Not every consultation ends with a date. Sometimes it ends with a reason to wait, and sometimes with a recommendation against the procedure you came in asking about. That is an uncomfortable answer to receive after travelling, and it is worth explaining where it comes from rather than leaving it as a personal verdict.
In practice it comes down to three things: timing, the present state of the tissue, and whether the change you are describing is one that particular procedure works on. This article is about our own reasoning. It is not a diagnosis, and none of it decides anything for an individual case, which is settled at consultation and examination.
The situations that come up most often
| What the consultation finds | Why it is a reason to wait | What is usually discussed instead |
|---|---|---|
| Active inflammation, irritation or an unhealed wound in the area | Healing is unpredictable while tissue is already reacting, and the result is hard to judge | Settling the skin first, then reassessing |
| A recent procedure in the same area that has not settled | Swelling and tissue change from the earlier procedure can be mistaken for the starting point | Waiting for the previous result to stabilise before planning the next step |
| Weight changing substantially at the moment | The shape being assessed is still moving, so both planning and judging the result are unreliable | Reassessing once weight has been stable for a period |
| A described goal the procedure does not address | The procedure would be carried out and the concern would remain | Explaining what the procedure does work on, and what would be discussed for the concern described |
| Expectations set by an image rather than by the face in front of us | A specific outcome from someone else's anatomy is not something anyone can promise | Talking through what is and is not adjustable in your own case |
None of these is a judgement about you. Four of the five are about timing, and timing changes.
Why we say it rather than book the date
The short reason is that an operation is difficult to undo and an appointment is easy to move. When the two are weighed against each other, moving the appointment is almost always the cheaper mistake to correct.
There is also a practical reason. When something in the area is still changing, the consultation is assessing a moving target. A plan made against a moving target has to be revised later anyway, and revising it after surgery is a different matter from revising it before.
What should happen in the room
If the answer is to wait, you should leave with three things rather than a general impression.
- What specifically needs to change. "Come back later" is not an answer. "When this has settled" is.
- Whether anything is worth doing in the meantime, or whether waiting is the entire recommendation. Both are legitimate answers, and they are different answers.
- A written record of what was found, so a later consultation begins from the examination rather than from what either side remembers.
If you are travelling and your return date is fixed, say so at the beginning rather than at the end. It does not change a clinical assessment, but it does change what can usefully be planned around it.
If the answer is about the procedure rather than the timing
This is the harder version to hear, and it deserves a fuller explanation than "it will not work." What you should get is a description of what that procedure works on, why the concern you described falls outside it, and what would ordinarily be discussed for the concern you actually raised. If that explanation is not offered, ask for it directly.
It is also reasonable to seek another opinion, and worth doing with the examination record in hand so that the second consultation starts from findings rather than from a summary.
What this article is not
This is a description of how a judgement is reached, not a way to predict your own. Whether any of the situations above applies, and what follows from it, is determined at consultation and examination. Nothing here is an assessment of an individual case or a recommendation for one.