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In this podcast, I’m going to talk about prioritizing, how I treat my patients. So I like to talk about green, yellow, and red lights. I just did a podcast in terms of green, yellow and red lights for hair transplant surgery. This is totally different. In that case, green, yellow, red light talked about safety, but in this case it does sort of talk about safety, but it’s sort of aesthetic priorities is what I’m going to focus on using this similar metaphor of green, yellow, and red light. So a lot of patients come in and they said, look, a great example, actually I just had a lady, beautiful lady, former model came in a other day and she wanted a face lift. She wanted a rhinoplasty and she wanted an otoplasty and she wanted an eyelid surgery. So I looked at her and I wanted, I said, look, from an otoplasty perspective, if I reduce your lobes, your upper ear is going to look off balance.
And if I pull your ear back, you’re gonna lose your, the amount of helix that’s going to show. And it’s not going to look right, so unfortunately that’s off the table. I call that a red light. That’s something that I would not do for you From the eyelid procedures, I’ve done fillers for her but she has a mild degree of what’s called bleharoptosis meaning the eyelid muscle is weak and I said for you in this situation I don’t think that you’re going to be happy if I did eyelid surgery or fat grafting around your eyes. You know a little fillers will make it better, but you ultimately have some mild about one millimeter bleharoptosis and in my opinion, this procedure called the parametric technique is about the only safe procedure that can be done. An external approach is almost too minimal to do this for ptosis, so that’s why I told her a traditional eyelid procedure is a red light for her.
It’s not that I don’t work on patients with some mild ptosis that have other issues that could already look better and not have the ptosis corrected. But I don’t do ptosis repairs. But I just said in this case for her, what she’s wanting from me is a red light. That in other words, I would not do it for her. The lift for her, the facelift for her, I believe actually would’ve been quite nice for her. But I looked at the cost benefit ratio and she had almost no neck changes whatsoever. So I said, look, there’s a lot of costs with it. There isn’t much downtime for the majority of my patients, but I would put in a yellow light, which she get a benefit. Absolutely. She would get a benefit, she would look better with it, but I’m always trying to weigh things for her.
She had a little bit of a natural fillers in the past. I said the lip correction and the rhinoplasty are probably big green lights. And so I helped prioritize this at the lip production first, the rhinoplasty second, the facelift third, but no eyelid surgery. No, otoplasty is for her. So I’m just using this an example to have you understand how I consult my patients and so someone comes in, I always try to help divide things into green, yellow and red lights so that I can tell you, and also priority. So I’ll help you say, look, Hey, if you have this much to spend, this is where we should go if you have this much to spend is where I go. Now the one thing I always tell my patients is if I stay in the green and yellows, which are levels of safety, it’s not safety, levels of aesthetic gain for useas I stay out of the red.
If you want more yellows and greens or if you want, none of the things I recommended. So long as I believe that I’m not her harming you, then I’d have no problem with it. But as an artist, I always try to give you my priorities of the things that I think would be the most powerful things I can do for you to make you look better. So to me, I think that is a critical element is giving you a consult. I was at a meeting many, many years ago, maybe close to 20 years ago when I was starting my practice and I had a gentleman that was at the time, 20 years older than I am so fortunate, believe it or not, he’s still alive, is still operate now. But of course I was a little bit arrogant at the time. And the gentleman before me said, give a patient what they want, not what they need.
Because if you give them what they need and now what they want and they’re unhappy with you, it’s your fault for choosing it. Now, I don’t disagree with that last point, which is yes, there’s a little bit of risk of telling a patient, look, they really need to do this and not that. But I still, I like to give the patient what they need and what not, what they want. And what I mean by that is, of course, what I deal with is only want, there really is not a need. No one needs a rhinoplasty unless they can’t breathe or something. No one needs, you know, a fat transfer. You know, they only want it. However, what he’s saying is just when a patient comes in, they want bigger lips. Even if their lips look crazy, just do it. That’s what they want it, that’s what they asked for.
Just do what they ask. Don’t mention anything else. Otherwise it may be offended and they’re not going to be happy with you. But my philosophy is I like to sit down and give you consult and really talk about the things and priorities that I think would help you. And I don’t force anyone, so I always say I don’t treat cancer, heart disease, I’m not treating an emergency if you don’t like what I say. You don’t want to do what I advised you don’t have to do it. The one warning is that if you come in with very unnatural areas, and I may forget that I told you last time, it doesn’t look right. I may tell you every time that looks a little bit off and that may bother you. So, but I’m very blunt with my patients and the one thing I always tell my patients is I so appreciate an honored by referrals.
I love referrals. But the one thing I’ll tell you is please don’t refer me someone that has very poor tastes that looks completely fake, that wants more fake things because I’ll have a bad relationship with that patient. It’ll be very difficult for, for that patient and myself. So I always tell my patients, if you like tastefulness where you can’t tell what has happened, if you think it looks natural, because here’s the problem. We live in Dallas where everyone looks a little bit slightly overdone and I hate that look. So, I will tell you this. So my patients are very loyal to me. Know that I do not like that look, I will tell you if something looks off. So if someone wants to be corrected and they know that they look fake, I’m more than happy to work with them to dissolve something, cut this out, reshape it. But if they think they look great and they look really scary, I would ask you, please don’t send them as a referral because I simply will tell them that they don’t look right and they may not like that. They may get angry at you, they may get angry at me, and then we have a bad situation. But this is how I sort of think it’s better to understand my philosophy before you come to see me, to make sure we’re on the same page.