Consultation with a Plastic Surgeon emerges from either a self-perception carried from youth, or one developed through arduous trials of living. Traveling to this office for a consultation to improve one's self-image through plastic surgery is an exceptionally courageous decision, and one which I gratefully acknowledge. Once the decision for change is made, surgical correction usually becomes very urgent for the patient. This is because of an infinite emotional and historical events in our lives, which may culminate in an aesthetic surgical experience for you, the patient.

It is very important to your well being and security to make your decision for surgery slowly and considerately. Take care to study both yourself and your surgeon.

It is very important and necessary for you to accumulate as much knowledge as possible about your surgery during the time we share together, both before and following surgery. Any and all information is freely offered by me and my staff at your request.

My job is to execute your surgery, technically and artistically according to my best talents, skills, and experience. I am also responsible for explaining the specific limitations, problems, complications, and feeling which relate to your individual surgery. My office staff and nurses are also dedicated to contributing as fully as possible to your learning experience, your feeling and physical caring before and after cosmetic reconstruction. No stone should be left unturned by this office, myself and my staff, to provide you with adequate support and factual information necessary for your decision to undergo such a major undertaking in your life.

Our ultimate goal is to satisfy you, our patient, emotionally as well as technically.

It is extremely important to realize that this is a joint undertaking, which involves a team effort. This team consists of a close working relationship with you, me, and our office staff. All of us must cooperate fully so that the end results become more satisfying for everyone involved. Nothing is more demoralizing for a human being than to expect greater improvement or change in one's life or self-image and not feel that this has been realized. Nothing is more demoralizing for a Plastic Surgeon and his staff than to create a successful operation, but has a dissatisfied patient.

Unfortunately, one major price that we must pay to achieve this satisfaction is time. The decision for change is usually immediate and urgent, but the history which prompts this desire for change is usually written over many long years. Realizing this, my staff and I routinely spend as much time as necessary to fulfill the individual needs of each patient. This includes extensive pre-operative education and relating closely to your feelings, both before and long after surgery. I hope that you will understand that each operation is a work of both art and science. Aesthetic surgery is becoming more and more technically complicated. This necessitates a great deal more surgical time spent to achieve greater artistic excellence. In wanting to provide highly satisfying support, as well as excellence in technical surgery, I, as an individual, cannot serve the total needs of the great volumes of patients who pass through these doors.

If you should choose me for your surgeon, I trust that you will fully understand the enormity of the task before us - you and me. Your choice implies that you wish to join fully with my staff in working toward a mutual goal of satisfying your needs. Please ask all the questions and demand all the care necessary for both your emotional and physical comfort. At the same time, we need you to be a patient-friend in understanding the tremendous time and energy which is necessary to give the same care to our other patients waiting.

You will shortly realize that an important feature of aesthetic surgery is that you will consider the result of the operation to be an enhancement, not a loss, as is usual after other types of surgery, such as a hysterectomy. These benefits are objective as well as subjective. Because of an improved appearance, patients frequently become more socially desirable to others and to themselves. Many studies have supported the fact that physical attractiveness is the most important personal characteristic, influencing how much one is liked in a man-woman dating situation. Especially for the woman, good looks are the passport to popularity and upward mobility. The confluence of beauty, wealth, and power is a universal phenomena in this world. Literally, it pays to be beautiful. Several studies have been performed and conducted, in which subjects are viewed in pre-operative and post-operative photographs. Individuals pictured post-operatively were judged to have more desirable personalities, to be better potential marriage partners, and to have happier lives than the same persons photographed before surgery. Since all the impressions were from photographs, actual personality was not a factor in these studies. These studies suggest that aesthetic surgery may have a stronger social impact on patients' lives than had been previously assumed. The "enhancement of appearance" from the operative procedure is not only in the mind of the patient, but also in the mind of those around him or her. The improved social reception reinforces one's sense of well being. It is not uncommon for our patients, after cosmetic surgery, to become even more outgoing, opening many doors for their future.

Numerous studies have shown that after a successful aesthetic operation, the patient's self-consciousness about a displeasing feature decreases, as do anxiety and depression. At the same time, self-esteem rises, as does the patient's perception of herself or himself as more attractive sexually. For males, there is an enhanced masculinity; for females, an increased femininity. Behavior patterns, sometimes complex, designed to camouflage an unpleasant body part and concomitant feelings of poor self-esteem and inferiority frequently disappears. New, non-verbal as well as verbal behaviors come to the fore, and the patient becomes less socially withdrawn. In patients that present for cosmetic surgery, 87% undergo surgery to improve looks, 80% to improve feelings about oneself, 67% to receive compliments, and 64% to decrease self-consciousness.

At first thought, it may seem perplexing that so many women today are seeking aesthetic surgery during the active feminist movement, many of whose leaders are opposed to such operations. However, the "be what you are" message is not as important to some women as the other message "be all you can be - actualize your potential".

A recent patient, a woman in her early 50's coming for a face lift said, "I have been a good mother, a supportive wife, and now I want to do something for myself." This was the expression of someone who was seeking equal entitlement - equal to what she thought her husband and her children had received from her.

The beneficial effects of aesthetic surgery extend even to the work place, where advancement may be partially the result in improved and younger looks. In fact, some executives have credited their rise to a cosmetic procedure. The point here is that it is not only how that person looks, but how that person feels he or she looks.

I am frequently reminded of a quote by Pope Pius XIII, who in 1958 stated, "If we consider physical beauty in its Christian light, and if we respect the condition set by our moral teachings, then aesthetic surgery is not in contraindication to the will of God, in that it restores the perfection of that greatest work of creation, Man."

Unequivocally, I would state that no patient has ever undertaken an aesthetic procedure without expecting a positive change somewhere to something on his or her body and to his or her life. In short, every cosmetic patient expects an enhancement of some sort from undergoing the ordeal - or for some - the opportunity of aesthetic surgery.

Please understand that my staff and I are dedicated to serving you in every aspect of plastic surgery. We thank you for your cooperation in this effort, and we are looking forward to the beginning of an exciting and hopefully a long-lasting relationship.


John M. Shamoun, M.D., F.A.C.S.

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