a protagonist in a Ramsay horror film. All
cosmetic surgery has a recovery period that’s more often an
extended one: from several days to several months. If you’re
thinking you’ll be able to get back to work a few days after the
surgery, you’d better rent a Frankenstein cassette and think
some more. Cosmetic surgery is the only medical discipline that
takes people who are well and makes them ‘sick’ — you’ll be
bruised, you’ll be swollen, you’ll hurt, and you’ll feel worse before
you look better. Like the Boy Scouts, your motto should be to be
prepared.

7. How to choose the right doctor.
Okay, so you’re prepared. Right motivation, right time, right
emotional state. What next?
It’s time to look for the right cosmetic surgeon. You’ll need to
check him out at two levels. First, his surgical competence. After
all, he’s going to take his scalpel to places no man has gone
before — your inner places. And you’ve got to feel secure about
entrusting your scalp, face, breasts, abdomen, whatever to him.
How do you find Dr. Right?

8. Dont's
 Don’t go to your friendly neighborhood beautician for
procedures like chemoabrasion or dermabrasion. Many of
them do offer these “services”, but both are potentially risky
procedures and the risks are naturally heightened in inexpert
hands. The last thing you want is for an aesthetic procedure
to leave you looking more than imperfect you started out.
 Don’t pick out the first name listed in the yellow pages, or the
one that’s nearest your residence. You need to put more
serious effort into finding your surgeon.
 Don’t go to a practitioner from a medical system that doesn't
include surgery in its curriculum — for instance, acupuncture
or homeopathy. An M. D. or an M. S. should be the basic
qualification you look for.

9. Dos
 Do consult your family physician. Tell him the technique you're looking
to get done; and listen to his advice and recommendations: he knows
the men in the field. He may have seen many of them at work; he
knows who’s a technical wiz, who overcharges, and who rejects
candidates from time to time — a good sign in a cosmetic surgeon.
(You’ll learn why in a later chapter).
 Do speak to others, who you know, have undergone the same
procedure — by no means an easy thing since cosmetic surgery is one
of the best-kept secrets of men and women. But if you’re lucky to be
able to talk to such persons, you’ll get first-hand reports of different
surgeons’ skills — which goes far beyond just their qualifications on
paper.
 Do contact a professional body, such as the American Academy of
Cosmetic Surgery or the Indian Association of Cosmetic Surgery, for
recommendations. Membership in this body is a good sign because it
offers board certification. Unqualified and unethical practitioners are
automatically weeded out. The Association has its offices in big cities.

10. CONSULTATION REPORT
Consultation Date: 6th
-7th
–June ,2003.
Ref.By:
 Colleagues and Doctors
 Hospital
 Nursing Home
 Clinic
 Self imagination
 TV programme
 Magazine
 Newspaper
 Beauty Parlour

11. Patients Details:
Name: Dr. Nikolay P. Serdev
11, "20th
April" Street,
BG-1606 Sofia, Bulgaria
Date of Birth: 18 Mar 19--
Email: nserdev@infocom.bg
Tel: +359 888 02004
Sex: Male
Patients GP:-
Name: Melvin Shiffman

12. Procedure/Interest:
1. How can I help you
2. Which part Specifically
3. Since how long you have been thinking to improve upon
History of Present Complaint:
1. Since how long you are aware
2. Number of years
Previous Surgery and Medical Illness:
1. Long hospital stay
2. Major ailment, operation, accident.

13. Previous Mental Problems:
1. Tension
2. Depression
3. Stress
4. Obsession
5. Anything else
Husband/Wife:
1. Married
2. Unmarried
3. Separated
4. Divorced or Live-in Relation

14. Children: Number and age
Work:
1. Business
2. Office Executive
3. Manager
4. Proffessional
Social:
1. How Active
2. Do like meeting people
Family/Friends:
1. What do they think
2. Do you mix with them well

15. Patients Hopes and Expectations:
Why would you be interested
• To please people around you
• Getting pushed or advised by others
• Purely for self

16. General History:-
1. Do you smoke,….. Cigarette, Cigar, Biddy, Chewing Tobacco
2. How many per day
Drinking:-
Do you drink, how often?
Pill: Contraceptive
Drugs / Medication: Do you have any kind of medicine
Previous Anaesthetic:
1. Head Injury
2. Epilepsy
3. Complications of Anesthesia
Allergies: To any medicine

17. Examination and General Description:
1. Height
2. Weight
3. Built, Average, Large small
Special Description of Relevant Areas:
1. Nose
2. Face
3. Breast
4. Body
General Examination:
B.P.------ H.R.------ Pulse------ CVS--------
Chest:
Cough, Asthma

18. Abdomen:
1. Constipation
2. Diarrhea
3. Irregular Menstruation.
My Opinion / Comments:______________________________
Patients is: (A) Good Candidate
(B) Suitable with Reservations
(C) Poor Candidate and surgery not Indicated

19. Operation Recommended:
Clinic:______________________ No.of Nights_______________
Type Anaesthetic:_____________ Date_____________________
Time of Report_______________ Last Food/ Liquid___________
Special Instruction to patient________________________________
Signature_______________
I agreed your contacting my GP and for him to provide you with details
of my medical history.
Signed________________Date_______________________
I do not wish you to contact my GP
Signed__________________________
Date____________________________

20. Thank youThank you
Dr. Vijay Sharma, M.D.
Mumbai, INDIA