• Ryan Kunkel

Philosophy on Aesthetic Consultations

Updated: Nov 10, 2021

When patients come to see me for a cosmetic surgery consultation, they usually have a specific concern and they want to know if I have any services to address those concerns. My training in plastic surgery centered around reconstructive surgery. Almost all plastic surgery residencies are focused on reconstruction.

The skills learned from performing reconstructive surgery lend themselves well to cosmetic concerns. After you learn to reconstruct a breast that has been excised for cancer, implanting a prosthesis (performing a boob job) in a healthy person can be relatively straight forward if you follow the same principles. After a surgeon learns to repair an abdominal wall that has been damaged from a gun shot wound, that surgeon can repair a rectus diastis (abdominoplasty) resulting from pregnancy using the same skills and techniques. For these reasons, the field of reconstructive surgery, naturally bled into aesthetic surgery.

It is always a challenge to take a healthy, attractive person and improve their appearance. So when a patient has a specific concern, I discuss their goals and decide whether I have a skill set that can address their particular situation. If they are worried that their breasts don't fit into clothes as they wish they would, or their breasts became deflated after breast feeding, I can offer them a breast augmentation. If a patient in concerned about the laxity of the skin and muscles in their face and wish to restore a more youthful appearance and defined jawline, I can offer them a facelift.

Sometimes, patients have concerns for which I don't have the right tool in my toolbox. In those situations, I will refer them to a surgeon who may have that tool. In some situations, I believe that there isn't a tool in existence to address those concerns. And in some situations, they seek a tool that will put them in a worse situation than they currently find themselves. I talk to them about those things.

Finally, I see patients who ask ME what I would change. I can understand the question and why somebody would ask me this. If you went to a car mechanic and asked if they could tune up your car, that might be a similar situation. You want to look as good as possible, but you don't know what the options are. The problem with this situation is that there isn't anything wrong. Beauty is subjective. I can't tell you what you want to improve.

Normally, I will start by asking if they have any specific concerns. People usually know if they want their breasts perkier or bigger, if they want their abdomen tighter or trimmer, if they want their eyes to look less "tired," etc. Sometimes they mention wrinkles or deep lines on the face. If they truly don't have any specific concerns, I will explain to them that they should consider themselves lucky!

I am not here to sell my patients on products, fillers, or surgeries. I am here to provide a service. If patients have something they wish to improve, I am honored to be the surgeon to meet your needs. Improving the bodies of healthy patients who want to address cosmetic concerns already carries the possibility of complications or outcomes that don't meet expectations. It is not prudent to offer a solution to a problem a patient has not identified.

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