The Role of Refunds in Managing the Unsatisfied Aesthetic Patient

Abstract

Introduction:

Unsatisfied patients are inevitable in the field of cosmetic surgery. There is limited literature regarding management of the unsatisfied patient, with even less discussion on the role of refunds. The purpose of this study is to present cosmetic surgery refund data from a multi-center oculofacial plastic surgery practice and review the literature regarding strategies to alleviate post-operative patient concerns.

Materials and Methods:

A retrospective chart review was conducted on patients who received cosmetic surgery refunds for pure aesthetic upper and lower blepharoplasty, brow lifts, ptosis repairs, fat grafting, and facelifts from July 2016 to December 2023 in our oculofacial plastic surgery private practice. Financial data, reasons for refund, demographics, and medical history were collected.

Results:

Eight patients (1 male, 7 female) with a mean age of 60.5 ± 16.1 years received cosmetic surgery–associated refunds during the study period. Reasons for patient dissatisfaction were perception of residual upper eyelid skin, lateral canthal web, prolonged malar edema, lower eyelid retraction, asymmetric palpebral fissure on downgaze, and temporal brow lift scarring. Dissatisfaction with respective procedures led to refunds in 4 of 1909 upper blepharoplasties (0.21%), 3 of 1704 lower blepharoplasties (0.18%), and 1 of 427 brow lifts (0.23%). Unsatisfied patients had a mean of 6 post-op visits. Refunds occurred in 0.23% of aesthetic surgical patients and represented 0.41% of the total cosmetic surgery income.

Conclusions:

Although willingness to provide refunds varies, when combined with pre-operative patient selection and expectation management, issuance of refunds may be an additional tool to help alleviate post-operative aesthetic patient concerns and minimize negative reviews and lawsuits.