Beauty is in the eye of the beholder, right?
To some degree that is true. Beauty is subjective. When a patient says to me, "Doc, you just do what you think I need" I quickly remind them that very little of the procedures I perform are things that people "need." Rather I try to do what people want. So what if somebody doesn't know what they want? Well that's were your experience can really make the difference.
Most of the time people have a fairly good idea of what bothers them when they look in the mirror. If they need some prodding, then I try to steer them into one of two categories: color or contour. Some people would like their skin tone to be more even by removing pigment from broken blood vessels or sun damage. Others tend to be more focused on their wrinkles or the texture of their skin. So one woman may love her crow's feet, but hate her freckles and it's the exact opposite for the next woman.
Why is all of this important? Have you ever read one of those magazines (Allure, Glamour, etc) where they send in the undercover journalist to have a consultation with the plastic surgeon? She goes to see about 5 different physicians and requests information on a nose job, for example. And she leaves with a laundry list of procedures she "needs" and the nose job has now morphed into the chin implant, eye lift, laser skin resurfacing, etc. Now she may have left the door wide open for the surgeon to recommend all the things that he thinks would be in her best interest. But, in general, the tone the author takes in the magazine article is as if she's just been to the auto mechanic and they have tried to replace everything under the hood. And the reader gets the impression that all plastic surgeons are out to up-sell every vulnerable, naive woman who walks in their door.
Now some patients may want to hear all the recommendations and then make an informed decision on their options. But a great many of them will be so overwhelmed that they leave your office running as fast as they can and feel grateful to still have their features intact. My practice involves no surgery. We specialize in all non-invasive or minimally invasive technologies and so we tend to attract patients who favor doing less over doing more. So it is important to read from them what they are interested in doing and what they could do without. And much of the time, my patients who start out only wanting to know more about sunscreen end up doing fotofacials, Thermage, or Botox as we develop a relationship and they learn to trust me and our practice.
The surest way to have an unhappy patient is to recommend or talk her into doing things that she's not intersted in or could care less about. She'll never really be thrilled with her results if that particular area didn't even bother her in the first place. If you stick to what is of value to them and give them all their options (including services you might not even offer), then she will feel most confident about moving forward in whatever she decides to do. And she'll trust you which is truly the cornerstone of the doctor-patient relationship.