Pearls & Perspectives: Patient Expectations, Physician Autonomy, and Life Beyond Surgery, With Andrew T. Cohen, MD, FACS

Welcome back to Pearls and Perspectives!

In this episode of Pearls & Perspectives, host Amy Pearlman, MD, sits down with Andrew T. Cohen, MD, FACS, a board-certified plastic and reconstructive surgeon in the Los Angeles area, for a wide-ranging conversation about plastic surgery, patient expectations, physician wellness, and the evolving role of social media in medicine. Cohen shares a look into his day-to-day practice, where he balances a diverse surgical caseload with patient consultations and an emphasis on maintaining interests outside of medicine. From golf and pickleball to the demands of long procedures in the operating room, the conversation explores how hobbies can contribute to life in and outside of surgical practice.

Pearlman and Cohen also discuss the changing motivations and expectations of patients seeking cosmetic procedures, including the growing demand for body contouring after significant weight loss with GLP-1 medications. Cohen describes common procedures among men and women, including gynecomastia surgery, tummy tucks, arm lifts, neck lifts, breast reductions, and labiaplasty, while emphasizing the importance of understanding why a patient is seeking surgery and whether their expectations are realistic. The conversation touches on the psychological impact of procedures such as breast reduction, and the importance of recognizing when surgery may not be the appropriate solution. Cohen also discusses his approach to postoperative care, wound healing, and helping patients understand the trade-offs of procedures, including the visibility of scars.

Beyond the operating room, Pearlman and Cohen explore physician autonomy, private practice, office-based surgery, and the potential impact of practice ownership and private equity on the future of medicine. They also examine how social media can help physicians educate patients and give prospective patients a sense of a physician's personality and approach.

Throughout the conversation, Cohen emphasizes the importance of a strong support team, knowing one's own outcomes, setting realistic expectations, and paying attention to red flags when choosing a surgeon. The episode offers a candid look at the similarities between plastic surgery and urology when it comes to patient-centered care, appearance and confidence, and the responsibility of physicians to help patients make informed decisions.