Though word-of-mouth referrals are still common in cosmetic surgery, “digital referrals” are becoming increasingly common.

Much before the consultation, most patients already have an idea of what you (the plastic surgeon) may be like after reading your website and online reviews, as well as viewing social media platforms.

Set the consultation up for success by providing prospective patients with educational information in the form of concise text and, preferably, videos and graphic illustrations on a mobile-friendly website and on social media.

Some patients may have attended consultations with other plastic surgeons and may introduce the diagnosis and plan from other consultation(s) into the discussion.

The clinic scheduler should arrange consultations as promptly as possible, as a new patient is often not willing to wait for months and will opt to find a different plastic surgeon instead.

Take the time to listen to the patients and learn their occupation, hobbies, lifestyle, and social support system.

Careful attention should be paid to understand the patient’s motivation for the consultation, the surgery, and the timing of the surgery (i.e., why now?).

The patient should be asked to list any and all prior related treatments, including injections, laser treatment, and surgery.

Although a patient may complain about a prior experience with a different plastic surgeon, always refrain from passing any judgment or speaking unfavorably about the other surgeon.

Let the patients describe their concerns and encourage them to prioritize the top three areas of concern.

A thorough, standardized nasofacial analysis should be performed, using a mirror to facilitate the discussion with the patient to identify specific areas of concern.

Gently guide the patient to view the face in its totality, thereby improving his or her understanding of the importance of facial proportions and relationships (e.g., the lip–chin relationship for a rhinoplasty patient).

For FaceTime or Skype consultations, request the patient’s photographs to be sent beforehand to review in preparation.

Incorrect self-diagnosis and unreasonable expectations, if not corrected by the plastic surgeon preoperatively, can result in significant dissatisfaction postoperatively.

Be honest and forthright with yourself and your patients with regard to what you can and cannot do.

Pre-emptively dispel common misconceptions, such as “liposuction will make you lose weight” or “a facelift will last forever.”

Patients will retain only a fraction of what they are told during the consultation. Reinforce expectations set during the consultation by providing written materials with the same information.

Remember, “You are a surgeon, not a magician.” Never guarantee a result. Rather, always under-promise and over-deliver.

Both static and dynamic standardized photographs should be obtained preoperatively. These photographs are critical postoperatively to remind the patient of the significant improvements gained with surgery, particularly when the patient is preoccupied with a less significant feature.

Computer imaging can be helpful to provide the patient with a general idea of the postoperative result but there is certainly no guarantee.

As always, the risks and potential complications of surgery should be reviewed in detail and informed consent obtained preoperatively.

If the patient is amenable, obtain a specific informed consent for posting the patient’s photographs and videos on your social media account and website. Realistic images of patients taken preoperatively, intraoperatively, and postoperatively may help future patients develop realistic expectations.

With the patient, define clear goals for the surgery and reiterate these on the morning of the surgery.