Z. Paul Lorenc, MD, FACS

Because I am a medical writer, I spend a fair amount of time talking to physicians about clinical studies and the reasoning behind their clinical practices. When it comes to treating patients, there are just some questions that you can’t answer by looking up and piecing together information from the medical literature. In the realm of aesthetic medicine, when there is something I want to know that I cannot look up, I go to the only place I can find it – the doctor! At Vibrant Authority, we include our physician friends, not in a “doctor says so” kind of way, but as part of a genuine exchange of ideas and information. These conversations are meant to serve you, dear readers!

The question of the day is “How can I prepare myself for my first visit to a doctor?” To answer it, I called up Z. Paul Lorenc, MD, FACS, a plastic surgeon who looks at thousands of faces and bodies, including those that belong to people who travel first class on flights across oceans to sit in his Park Avenue waiting room. And for good reason! If you ever want to feel like an underachiever, look at his resume. The list of his medical publications alone take up 27 pages, and there is a section for patents.

I wanted to know how a first-time patient can be a good first-time patient. How do you prepare yourself to talk to a doctor about your aesthetic goals? It turns out that preparation includes a few things: 1) considering your motivation for a nonsurgical procedure, 2) finding a doctor whose vision is compatible with yours, and 3) form a collaborative relationship with your physician.

Think About Your Motivation

A great reason to get an aesthetic procedure is because you want to feel more like yourself (or a younger version of yourself), or to correct something that you feel is getting in the way of you moving in the world the way you would like to. The kicker is that you have to be okay with the fact that after a procedure, you will still be left with YOU.

It’s tempting to think that changing visible parts of ourselves will cause a bigger change. How many of us have sought solace in a post-heartbreak haircut? You come out of the salon feeling so good about your new single life, then you hear that your ex was slobbering all over someone new at your old favorite restaurant. No haircut or color is going to immediately get you over that one!

Taylor SwiftTaylor Swift, Post Calvin Harris Platinum… We See You, Girl.

Aesthetic medicine has the potential to be approached with the same mentality. It comes down to self-esteem and self-image, both of which no cosmetic procedure can give you. If you’re feeling good about yourself and want to refresh your skin, rejuvenate your appearance, or eek closer to perfectly balanced aesthetic proportions in a way that is meaningful to you, do it! That said, aesthetic medicine won’t fix your relationship with your mom or make you a happier person. Obsessive and destructive thoughts and dysmorphic body issues can’t be righted by aesthetic medicine because the issues are not skin deep.

I asked Dr. Lorenc what the red flags are that signal a patient is in an “unsatisfiable” state. For him, it’s about the way a patient communicates. Obsessively wanting something that is drastically different than their natural appearance or showing signs of fixation is a dead giveaway.

One example starts with patients using social media photos altered with filters and whatever other face editing apps as an ideal outcome of a procedure. Dr. Lorenc says, “There are some patients, more often young adults, that will show me a picture of themselves they’ve made with Snapchat or Instagram filters and say, ‘I want to look just like that.’ And nothing short of that will suffice. Here, their expectations are just not realistic.”

Filters can be so good… but I see where he’s coming from. I love the idea of having Kate Moss’s waist, but I’d have to get my liver and most of my ribcage removed to pull it off. Gross!

Fortunately, that is not a medically accepted procedure. Since I am keeping my liver, I will live another day to tell you that aesthetic medicine is all about looking like a better version of yourself: your bone structure, proportions, and the actual physiological limits of skin and body type will play a role.

Kim KardashianButterfly-Plasty Only Available in App Upgrades

While providing photos with filters of butterflies around your face won’t exactly make your doctor jump for joy, it could help to bring in a photo so that you can better communicate your vision; just know that it isn’t as simple as ordering a coffee.

“If someone wants that nose, my job is to tell them how I can use it as a guideline and point of reference, but can’t achieve it for anatomical reasons,” says Dr. Lorenc. Even for patients who are all clear in terms of motivation, “it’s a good thing is to come prepared to have an open discussion about what is realistically achievable with your skin and facial (or other) anatomy,” he added.

