The paranoid patient: surgeon beware!

Patients who have a paranoid disorder have a general expectation of being exploited or harmed. Assessment of personality and mental health is an important aspect of the preoperative patient evaluation. Paranoid patients can be troublesome or even physically dangerous, but may be difficult to detect preoperatively. We recount our experiences with such a patient and suggestions are made for detecting these patients and managing them. Care should be taken to avoid cosmetic facial surgery on such patients.