Patient Perceptions of Informal Aesthetic Surgery Terminology
Patient-centered language is fundamental to professionalism. Unlike other surgical fields, the language used in aesthetic surgery has largely been influenced by marketing and popular culture, rather than scientific terminology. Yet, little is known regarding how patients perceive informal terminology in aesthetic surgery. Since unprofessional language may negatively affect the patient-surgeon relationship, we sought to understand how a set of commonly used aesthetic surgery terms is perceived by aesthetic surgery patients. We hypothesized that some patients would find these terms inappropriate, representing an opportunity for improved professional communication.
Methods/Technique:
After institutional review board approval, a survey instrument was iteratively revised through pre-pilot testing. The instrument was pilot tested (n=25), and internal validity was assessed by computation of Cronbach’s alpha (0.86). Between July and August 2020, we invited 898 aesthetic surgery patients to participate in the anonymous online survey. All patients over 18 years old who were scheduled to undergo a cosmetic plastic surgery procedure between January and December 2019 at Vanderbilt University Medical Center were invited by email. No invitations were returned to the sender. Two subsequent email requests were sent to non-respondents.
Results/Complications:
347 patients completed the survey (38.6%). The median age was 51 years, most were female (95.7%), and the majority identified as white (85.6%). The demographic information of respondents and non-respondents were comparable (non-respondent median age = 50 years; 92.8% female; 76.6% white).
Over a third (37.3%) of respondents perceived the phrase “mommy makeover” as inappropriate when discussing aesthetic surgery after pregnancy, and over a quarter (25.9%) disapproved of the term “nose job.” Two thirds (66.0%) felt the phrase “boob job” is inappropriate. A third (33.7%) reported that the terms “top” and “bottom” surgery are inappropriate when discussing gender-affirming surgery. Nearly half (44.7%) perceived the term “turkey neck” as inappropriate, and 29.2% disapproved of the phrase “love handles.” However, a majority (73.1%) felt the phrase “tummy tuck” is appropriate when describing aesthetic abdominal surgery. Nearly three-quarters (70.9%) preferred, or were neutral about, the exclusive use of medical terms when discussing aesthetic surgery.
Conclusion:
Many patients found the informal language of aesthetic surgery to be inappropriate. In open response comments, patients characterized common phrases as “degrading,” “patronizing,” and “a barrier to clear communication.” For these patients, informal terminology may be perceived as unprofessional and may harm the patient-surgeon relationship. Since most respondents prefer, or were neutral about, the exclusive use of medical terminology, avoiding non-medical terms is generally the most patient-centered approach to communication. Although some patients may use informal aesthetic surgery terms in conversation and may not recognize or understand the medically equivalent term, surgeons should only use informal language when it reflects the patient’s preferences. It should not be the default among all patients. When informal terms are used, we encourage the adoption of body-positive language and advocate against the use of misogynist terminology or conceptions. To maintain the highest level of professionalism, surgeons should strive to use patient-centered language, and this may require rethinking the current vernacular of aesthetic surgery.