Dimitrije E. Panfilov
After initial consultation and examination, we try to identify preferably the most convenient candidate, who should, in the ideal case, be emotionally stabile without psychic disturbances, and the intended surgery should promise a great deal of success, that means facial constellation is obviously correctable. If the findings are minimal and psychic instability is present, we are advised to think twice or to refuse to perform surgery under such circumstances. The most dangerous case would be obvious deformity connected with psychic instability. Also in such cases we should do psychological sounding out. To operate on somebody with untreated psychosis could have catastrophic or tragic consequences.
The ideal patient is not really that rare. He or she has thought over the desired correction for a considerable time (at least for a few months). The deformity is clearly recognizable, to the patient and the surgeon as well as to an unbiased observer. The patient can formulate precisely what he or she expects to have altered. The patient is motivated and would like this correction to be done for himself/herself, that is, with the purpose of achieving a better relationship with himself/herself and not for the sake of other ambitions.
The expectations regarding the changes that could occur after the operation should not be set too high, otherwise disappointment is preprogrammed. Fear of the operation is normal and by all means understandable. Sometimes, however, it is so pronounced that it prevents the patient from having the desired correction performed. It is for this reason that the fear threshold should not be too low.
The ideal patient must have the ability to build up trust in the surgeon of his/her choice. Not only good
healing qualities but also a healthy portion of optimism are very desirable and helpful. Finally, the ideal patient must be organically healthy, that is, healthy with regard to bodily functions. Emotional stability is also important. This listing of characteristics does not of course mean that we only accept ideal patients to operate on. Under certain circumstances and after thorough counselling, deliberation, and scrutiny, even less ideal patients can be considered for surgery if the patient's expectations have been clarified and there is mutual trust.
The patient beaming with happiness after completion of the treatment is a meaningful experience for us. I would even say that many of us have become really addicted to this feeling and always want it anew. To know that you have liberated someone from the dungeon of their inhibitions and insecurity and inferiority complexes is a feeling that is second to none -at least for me.
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