Know Your Physician’s Aesthetic Sense

“I always believe that the patient’s sense of aesthetic has to meet yours. It has to, or it makes for an unhappy relationship. There has to be open communication and honesty on both sides,” says Dr. Lorenc. Of course, it’s tricky to verbalize qualities of skin and facial features, but for an experienced physician and a patient who knows to look for a shared aesthetic sense, it can be pretty clear when everyone is not on the same wavelength.

Here’s an analogy for you: my office decor is pretty minimal and I need crypt-like silence to work. I don’t like clutter and the fastest way to give me a nervous breakdown would be to sprinkle paper clips on my desk. Neurotic, maybe, but it is how I roll. If I want to hire someone to decorate an office for me, and I see a portfolio full of spaces cluttered with cuckoo clocks and seashell wind chimes. I’m probably going to pass that project along to a different designer.

Nice OfficeThis is where Ginny works

Images on physicians’ websites aren’t always the best gauge of a physician’s aesthetic sense. They, ahem, aren’t always the work of that physician either. Once you’re in an office, it is perfectly acceptable to ask to see photographs of a doctor’s work. Most doctors take before and after pictures of every patient they see, so they should have plenty to show you. You can tell pretty quickly if you’re being handed three images provided by the companies that make devices or a handful of images from real patients. When you look at the physician’s work, do you think to yourself, “Nice work!” and “She looks great!” or do you find that tiny voice in your head thinking that “things don’t look quite balanced?” An even better sign is if you know someone else who has worked with a particular physician and they’re happy and look great.

No one wants a dysfunctional relationship, and your relationship with your aesthetic medicine practitioner is no exception. Dr. Lorenc encourages his patients to have multiple consultations. It’s all about finding someone you can work well with. “If a physician is against multiple consultations and says negative things about his colleagues like, ‘No, you shouldn’t see Dr. Schmucko,’ it’s a bad sign.” Usually, discouraging patients from seeing other practitioners is an indicator that there is an interest at play that has nothing to do with what’s best for you.

"I heart Schmucks" coffee mugGift Suggestions for Doctor Schmucko

When you’re looking for an aesthetic physician, a good rule of thumb is to find two that you are interested in working with. You may find that you need a tiebreaker or need to go see a third. Ultimately, it is important that your aesthetic sensibilities meet your doctor’s, and that if you have a workspace like Ginny’s, you may not want to have someone like Shannon decorate it.

circus performersThis is where Shannon works

Respect the Physician’s Advice

Even as you’re seeking a collaborative relationship, it is important to remember that your physician is the expert in the room. It is completely within the realm of possibilities that you read up on procedures that address your aesthetic concerns using an objective resource like medical society pages or ahem, this site, and show up convinced that you need a particular treatment, and then it turns out that there’s another better course of action.

Don’t be afraid to follow the lead of the physician: they have seen thousands of faces and bodies and know the capabilities and limits of all the treatments they offer. As long as you feel you’re on the same page in terms of aesthetic sense, it’s perfectly fine to adjust the course of action.  

“I love patients who do their homework and come in informed,” says Dr. Lorenc, but you have to remember that “Dr. Google is good and bad because there is no restriction on the level of nonsense. Information on society pages like [American Society for Dermatologic Surgery] is well contained and vetted and it was written by good practicing physicians with committee oversight. If you go on physician websites or beauty magazines, everything is biased.”

This is the whole reason that Vibrant Authority exists, so I think we’re good here. For a list of places to find information (albeit far less captivating and witty), check out this article on resources.

And there you have it, dear readers, straight from the doctor! Going to a doctor’s office for a first-time aesthetic consultation can be nerve-wracking, but if you consider your motivations, find a doctor that is compatible with your aesthetic sensibilities, and maintain an open mind about available options, you are likely to have a stress-free experience and see results you can be truly happy with.

Thanks to Dr. Paul Lorenc for taking the time to talk doctor to me!


All content and media on Vibrant Authority is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice.

Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional, or delay in seeking it because of something you have read on this Website.

If you think you may have a medical emergency, call your doctor, go to the nearest hospital emergency department, or call the emergency services immediately. If you choose to rely on any information provided by Your Health, you do so solely at your own risk.

External (outbound) links to other websites or educational material (e.g. pdf’s etc…) that are not explicitly created by Your Health are followed at your own risk. Under no circumstances is Your Health responsible for the claims of third party websites or educational providers.