Surgical patient selection and counseling.

Area of Science:

• Plastic Surgery
• Surgical Outcomes
• Patient Psychology

Background:

• Current definitions of surgical success are often limited, neglecting patient desires, disease progression, and independent validation.
• Patient satisfaction is influenced by pre-operative expectations, surgical complications, and the need for revisions, varying by procedure.
• Effective patient selection and counseling are crucial for enhancing surgical outcomes.

Purpose of the Study:

• To define a comprehensive model for patient selection and counseling.
• To identify factors contributing to patient satisfaction and dissatisfaction.
• To highlight the importance of aligning patient expectations with surgical realities.

Main Methods:

• Literature review on patient selection and counseling factors.
• Analysis of patient and surgeon variables influencing outcomes.
• Discussion of a mnemonic (CURSED Patient) for identifying high-risk patients.

Main Results:

• Successful outcomes depend on integrating patient psychological capacity, expectations, and surgeon expertise.
• High-risk scenarios involve inexperienced surgeons, complex cases, and patients with high expectations or limited psychological resilience.
• The CURSED Patient mnemonic aids in identifying patients prone to dissatisfaction.

Conclusions:

• Comprehensive patient counseling, including expectation management and risk disclosure, is vital.
• Utilizing resources like educational materials and advanced practice providers can support thorough counseling.
• Poor patient selection and counseling can lead to adverse outcomes, including patient harm and legal repercussions.