Patient satisfaction while addressing their concerns about cosmetic improvements for the aging face can be a tricky situation. In her presentation at 2020 Winter Clinical Dermatology Conference, Dee Anna Glaser, MD, discussed some simple tips for addressing the patient who wants to reverse signs of aging in the face.
The presentation, titled “The Aging Face: Pearls From an Expert,” emphasized that patient satisfaction in these cases can be heavily affected by the initial consult, even before dermatologists have a chance to apply a treatment plan. Prime examples of a what not to do at this initial consult include spending a short amount of time with a patient, having staff explain the ins and outs of the procedure, not answering any patient questions, and providing a generic treatment plan. Instead, Dr Glaser noted taking the time to develop a relationship with the patient when they first come into the office looking to address aging in the facial region. This appointment should, most importantly, include a conversation about the patient’s cosmetic desires. Ask the patient for a specific list of their top three wishes. “You really try to get them to be specific; not that they want to look younger, not that they want to look more rejuvenated, not that they are looking like their mother,” said Dr Glaser. “You want them to be specific so that you can really understand what they want.”
Examine those desires from a clinical standpoint. Are these realistic for their lifestyle? “If they have little tiny kids, major resurfacing is not going to be a good option for them,” offered Dr Glaser, “Little kids don’t like to see their mothers or fathers with these bloody faces for a week or two.” Diet can also play a special role; certain popular eating plans can hinder the postprocedural healing process due to nutritional deficiencies. Patients should also be quizzed on their sunscreen use.
Note the patient’s previous medical history as well by asking in a non-judgemental way, “Have you had any previous procedures?” If so, ask who performed that procedure and where did it occur. Dr Glaser recommended being careful with asking about complications by framing the question as “how did that procedure go?”. The patient’s answer may help fill in any holes regarding the patient’s cosmetic wises as well as help lay a foundation for their individualized treatment plan.
After talking through the patient’s thoughts, do a close examination of the patient and discuss your findings with them. Be nice and specific with your feedback. “Don’t just say you’re asymmetrical,” suggested Dr Glaser. Pointing out a patient’s best features (eg, strong right eyebrow arch) vs what can be corrected (eg, a weak, drooping left eyebrow) can increase patient confidence and improve the overall patient-physician relationship.
Lastly, the initial consult conversation should fully outline your plan for the patient. Though you should have a firm idea of the patient’s budget, discuss what the ideal treatment plan would be for their cosmetic desires. The patient should be made aware that to achieve their aesthetic, multiple procedures may be needed, which may incur additional costs. As part of that plan, be sure to highlight a 5-year plan for the patient so they understand any future procedures or maintenance needs. Dr Glaser mentioned to always discuss complications, both minor and serious adverse events, so that the patient can make the most informed decision going into their procedures.
Glaser DA. The aging face: pearls from an expert. Presented at: 2020 Winter Clinical Dermatology; Kohala Coast, HI; January 19, 2020.