CAUSES FOR CANCELLATION OF AESTHETIC AND RECONSTRUCTIVE PROCEDURES

Cancellation of plastic surgical procedures has several deleterious ef fects, including emotional distress and economic ramifications. This p rospective study, conducted over a 12-month period in a solo practice, reviewed the factors that contributed to surgical cancellations. Canc ellations occurred despite many strict measures such as at least two p reoperative visits, in-depth counseling and reinforcement by surgeon a nd staff, laboratory testing done 2 weeks prior to surgery, detailed e valuation of medical background, extensive written and verbal instruct ions to avoid medications that adversely affect surgery, and thorough discussion of payment plans and insurance coverage, including predeter mination of any third-party coverage. Of the 952 patients (667 males, 285 females) scheduled for surgery, 113 experienced cancellation of th e operation, either by the surgeon and staff or by the patient. Cancel lations were proportionally fewer in male patients (p < 0.025). The to tal number of scheduled procedures was 1590 (some patients scheduled f or more than one procedure); 727 of these were cosmetic (46 percent), and 863 were reconstructive (54 percent). Of the 205 procedures cancel ed, cosmetic procedures were more likely to be canceled (p < 0.00 1), since 123 (16.9 percent) cosmetic procedures were canceled in contrast to 82 (9.5 percent) canceled reconstructive procedures. Because of mu ltiple cancellations, there were a total of 119 cancellations for 113 patients. Thirty of the 113 patients were rescheduled at a later date. Of these 30, 24 did undergo surgery, while 6 canceled for a second ti me. Thirty-two of the 113 canceled patients (28.3 percent) were patien ts in their fifth decade of life. There were 199 patients in their for ties, which comprised 20.9 percent of the total patient population, an d these patients were most apt to cancel surgery (p < 0.05). The pedia tric group had less incidence of cancellation (p < 0.05). There were m ore cancellations during the fall and winter than in spring and summer (p < 0.001), and it was interesting to note that 50.4 percent of canc ellations occurred in the period from November to February (p < 0.05). Other medical problems led to the greatest number of cancellations in both sexes. The second most common cause for cancellation in men was financial concerns, and for women, personal reasons were cited. When t he complexity of the procedure was taken into consideration, the lowes t incidence of cancellation was found in minor (< 1 hour) procedures w hen compared with intermediate (1 to 2 hours) or major (greater-than-o r-equal-to 2 hours) procedures (p < 0.01).