Aesthetic Surgery Techniques E-Book

A Case-Based Approach

James D. Frame, Shahrokh C. Bagheri, David J Smith, Jr., Husain Ali Khan

• Publisher: Elsevier
• Year: 2017
• ISBN:
  9780323430173
• Topic: Medicine
• Subtopic: Plastic & Cosmetic Medicine

Changing trends, ethnic and regional preferences, and a hands-on teaching method make cosmetic surgery uniquely challenging for novice and experienced surgeons alike. Aesthetic Surgery Techniques: A Case-Based Approach offers expert, real-world instruction by presenting chapters and patients in a classical fashion, providing a clinical perspective as you work through case after case, honing your knowledge and skills. A diverse, international group of highly reputable faculty takes you step by step through each case.

• Covers a wide range of the most common cosmetic procedures in a templated, atlas-style format, highlighting case presentations with superb illustrations andclinical photographs.
• Presents each case using easy-to-understand text that highlights potential risks and tips and tricks to avoid them.
• Conveys the real-world knowledge and expertise of a multidisciplinary team of editors including oral and maxillofacial surgeons and plastic surgeons.
• Uses a chapter format based on the 14 Cosmetic Surgery Competencies used to train Consultant Plastic Surgeons at the Anglia Ruskin University, UK.
• Offers global coverage of specific techniques to help you refine your skills and expand your surgical repertoire:
• • Abdominoplasty (Modified Brazilian Technique in the UK and Middle East)
  • Open Rhinoplasty (European approach)
  • Surgical correction of the Neck (New Zealand and U.S.)
  • Advanced Medical Aesthetics (UK and Dubai)
  • Facelift Made Easy (U.S.)
  • Asian Blepharolasty
  • Ethics in Aesthetic Surgery (UK and U.S.)
  • Breasts, Buttocks, and Thighs (Brazil)

Part 1

Introduction

Outline

1 Informed Consent Protecting the Patient and the Surgeon

2 Aesthetic Medicine Surgical Pearls

3 Aesthetic Applications for Fillers

1

Informed Consent

Protecting the Patient and the Surgeon

Neal R. Reisman MD, JD, FACS

Hugh Henderson FRCS

The Process of Informed Consent

Neal R. Reisman MD, JD, FACS

The process of informed consent is very important to the practice of plastic surgery. Not only is it a requirement from a legal standpoint, but it should assist in clarifying goals and expectations. Understanding informed consent is a process and not specifically the document that becomes signed; the process should include not only the surgeon, but the team interacting with the patient. There are legal standards that every jurisdiction adheres to defining requirements in accomplishing informed consent. The majority of states in the United States follow a “reasonable patient” standard which defines informed consent information necessary for a reasonable patient to make an informed decision. The minority standard is what a “reasonable physician” deems appropriate to accomplish informed consent. Such standards do not mean that all information pertinent to a procedure must be discussed but only such information as a reasonable prospective patient would need to understand to make an informed decision. Practices spend much time creating and discussing informed consent. The reality is that there are very few litigation cases specifically lost on a lack of informed consent. It is important to have the consent discussion and documents in the patient's language. In addition to language issues, the bigger task is having the patient “understand” what the risks, hazards, inherent risks, and concerns are. The understanding of this information becomes the main issue in creating and achieving informed consent. A mere signature at the bottom of the document only demonstrates that the patient signed it and not that it is understood.

Informed consent documents present and discuss death and significant morbidity. It may be difficult for a jury to believe the plaintiff is objecting to a scar or a less than desirable result when they have understood and signed to say that they acknowledge that death is an acceptable risk. The scar seems much less significant. Herein lies the challenge to achieve informed consent, and I suggest to accomplish the legal requirement by going beyond the document itself and using the discussion to better interpret and decide whether goals can be reached.

The reasonable patient would inquire about the different procedures suggested, their complications and inherent risks, anesthesia concerns, drug interactions, cost and expenses, and the risk of doing nothing. It behooves the practice to see the prospective patient more than once and to utilize multiple learning style techniques in providing necessary information. There are many learning styles, but the most common three are visual, auditory, and kinesthetic. Understanding is enhanced when all three styles are incorporated in the informed consent process. Many patients are visual learners and achieve understanding by looking at photographs, schematics, and other tools the patient can see. One must be cautious in not having photographs interpreted as a warranty of results but rather representative of different aspects of the procedure. Demonstrative tools should clearly not be presented as the prospective patient's result but rather a general representation. Patients may bring in their own photographs of goals and expectations that are helpful in defining their desires, but these should not be made part of or included in the medical record. Auditory learners are the next most common group. The auditory learner listens in great detail to describing information pertaining to the procedure, follow-up, and care. Your words paint a picture for them, achieving a better understanding of the procedure and inherent risks. Often the more detail you can provide in advance, the more comfortable the patient is with the entire event. The third learning style is the kinesthetic learner. This can be more of a challenge in discussing how the procedure specifically relates to the patient and past experiences the patient can recognize. An example might be, when attempting to determine size goals in a breast augmentation, to have the patient refl...

Table of contents

• Cover image
• Title Page
• Table of Contents
• Copyright
• Video Contents
• Preface
• Acknowledgments
• List of Contributors
• Part 1 Introduction
• Part 2 Head and Neck
• Part 3 Perioral Aesthetics and Dentistry
• Part 4 Breast
• Part 5 Trunk and Abdominal Wall
• Part 6 Upper and Lower Extremity
• Index