One of my blepharoplasty patients recently brought a friend to her post-op visit. Six weeks earlier, her friend had gone to another physician to undergo a browlift, autologous fat injections to the cheeks and full face CO2 laser resurfacing. She’d asked the doctor to lower her hairline and fill the hollows in her cheeks, but he’d talked her into laser resurfacing — she didn’t even know why.

Now, she was unhappy with the way she was healing. Her face was very red and felt tight. She had significant erythema and was already developing hypertrophic scarring. When I asked her how she was taking care of her skin, she said her doctor told her to get some Aquaphor ointment. She didn’t have a follow-up visit scheduled and didn’t know what to do.

This patient was unhappy not only because she was still red, but because she wasn’t getting her doctor’s attention. She was developing a significant complication that her physician wasn’t aware of because he didn’t follow her closely enough. This case illustrates what can occur if you don’t tailor your practice to meet the unique needs of aesthetic surgery patients. With better planning, better communication and closer follow-up, these problems could have been avoided.

This article will outline how to modify your practice to maximally satisfy aesthetic surgery patients while maintaining smooth office operations.

Different strokes

It’s important to understand that aesthetic surgery patients are different from regular patients. They have different motives than patients with medical problems. They also tend to have higher expectations and a lower tolerance for anything less than perfection. Often, before coming in for the initial consultation, they shop around and have some information about their condition and its possible solutions. They’re as much consumers as they are patients, so how you deal with the individual is just as important as how you deal with the surgical problem.

First impressions

These strategies can turn people who contact your office into patients.

• Use the phone to your advantage
. Usually, the first contact patients have with your office is when they call for appointments, so how they’re handled on the phone makes a tremendous impression. Patients calling my office to schedule consultations are referred to my surgical coordinator. The coordinator gives them information about the condition, answers questions and schedules the appointment. She also tentatively schedules surgery if what the patient needs is already clear.
• Offer patients a friend
. My surgical coordinator assists in surgery and handles calls. She gives patients her business card and tells them to call with any questions. Patients form a bond with her, and she becomes their confidante.
• Provide information up front
. Before the initial consultation, make sure that patients receive informational brochures, pre-registration forms and a manual of office policies. These answer most routine questions and save time later.
• Appearance counts
. How the office looks is important. It must show that you care about the patient’s comfort as much as your own. It must be clean, and the decorating scheme needs to be more elaborate than paneling and wooden chairs.
• Patient privacy is key.
Remember, privacy is extremely important to an aesthetic surgery patient’s happiness. Comfortably furnished waiting rooms should be away from the main traffic flow. If there’s sufficient space, a private entrance and waiting room are nice touches.
• Create confidence in you and your services.
It’s a good idea to keep a binder of articles from fashion magazines mentioning procedures and lasers that you use. This gives more credence to your services than medical literature, and it indicates that you keep up with the latest techniques.

Customer service counts

Staff must be comfortable dealing with aesthetic patients. Customer service is what brings patients back.

• Spend extra time.
Communication is critical with these patients. If you move 80 or 100 patients a day, these special ones will be lost in the shuffle. They expect to pay a lot and want a level of service commensurate with that fee. Don’t herd them through with only cursory explanations. Typically, I spend 45 minutes to an hour with new patients, so I can get a better idea about their goals and motivations and explain the benefits and limitations of the proposed treatment.
• Prevent unrealistic expectations.
Poor communication and bad marketing can lead to unrealistic patient expectations. During the initial consultation, listen to what the patient wants. Then, explain what you can and cannot do.
• Point out other features that need attention and identify when additional procedures are necessary to achieve the patient’s goals. Also, when obtaining informed consent, explain all risks, including the possibility that you won’t be able to completely fulfill all of their objectives.
• Don’t try to talk patients into services that they don’t want.
Stick to meeting your patients’ goals. Remember the unhappy woman mentioned earlier. She was talked into laser resurfacing and developed a severe complication because of it.

Getting down to business

After the consultation:

• Have patients meet with the surgical coordinator for information and scheduling
. The coordinator should explicitly explain the costs. It’s also important to explain that, for some procedures, charges are per treatment. If this isn’t made clear in advance, patients will be disappointed and won’t want to pay for subsequent treatments. Have them sign an agreement that clearly details payment terms.
• Schedule post-op visits at the same time the surgery is scheduled
. Patients are self-conscious about their appearance during post-op and don’t like waiting at the appointment desk.
• Schedule post-op visits for the beginning of the day.
This way, patients won’t have to wait if you’re running behind. (I see laser resurfacing patients on post-op days 1, 4 and 11.)

Leave no stone unturned

Things can go wrong in the immediate postoperative period, so you should maintain close contact with patients and provide them with everything they’ll need.

Provide resurfacing patients with all the necessary skin care products — this way, you’re in control of what’s being used. This also enhances patient satisfaction. Everyone likes to go home with something, so bundle the items in with the cost of the procedure. On average, I provide about $200 worth of moisturizers, lotions, sunscreens and bleaching agents per case. Another positive side effect of this is that many patients continue to come in to purchase maintenance products even after they’re discharged. If you keep patients coming back, they’re sure to notice the other services you offer.

Follow patients as long as necessary. They must be comfortable about being discharged. Some only need to be watched for a few weeks, while others require several months.

You can do it!

A successful and rewarding aesthetic practice is within your reach, but it requires a significant commitment by you and your staff. Be sensitive to patients’ need for privacy and comfort, make sure that both sides are well informed, and maintain relationships for as long as necessary. In the end, it will pay off.

Most of this business comes from referrals. If you adapt to meet the needs of aesthetic surgery patients, it makes your patients and you look good — and that’s what it’s all about.

Are you really ready?

Before establishing

an aesthetic practice you must be well trained and understand the principles of aesthetic surgery — especially if you plan to use a laser. For each case, you must consider risks and determine how to manage complications.

It’s important to be well equipped. Merely buying a CO2 laser doesn’t make you an aesthetic surgeon. Take into account the complications and limitations of the lasers you plan to use.

Dr. Migliori is an oculoplastic surgeon in private practice in Providence, R.I., a clinical assistant professor of ophthalmology at Brown University and Director of Ophthalmic Plastic Surgery at Rhode Island Hospital.