By Steven H. Dayan, MD, FACS Attend any aesthetic medical conference and you’ll find the lecture halls addressing the newest technique for tightening a neckline or lifting a jowl filled to capacity. As students of science as well as artisans of anatomy, we are drawn to believe that our healing influences are primarily delivered through our fingertips. Yet, if our measure of success is recalibrated to achieving patient satisfaction rather than just the mathematics of perfection, then the secret to a robust practice and happy patients may have as much to do with psychic allure as the technique du jour. When assessing patients, it’s important to understand the underlying motivating factor causing them to seek treatment in order to provide the best possible outcomes. It is not uncommon for a patient seeking out cosmetic surgery to have experienced pubescent taunting and emotional scarring secondary to their physical form falling outside a standard deviation. Other would-be cosmetic seekers may desire beauty as a means toward professional advancement, a romantic interest, or an improved social status. Regardless of the motivators, our patients may be particularly vulnerable to critical judgments. And the likelihood of them achieving their goal is more related to the self-esteem gained than the physical form obtained. As any practicing aesthetic physician can report a seemingly great outcome, meeting all objective measures of physical perfection may fall short of a patient’s expectations, whereas a less than perfect result may be met with utter adoration. Additionally, at times doing nothing at all, akin to placebo, can be effective at improving self-esteem. Our success both as individuals as well as a specialty is determined by the satisfaction of our patients regardless of the means to achieve it. What factors and to what extent determine our patients’ post-treatment happiness? How much of our success and the patient’s satisfaction is based on the physical outcome achieved and how much of it is based on other seemingly less direct causes, such as the post-treatment judgments by peers and family, or even the physician’s communication style, mood, and attitude? Clearly all of these impact the patient’s mindset, attitude and self–esteem and ultimately calculate into their satisfaction. Read more at Modern Aesthetics.