W hen we talk about facial cosmetic surgery, what comes to mind for most people is a facelift. However, there are many types of facial procedures one may consider. Whether it is a laser facelift, eyelid surgery, rhinoplasty, or even injectable fillers, each of these require a thorough consultation to ensure that the result will make you feel confident and rejuvenated.
There are a ton of ways to prepare for your consultation. The more information you can bring with you, the better your consultation will be. Goal setting is an important part of any procedure, and it is no different in this case. In this episode, I’ll guide you through the four main goals of a facial consultation, from pre-consultation to recovery, to help you understand what to look for and to empower you to be part of the process.
Dr. Hall: Welcome to The Trillium Show, where we help you make the changes you want to see in your body, in your mind, and in your life. I’m your host, Dr. Jason Hall.
Dr. Hall: Hello, and welcome to another episode of The Trillium Show. I’m Dr. Jason Hall. In today’s episode, we’re going to talk about getting yourself ready for a facial cosmetic surgery consultation.
It’s important to be prepared for this consultation because the more information that you have and the more knowledge that you bring with you to your consultation, the more effective that consultation can be. And this is not only for patients who are interested in facelift surgery—which I think is the first thing anybody thinks of when they think about facial cosmetic surgery—but any type of facial procedure, whether that is laser, facelift surgery, eyelid surgery, rhinoplasty, or injectable fillers and neurotoxins. For all of these things, the more information you can bring with you to the consultation, the more effective and the better your consultation is going to be, and the better treatment options you’re going to be presented with. That being said, we need to set out some main goals of our facial surgery consultation.
So, what are the main goals of our facial surgery consultation? Well, there are four of them. First and foremost, is to ensure that you and whoever is treating you—whether that’s your surgeon or your injector—have the same goals in mind because you can get a fantastic result and still not be happy if that result didn’t set out to accomplish the things that you wanted to accomplish.
Secondly, we need to ensure that you’re a good candidate for whatever procedure it is that you’re interested in. That’s both medically, physically, and most importantly, psychologically. And we can talk about some of that here in a minute.
Third is to ensure that you and your surgeon or injector get along. If you don’t get along, and trust who’s going to be treating you, or there’s some friction between the two of you, it doesn’t matter how talented they are, it doesn’t matter how good their reviews are online, or how good an experience one of your friends had with them, if you don’t get along, it really doesn’t matter. You need to go seek a treatment with someone who you gel with personally.
And lastly, you want to get the surgical date that best fits with your schedule. So, let’s talk about these goals individually here. So, our first goal really is to make sure that we identify the areas that concern you the most, and that we’re able then to come up with an appropriate treatment plan. You know, in medicine, one of the things that we learned very, very early on, we need to diagnose and get an accurate diagnosis before we can come up with a treatment. And so many times what happens in cosmetic medicine and in plastic surgery is that, as a patient, you come in suggesting a treatment, and one of the ways that things can go sideways pretty quickly is we don’t stop to make sure that the treatment that you found over the internet is the right treatment for the problem that bothers you.
One of the questions that I laugh and really don’t answer in the office is the, “Hey Doc, you just tell me what I need, and we’ll go from there.” That really doesn’t work because as plastic surgeons, we are trained to see millimeters of difference. I can tell patients in the office that I can look at somebody and absolutely pick them apart and make you feel terrible about yourself because there are so many things that I’m trained to see that you probably have never even paid attention to. Millimeters of difference between, in eyelids, and cheeks, and the base of your nose, and things like that that you probably if you aren’t paying very, very close attention, don’t notice. And so it’s important that you can identify, even if it’s just a feeling, but I have an idea in your head of what it is that you’re looking to treat.
Sometimes a good way to do that is to say, “You know, I look in the mirror and I feel like I look sad,” or, “I look angry all the time,” or, “People ask me why I’m angry all the time.” Those types of things are good starting points because then we can have a detailed discussion atomically about what it is that contributes to that appearance of anger or sadness. The other thing that we really need to do and is a good—serves as a good frame of reference for you, the patient, and your surgeon, is to bring in a picture of yourself—preferably a picture of yourself not smiling—from when you were about 30 years old. That gives us an opportunity to look at those, and determine where you started and how the aging process has changed things so that we can have a target to what we’re getting back to. The goal in facial cosmetic surgery is not to make you look like a different person but is to naturally rejuvenate your appearance.
And so having a younger photo allows us to really look at where you’re coming from and to say, “All right. This is where we’re started. We can tweak things to a degree, but given where you started, we’re only going to be able to go so far.” That keeps us both from getting into trouble by trying to—by keeping us from accomplishing something that really wasn’t possible.
