Aesthetic medicine has blossomed as a surgical discipline over the past 20 years and positioned itself toward the forefront of medical specialties. With this blossoming has come acceptance of the virtues and benefits of aesthetic medicine among patients.

Long gone seem the days of the pizza and flounder recovery diet (anything that can be slid under the front door), where patients would sequester themselves away during the healing phase and make all efforts to keep their cosmetic surgery secret. Nowadays it is not uncommon for patients to broadcast the play by play of their surgical recovery and outcomes via social media outlets. Journals and periodicals, television programmes and movies now exist dedicated solely to aesthetic medicine. Nose splints and dark sunglasses are commonplace in shopping malls and boutiques across the country, often even worn as a badge of honour.

With this acceptance and continued rise in popularity of aesthetic medicine, a new class of patients has also arisen, a group that I refer to as the ‘aesthetically oriented functional patient’. This class of patient now easily accounts for 50% or more of my oculoplastic surgery practice. These patients present with functional problems, but they approach the surgical solution through an aesthetically tinted looking glass.

The classic example is that of the patient presenting with visually significant upper eyelid dermatochalasis. These patients recognise the functional disability of their often insurance-covered medical problem; however, they demand an aesthetically pleasing outcome in addition to functional improvement. Removal of redundant visually obstructive tissue, thus rectifying the functional problem, with failure to recognise and adhere to aesthetic surgical principles, will result in an unhappy patient. Strict attention to aesthetic tissue handling, precise skin closure, and addressing subtleties such as fat prolapse are requirements for a ‘successful’ result, and ultimately a happy patient.

As aesthetic medicine continues to grow and pervade the mainstream, patients will continue to demand more aesthetic skill from their surgeon regardless of their presenting problem, functional or aesthetic. The ‘aesthetically oriented functional patient’ will find their way into waiting rooms across the country, demanding aesthetically pleasing functional outcomes. Surgeons will be required to continuously improve and hone their aesthetic skillset, patients will be all the better off for these improved outcomes, and ultimately we will all, patient and surgeon, benefit.