We see patients by video consultation and we find it useful, above all for anyone living outside Lima. But it is worth being clear about where its usefulness ends, because it is easy to sell a video call as if it were a full assessment, and it is not.
What it is good for
- Orientation. Knowing whether what concerns you is solved by surgery, by something else or by nothing. It is the question most people arrive with and it is often answered without touching.
- Deciding whether the journey is worth it. For someone outside Lima it is the difference between organising a trip that makes sense and discovering in person that the procedure was not the one they had in mind.
- A second opinion on an indication you have already been given, with your reports to hand.
- Post-operative follow-up. This works very well: checking a wound that is healing normally, answering week-three questions, seeing whether a firm area is to be expected.
- Preparing the in-person consultation, so that the day you come real progress is made.
What it is not good for
Physical examination is half the diagnosis in plastic surgery, and it cannot be done through a screen. A camera cannot assess skin quality, its elasticity and capacity to retract, the tone of the abdominal wall, whether there is a diastasis and how wide, the consistency of a gland, the mobility of a scar or the stiffness of a cartilage.
All of that is felt. And the indication depends on all of it.
Nobody can indicate surgery or close a price without having examined you. If they do, what you are getting is a quotation, not a medical opinion.
What comes out of a video consultation is a range, an orientation and a plan of what to check in person. The definitive quotation comes after the in-person assessment, because before that there is not enough to go on.
How to get the most from it
- Natural light, in front of you. A window ahead of you, not behind. Backlighting erases exactly what needs to be seen.
- Photographs sent in advance. Front, right profile, left profile and three-quarters, without make-up, without filters and in the same light. For the body, in close-fitting clothes or underwear, standing and relaxed.
- Your reports and test results to hand, as PDFs or photographed clearly.
- The list of your medication, including supplements and anything "natural".
- Your questions written down, because on a video call they are more easily forgotten.
- Somewhere private. If you are going to show part of your body, not in the street and not at the office.
A warning about the photographs
No filters, no portrait mode, no front camera up close: the wide angle visibly distorts the nose and chin and wastes everybody's time. Better to have someone else take them, from a metre and a half away, with the rear camera.
And the honest limit
If what concerns you needs a surgical decision, you are going to have to come. The video consultation does not replace that: it makes it shorter, cheaper in travel and more useful.
What is decided on screen is whether that journey makes sense. Which is not nothing.