Expectation management and patient-surgeon communication in aesthetic surgery: A narrative review of current challenges and communication strategies

OBJECTIVE: To examine patient-surgeon communication challenges in aesthetic surgery and identify effective strategies for expectation management and informed consent through narrative review of current literature. METHODS: A comprehensive narrative review was conducted using PubMed, PsycINFO, and communication databases (2010-2024). Search terms included "aesthetic surgery," "patient communication," "expectations," "informed consent," and "social media." Literature was analyzed thematically to identify key communication challenges, digital media influences, and evidence-based intervention strategies. RESULTS: This review identifies three primary themes and proposes an integrated framework combining traditional communication barriers with digital-era influences: (1) Communication barriers arise from the subjective nature of aesthetic goals and patients' difficulty articulating desires in clinical terms; (2) Social media significantly influences patient expectations, with recent surveys indicating that a substantial majority of facial plastic surgeons encounter patients requesting procedures to improve social media appearance-representing a significant increase from earlier years; (3) Evidence-based visual communication tools and structured decision aids demonstrate effectiveness in aligning expectations and improving satisfaction. Studies consistently show that unmet expectations account for 14.4 % of malpractice claims in plastic surgery versus 3.8 % in other medical specialties. CONCLUSION: This review presents a comprehensive integrated communication framework specifically designed for the digital era of aesthetic surgery practice. Effective patient-surgeon communication now requires specialized approaches that address both traditional expectation management and unprecedented social media influences on patient goals. PRACTICE IMPLICATIONS: Surgeons should implement structured communication protocols including visual outcome ranges, psychological expectation assessment, and explicit discussion of social media influences. Professional development programs must emphasize communication skills specific to aesthetic consultation, with particular attention to cultural competence and digital literacy.