The Consultation

When I see a patient for a consultation and evaluation, whether it’s in person, or virtual with the aid of photographs, I’m developing a treatment plan for that patient. I may make nutritional recommendations as part of their overall treatment. Compression recommendations may also be made prior to surgery. A big aspect of my evaluation is crafting my surgical treatment plan. I am determining my exact approach for that patient, what specific areas will be treated, and if treatment needs to be parsed into multiple surgeries.

For example, when I am treating a patient with lipedema, this is almost always broken up between two, three to four hour-long surgeries. The first surgery may be the calves and ankles, along with the circumferential upper arms, and the second surgery may be a circumferential thigh. There is also a discussion of the interval of time between the surgeries, and that of course translates into an estimate of fees. This consultation and evaluation allows me to educate my patient on how I will be approaching their surgery, and what devices I may be using, depending on their specific concerns.

I like my patients to have a very clear understanding of how the treatment will be performed. From a surgeon’s perspective, there should always be a clearly laid out plan for treatment—there should never be guesswork. Another example is the revision work I perform. The diagnosis for revision work is important as we may be dealing with irregularities, disproportion and scar tissue. I discuss with the patient what devices I will use to emulsify the scar tissue, and how I plan to rebalance the proportions of their body.

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