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Will Some Patients Be Dissatisfied No Matter What?

Patient satisfaction in plastic surgery is the cornerstone for any plastic surgery practice. 

Positive outcomes increase the opportunities for more bookings, improved staff morale and a happier surgeon.

Negativity within a practice can impact the patient’s sales funnel, deflate staff and productivity, and leave a surgeon with sleepless nights worrying about whether one review will destroy their reputation. 

The accepted axiom is that a practice will always have dissatisfied patients and that it is just part of the day-to-day life of an aesthetic plastic surgeon.

Each practice strives for the perfect patient base, but can often feel the pressure to accept certain candidates that they may suspect could be time consuming or somewhat difficult throughout the process.

This all begs two questions:

  1. Will there always be dissatisfied patients in a practice?
  1. Is there anything a surgeon or practice can do to change the outcome?

Patients’ Underlying Problems

On our podcast, Finally, we discussed whether a patient’s history will affect whether they will be happy with the outcome of a procedure.

We were joined by Aesthetic Psychologist, Kimberley Cairns, and discussed the relationship between patients’ life experiences and their satisfaction with the result of their procedure. 

A key theme is that if a patient’s underlying concerns or past traumas are not successfully identified and treated, they have a far greater likelihood to be dissatisfied with their procedure. Even if a surgeon has given them everything they said they wanted. 

Many patients seek help and require expertise to guide them on aesthetics, however it is in the practice’s best interests to uncover psychological drivers that are motivating patients to seek procedures.

In many cases, there is a high probability that patients may not have revealed their real reason for wanting surgery.

If surgeons do not uncover these true motivating forces, then they are at risk of treating a patient who may be problematic post surgery.

Knowledge Of Patient History To Provide Patient Satisfaction

Discovering each patient’s “why?” has enormous benefits. That means understanding all aspects of their journey to get a clear idea of:

  • When did their journey start?
  • What was their first treatment (if there were prior treatments)
  • What are their motivations?

Covering a few simple areas also enables patients to get a better understanding of themselves, by considering elements they may not have previously thought of as relevant. 

Furthemore, covering a patient’s history will help find the answers to understand what has led up to the present moment.

Perhaps a patient has dealt with a different surgeon on a previous occasion. Why did their journey stop with them?

Unearthing essential answers empowers surgeons to deal with patients with an empathetic approach, whilst understanding previous practices that didn’t work and the reason why; limiting the possibility to repeat history and offer patient satisfaction.

The Problem With Unrealistic Expectations And Patient Satisfaction

Facilitating realistic expectations of patients is another influence in patient satisfaction. 

We spoke to Russell Babbitt, MD who explained how steering away from the usual before and after narrative in Plastic Surgery is crucial for practices. 

Obviously, photoshopping or adding filters to images is incredibly unhelpful for patients. 

The other key is preventing an “I want that!” scenario where a patient resonates with a before and after, and believes that result is all they need to become happier.

For many patients, the plastic surgery process is not purely about aesthetics. It is one part of a process in growing their confidence or leaving a past trauma behind.

Surgeons who incorporate this understanding into their practice and actively work to reduce the psychological load on their patients. Therefore, will have a better chance of mitigating the risk of encountering unhappy patients due to providing patient satisfaction.

The Importance Of Correctly Conducted Consultations 

Correctly conducted consultations hold huge benefits within a practice and make way for a healthy patient and surgeon relationship to provide patient satisfaction.

Kimberley Cairns stresses the importance of consultations being conducted by the person who will be doing the prospective patient’s treatments.

This also makes sure that patients don’t have to repeatedly take time to share their journey with different people. 

Patients do not want to feel like they are on a conveyor belt of interviews before they see the person who will be performing their procedure. 

To start off a consultation with respect to the aesthetic and psychological wishes of patients, maybe try asking:

What brings you here today?


When you look in the mirror, how do you feel?

These questions allow patients to discuss every angle that may be at the front of their mind.

The Problem With Not Asking Patients The Right Questions

Besides building confidence in patients, practices should also focus on building confidence within their team. With the correct training, practice staff should be knowledgeable in the best approaches with patients. Part of this is ensuring they are confident enough to be asking the correct questions. 

Kimberley Cairns, Aesthetic Psychologist, explains that “psychology and surgical assessment should be combined as one to stop any chance of crisis arising.” This means surgeons not only listen to patients’ surgical needs, but also identify their underlying reasons and history when necessary. 

Staff Training To Provide Patient Satisfaction

All staff should be equipped with the correct training and education to deal with patients in the right way. Not only surgeons, but from the staff who work internally answering calls and creating the first experience for prospective patients. 

Staff should be doing a number of things:

  • Learning as much as possible about the person helps both sides 
  • Encouraging emotional change with patients – no patient should be responding with a binary outlook, as opposed to only yes and no closed responses. 

It is also important to have a trauma informed approach to create a safe space for patients. This can include 6 guided principles;

  • Safety
  • Trustworthiness & transparency
  • Peer support
  • Collaboration & mutuality
  • Empowerment & choice
  • Cultural, historical & gender issues

Focusing on successfully measuring qualitative and quantitative information, alongside the ability to measure it objectively, has enormous benefits. 

Training all staff to speak with patients in the right way can start healthy conversations whilst also keeping professional boundaries.

Staff should also be asking themselves, how can they create a calm space? Patient care is about justification, and the focus on nurturing and being able to assess while still being emphatic is very important. 

  • Complex case management has to include patient psychology
  • Full assessments and provide a safe space before a crisis 
  • Keep professional boundaries
  • The gaps in research


While it can be probable that there will always be dissatisfied patients, the result of this can largely be down to not successfully incorporating psychological understanding in your practice.

Which is to say, taking into consideration important areas allows practices to be better structured and limit the chances of problematic patients. From trauma informed approaches, to correct staff training for consultations and post-procedure care. This can all be done alongside identifying patients true motivations, which all align to help build a healthy patient and surgeon relationship. 

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