The second goal that we have is to make sure that you are a good candidate for surgery. This is both physical, meaning you don’t have any medical issues that will make surgery overly risky or dangerous, such as cardiac problems, lung problems, uncorrected diabetes, things like that, but also psychologically that you have a realistic picture in your head of where we’re going. You know, I mentioned in the beginning of the show that if you have an idea of where you’re heading, and your idea and your surgeon’s idea are different, you can get a wonderful result for where you’re starting out and still be unhappy at the end if it didn’t accomplish the goals that you had for yourself. Part of that is ensuring that those goals are realistic, and the only way to really do that is to sit down with your surgeon, talk through where you are, figure out where you’re going, and then make sure that there is a process to get you from point A to point B safely.
The third part of making sure that you’re a good candidate for surgery is to ensure that you have appropriate support around the time of your surgery. You know, most facial procedures are fairly involved, major surgeries, and you are going to need some assistance during the recovery process. If you don’t have that kind of support or are trying to hide your surgery from your family, that can make for a very difficult recovery period. So, this is a time where we sit and discuss that, if not with your surgeon, with their coordinator or nursing staff to make sure that the appropriate support is available, and if it’s not, that we can set that up for you. One of the major goals of any plastic surgery, cosmetic surgery consultation is to make sure that you and your surgeon are compatible, that you’re on the same page, that you get along.
And I don’t say ‘getting along’ in terms of being friendly, and that they’re your best buddy, and you want to go out and have dinner with them. It is that you have compatible personalities. One of the main reasons that this is important is that plastic surgery at the end of the day is still surgery. Complications happen and when they happen, you and your surgeon are going to be spending a lot of time together in the office. You have to be able to work with your surgeon, and your surgeon has to be able to work with you to be able to overcome any of the problems that might come up. If the two of you can’t get along and partner in that journey, it’s going to be a very rough time for both of you. So, that’s really what I’m talking about when I’m talking about being compatible.
The third point is that you want to make sure that you get the date that you want. It’s very important before you even schedule a consultation that you plan for appropriate time off from work and recovery time because you are going to need approximately two weeks for most facial surgeries before you can go back to work or go back out into public without it being obvious that you had something done. This is something that you really want to discuss with a patient care coordinator prior to even scheduling your consult, as you call into the office, in that you and the patient coordinator are meeting for the first time over the phone, that you really discuss potential surgery dates around your work schedule, and that you look at your work schedule before you even call so that you know when you can take that time off.
Most busy cosmetic surgeons are booked out for months, and when you’re on the phone with the patient coordinator during that initial phone call, you want to know when the first available surgery date is, and what the likelihood is that if you came in, you would be able to at least get a surgery date on the days that you’re looking for. This really brings up another important point is that most cosmetic surgeons are booked out for a few months. Now, there was a point in time when I wasn’t booked out for a few months, we could schedule a surgery within a couple of weeks of a consultation, but with experience, with time, certainly with the tax on plastic surgery that COVID put on everybody in that everybody is just busier now than they’ve ever been, that’s something that is really important to know when you’re on that phone with a patient coordinator the first time. I think it’s important to note that one of the things that COVID has really done for plastic surgery and for cosmetic surgery is that with the popularity of Zoom and how Zoom has kind of penetrated every industry. If you can work remotely, within about 72 hours you should be able to get back to work remotely without much hassle. The biggest thing is that you’re going to want to make sure your video’s off and just be able to use a profile picture.
Now, if you’ve got to be on video and have just had facial surgery, that’s a totally different ballgame, but really the requirement for going back to work remotely is that you’re sober and that you’re not needing anything other than Tylenol and Ibuprofen or Motrin, which most facial surgery patients can reliably do within about 72 hours.
So, we’ve touched on the immediate post-operative recovery as part of facial surgery. The second part of recovery is that big event recovery: the wedding, the class reunion. Those things you really want to give yourself about three months to budget before you go back to doing those things. The reason is not that you won’t be ready for those things, the reason really is that we want to give you adequate time to recover and be able to be at a hundred percent at the time of your event. So, we’ve talked about the immediate post-operative recovery being about two weeks before you can go out in public without looking like you’ve just had surgery.
The other part of recovery is what I refer to as the red carpet recovery is when you’re going to be ready for live speaking engagements, talking on a podium, weddings, class reunions, things where you’re going to be photographed. And that, you really want to give yourself about three months after surgery before any big planned event. And the reason is not that you won’t be ready by then; the reason really is one out of precaution, is that if we run into a complication, if we have a hematoma, if we have some delayed healing, if there’s an issue that needs to be addressed, that three months allows us the time to take care of those things and still have you ready for your event at that time. So, that’s one of the things that we talk to with patients about as we’re getting ready to schedule that consultation, and certainly during the consultation is making sure that we have those things squared away. Because the last thing we want to do is find out at the pre-operative evaluation, that you have a wedding planned for three weeks after your surgery. Nobody’s going to be happy at that point.
So, in terms of recovery from most facial surgeries, you really want to plan for six weeks out of the gym, six weeks out of working out. And again, not because you’re not going to be able to, you’ll actually feel like going and doing things after a week or two, but we really want to give you that time so that you can recover adequately, so that you give the swelling time to go away, and you don’t make that swelling worse by trying to get to the gym at a week-and-a-half or two weeks.
