One of the unavoidable truths in medicine is that sometimes bad things happen to good doctors. No matter the education, skill, or caution of the physician, complications must be expected. This is particularly true in the realm of aesthetics, in which the results of each procedure we perform can be decided by a litany of causal factors—some anticipated and some not well understood. Often the difference between a good doctor and a great doctor is not the number of complications but the response to complications.

In the United States, any ‘occurrence' invariably involves talk of malpractice. We all want to avoid the financial and emotional effects of litigation. But in this day and age of social media and Yelp!, one comment on a bad outcome—even if it wasn't caused by the physician—can have a domino effect on an otherwise good reputation. Conversely, creating a positive relationship with a patient post-treatment improves not just her or his loyalty to the practice but will ripple out to referrals of new patients. Think about the last time you had a bad experience at a restaurant or store that the manager or owner made right: that story gets repeated again and again.

So how should a responsible, caring aesthetic physician manage bad things? First, we need to hear about them as early as possible: educating staff to triage and sort routine side effects from significant adverse events is crucial. The goal is to get that patient back in your office, not someone else's office. The patient should not be made to feel like a burden. Everyone from receptionist to doctor needs to be on the same page and make it easy for that patient to be seen expeditiously. Attitude is key: caring that the patient is going through something untoward and confidence that you can help are both essential.

This edition of Modern Aesthetics® dives into a wide spectrum of complications in aesthetic medicine. In addition to offering tips on preventing and managing poor outcomes, our authors also address other “complications,” such as patient and employee safety and how to handle difficult patients.

Physicians, like firefighters, are taught to run toward a fire and extinguish it with imperturbability. Our patients and staff are counting on us more than we realize to make difficult decisions under stress. It is how you act in the face of adversity rather than in the space of prosperity that will likely define your greatness as a physician.

Co-Chief Editors

Heidi Waldorf, MD, FAAD, and Steven Dayan, MD, FACS