Why do we need a symposium focusing solely on the breast?
I have seen thousands of patient’s post-surgery. I receive images most days from patients who have had breast surgery and I find myself often interpreting what the surgeon has told a patient. Yet, I am still shocked by the patient’s perception. I may see a great result, but the patient is devastated. I may see what I believe is a deformity, but the patient is focused on something else I never even noticed. The point being, perception is not consistent. You cannot follow a rule-book or formula to ensure patient satisfaction after every procedure. Even if your communication, implant choice, and surgery are impeccable, there is still a risk the patient will not be satisfied post-surgery. The risk is minimised by experience, expertise and an aesthetic eye. However, all these quality’s take time to acquire and practical experience is not gained in a class room.
So how does a new aesthetic surgeon minimise complications and manage patient expectations? This is a great question. A new surgeon has been studying for 12 years to receive the title Specialist Plastic Surgeon. They have refined their suturing techniques, they have completed complex reconstructive cases and have the critical thinking skills of an elite scholar. The new surgeon can potentially be a life changing aesthetic surgeon. So, what equips the new surgeon with the skill and eye to move into the aesthetic space. The answer to this is the Australasian Society of Aesthetic Plastic Surgeons (ASAPS). ASAPS are world class leaders in ongoing aesthetic education and Breast Masters is another example of ASAPS raising the bar.
Considering I am attending this world class event and surrounded by industry experts, why would I feel so saddened?
I started out feeling impressed as I often am by Dr Naveen Somia who opened the event with this quote, “It takes a lifetime to master what NOT to do”.
We quickly went into the jam-packed program. Talking about size, shape, measurements and technology. All the complications I had seen before, but I never really knew why or how these complications occur. I am certainly not an expert after watching a few presentations but as the slides and explanations went on, I found myself wanting to cry. I was overwhelmed with sadness because it seemed that everything I had witnessed in practice was what NOT to do. Complex patients were displayed on the screen. The presenter explained why and how to overcome the challenges with such a complex case. It reminded me of patients I had seen before with the surgeons not really appreciating these challenges. The surgeons I am referring to, did not attend ASAPS surgical events and they were all measuring wrong (so the patient was disadvantaged before even starting the procedure). I quickly realised why I saw so many complications and why I continue to see so many devastating complications. Many young women have been left looking and feeling worse then they did before. It is incredibly sad, we have surgeons in Australia operating on women with no lower pole, with a chest wall deformity, with a difficult nipple position and so on. These so-called surgeons are not surgeons at all. They are doctors who have decided to become cosmetic surgeons. There are no conferences which offer crash courses in Breast Augmentation. And here we have surgeons who are renowned for their exceptional work, still learning.
Patients are constantly misled, preyed on and sold an outcome. These cowboys target women with low self-esteem, low socio-economic status and use their weakness to their advantage. These patients put their trust into the surgeon. They rely on reviews, forums, social media and direct referrals. Do any of these patients consider if the surgeon is committed to ongoing education? Highly unlikely. Especially if you have the preconceived bias that the surgeon you have chosen is an expert. The women I saw had paid a deposit, were sold hook line and sinker and were counting down the days until surgery. Whenever the question was asked, do you use “teardrop implants” (also known as anatomical), the answer was scripted with words to the effect, “no we do not use anatomical implants because the risk of complication is significantly high, there is also the risk of the implant rotating and we use the latest dual plan technique”. Patients lapped this up. If asked “why is it so cheap?” the response would again be scripted, such as “we have our own operating theatre, so patients do not have the huge outlay as we do not have the overheads of most surgeons”. And of course the common question “what is the difference between a plastic and cosmetic surgeon” to which the response would be “a plastic surgeon specialises in reconstructive procedures and has limited to no training in cosmetic surgery, our cosmetic surgeons have been handpicked by our surgical director and specialise in nothing but breast augmentation, making them highly specialised.” Again, this seems a reasonable response and the patient’s confidence in the clinic sky rocketed. None of these scripts are factual. None of the surgeons have recognised qualifications in aesthetic surgery. They have no more than 2 days training and only had a limited selection of implants to choose from. This recipe for disaster is still common practice for some. Although I speak retrospectively, this is still happening and there is no sign of this practice slowing down. Incredibly sad.
How can patients be protected moving forward and choose a breast master? A surgeon who is abreast of the latest techniques and research whilst committed to achieving the best results, safely. The simplest way for a patient to differentiate is by asking or checking, Is this surgeon a member of ASAPS? One question is all it takes. The answer can mean the world of difference in not only your results but also your safety.