So, now that we’ve gotten through the recovery aspect, let’s talk about what to expect the day you schedule your consultation. What should you be doing right when you get off the phone with our patient coordinator? Well, the first thing—and I would encourage everybody to do this—is you’re going to get a link to our intake paperwork online. And most surgeons now have an online portal where you fill out your paperwork, and you’re going to want to do that as soon as you get that link. The reason is, one, you’ll forget about it if you don’t—and that happens all the time—but oftentimes—and I know this is the case in my office—is that busy cosmetic surgeons are usually booked out months and months as we talked about before, but they’ll have cancellations. They’ll have people who get sick, they’ll have people who don’t show up for their consultation, even though they’ve gone through the whole process like this.
If you have got your paperwork filled out, everything is squared away and good to go, you’ve talked to the patient coordinator, they’re going to call you to jump up on that schedule and fill that waitlist time. So, it’s important to have all of that paperwork done beforehand so that you’re on that shortlist of patients to be called. The second thing you’re going to want to do is start looking for an old picture that you can send in or bring into your consultation so that we can go over. With facial surgery, especially facelift and necklift surgery, whether that incorporates fat grafting or not, is really important for us to know where you started. So, a picture of yourself in your 30s, preferably not smiling, gives your surgeon a good idea of where you started and where you’re coming from, so that we can plan an operation that’s going to help turn back the clock, make you look like you, and not give you some unnatural, caricature result which nobody wants. Hunt through your old photo albums and find that picture or two that you want to bring in.
The next thing is to really figure out who else needs to be involved, whether that’s your spouse, significant other, best friend; the person who is going to be supporting you and helping you make these decisions needs to be involved with you, and really should be in the office with you during your consultation. Two sets of ears is better than one and you will invariably miss something that another person will pick up. And it’s important for that person who is going to be with you through the surgical process and through the recovery, to be able to hear the consultation description, the description of the procedure or procedures that we’re talking about, to help you recover and plan things at your best.
Lastly, if you’re over 50 years old or have medical problems like diabetes or high blood pressure, you need to talk to your primary care doctor and get a physical exam scheduled because your surgeon—whether that’s myself or someone else—is going to need a pre-operative medical evaluation and clearance, which includes for us, a history and physical examination, an EKG, blood work, and if there are any hint of lung problems, a chest X-ray, before safely putting you to sleep. So, you’ll want to talk to your primary care doctor because a lot of times they’re just as busy as your surgeons to get on their schedule around the time of your consultation so we can get that paperwork and medical clearance process squared away.
So, we’ve kind of gone through the pre-consult process, the recovery process, kind of what to expect what to plan for. So, now we’re at the day of your consultation. This is exciting; it’s a little bit nerve-wracking for the patients because you’re finally sitting in the office talking about a procedure or procedures that you’ve been thinking about and researching for a long time. So, this should be an exciting time.
Tips for the day of the consultation. One is don’t wear makeup, or at least if you’re coming from work, bring makeup that you can put on after your consult if you’re a woman. Guys don’t have to worry about that as much. But bring your makeup and come without makeup to the consultation because it’s important for me to be able to assess your skin and really get an accurate assessment of where you’re starting so we can put together a good facial treatment plan which always includes skincare. And we’ll get into other podcast episodes, we’ll talk about skincare and facial surgery itself.
Suffice it to say, skincare is really important and we need to get a good evaluation of your skin at your consultation. Things to bring with you, your photo, a list of your current skincare regimen—and just taking a picture of your skincare products on your bathroom counter is totally fine—your calendar book with tentative surgical dates that you’ve talked to the patient care coordinator about, some way to pay for your scheduling fee so that you can get that date that you want, but really the most important thing is a great attitude. This is fun, this is a elective procedure, something you’ve been looking forward to. It should be an exciting time, even if it is a little nerve-wracking.
So, in this episode about preparing for a facial surgery consultation, I think it’s important to kind of recap our main goals: first and foremost, that you and your surgeon have the same goals in mind for what you’re looking for; secondly, that you’re a good candidate for the surgery, medically, physically and psychologically; third, is to ensure that you and your surgeon are compatible personalities, and lastly is we want to make sure that you get the date that best fits in with your schedule and your lifestyle.
So, I hope this was helpful. I appreciate you listening and we look forward to kind of delving into more of these detailed facial surgery topics in future episodes.
Dr. Hall: Thanks for listening to *The Trillium Show*. You can keep up with the latest on the podcast at https://jhallmd.com. Be sure to follow us on Spotify, Apple Podcasts, or wherever you listen to podcasts. If you want to connect with us on social media, you can find us at @jhallmd on Instagram and Twitter and @DrHallPlasticSurgery on Facebook. Remember, be the change you wish to see in the world.