Selection of patients

Abstract

Technical ability is fundamental for good medical practice, but the correct selection of patients is mandatory. Physicians who would like to successfully practice aesthetic medicine must understandthat the vast majority of patients are unaware of what they really need. They know what they want, however it is the physician who understands the anatomical basis and aging process and who has to find a compromise between theexpectations of the patient and what is possible. Patients are prone to ask for procedures that they have heard or read about in lay magazines. For example, it is quite common for patients request treatment of nasolabial folds with botulinum toxin A (BoNT-A), only because this product iswidely advertised. In most cases, however injection of BoNT-A into the nasolabial fold would result in an unhappy patient because this would have little effect on the depth of the fold. Patients with multiple needs and requesting immediate results are legendary. The first consultation is very important, as it gi ves the physician the opportunity to establish the kind of patient he will be treating. Uncompromisingpatients, for example, are best avoided. Dissatisfaction with prior aesthetic procedures is one of the most important points to be evaluated. It is therefore mandatory to conduct a thorough examination of their past history, which should include any prior cosmetic procedure, and how theresult was perceived by the patient. Depending on the answer, the practitioner can evaluate the patient's perception. Unrealistic expectations are another important factor to be analyzed before starting with any treatment. Experience showsthat sometimes it is preferable not to treat a specific patient, because whatever is done, dissatisfaction will invariably result. © Springer-Verlag Berlin Heidelberg 2006.