I am currently co-chair of an aesthetic symposium for the American Association of Plastic Surgeons.  In putting this symposium together, my colleague and I are of course selecting the best surgeons to teach the members of this prestigious organization.

As I went to the Internet to find phone numbers, I discovered that most of these surgeons had mediocre ratings – – 2.7 stars, 3.5 stars.  How could this be?  These are the best of the best.

When I looked at the individual ratings, they did not form a bell-shaped curve.  It was not an even distribution, most patients giving 3 stars, with a few lower and higher scores.  Instead, these surgeons had only fives and ones – – nothing in between.  So naturally I read what the one star patients had to say.

It was just like reading one star reviews on builders or repairmen, only worse.  These great surgeons, to whom I would entrust my family members or myself, got reviews like this: “He is a monster.”  “He ruined my face forever.  Now he won’t even see me.”  “He experimented on me.  Everyone on the street stares at me.”  “He destroyed my life.”  “He left in the middle of the operation and didn’t finish it.”  “He is a criminal.”  “He refused me for surgery.  That’s a hate crime.”

This is not ordinary stuff.  These patients are not being critical of a result or complaining that they had to wait too long or that the doctor was not pleasant — they are writing angry, harsh personal attacks full of extreme words.

I have taught and done a great deal of research on unhappy patients for three decades.  A few patients have been very unhappy and say angry things.  But it is not all their fault.  The overwhelming majority had abusive or neglectful childhoods.  They feel shame.  They seek plastic surgery to eradicate that shame.  Many have said so.  They want surgery for self-esteem.  They want to change their appearances to erase shame.

Of course, that never works, so they feel just as awful afterward.  Why don’t I feel better?  Someone must be responsible.  I know.  It must be the surgeon.

I am not saying that surgeons never get bad results or have postoperative imperfections that need second surgeries to get the best results possible.  We all do, especially surgeons who treat the most complex problems. I am also not saying that patients do not have the right to be unhappy.  They do.  But great surgeons do not ruin patients’ lives, experiment or behave like monsters.  These are well-respected teachers and surgeons.  Their colleagues would know if they were criminals.  Their hospitals would know if they left their operating rooms without finishing.

As you read these reviews, listen to the language.  Watch out for disaster language and extreme words.  Then ask yourself, when would I say such things about someone who is trying to help me?