Dr. Cardenas has hundreds of happy FFS patients dating as far back as the mid 1990's. Like any surgeon who operates as often as he does, there are a small number of unsatisfied clients who are very vocal about it. A surgeon with no negative mentions online is one that simply hasn't performed the procedure in question long enough for it to happen.
In any case, there are many reasons why a patient might become disgruntled and I think it's important to mention some of them here in this forum:
1. The patient has unrealistic expectations about the procedure(s): All surgeons have had patients that fall into this category. It's not difficult for the surgeon to avoid the most obvious cases, but sometimes patients have a hidden objective in mind. For example, a patient might say that her goal is to make her masculine facial features appear more feminine. But, after the surgery, she might express dissatisfaction about her perception that she is not "beautiful." We once received a call from a young Asian teen from Manila who wanted to know if we could guarantee that she would look like Angelina Jolie! The answer is no. Unfortunately, most patients are not quite this obvious in broadcasting their unrealistic expectations.
2. The patient suffers from Body Dysmorphic Disorder (BDD): People with BDD are preoccupied with an imagined physical defect or a minor defect that others often cannot see. We look carefully for signs of this, but aren't always successful in detecting it in advance. Someone who suffers from Body Dysmorphia cannot be made happy with surgery. She must first treat this problem before considering surgery. If you look carefully as some of the recent posts on this forum, you'll see signs of BDD. Although we try to identify and refer patients with BDD for mental health treatment, they are sometimes able to mask the problem until after the surgery.
3. The patient is uncertain about what she wants: Transitioning is no cake walk and decisions don't happen overnight. We realize this. But, sometimes patients move the goal posts after the surgery is done and unfairly blame the surgeon. We once had a patient that told us that he didn't want complete feminization because he wasn't transitioning. He merely wanted to soften some of his features and to repair a poor surgical outcome from another surgeon. He cautioned Dr. Cardenas not to make the features too feminine since he must be able to pass as male. We understood that the patient wanted to live as a male most of the time. The patient contacted us about a year later and stated that she had now decided to transition and wanted the procedures done again, but this time with feminization in mind. She felt that we should have treated them as "touch ups" and not as new procedures. We declined to do this since the goal had been completely changed. We did what was requested but it was no longer good enough since the patient now wanted full feminization. In hindsight, we wish we had detected the uncertainty in her objectives. What a difference a year delay would have made.
4. The patient has complications: Complications sometimes happen despite the best of care and patients are always informed in advance about them. When they happen, the patient will usually accept them and accept our help in resolving them. However, we've also had patients who blamed us for a complication that was not within our control. Some patients develop infections or other complications because they refuse to follow the post-op instructions, don't take their antibiotics, or fail to keep the incisions clean, etc. Yet, some of these patients will blame the surgeon.
5. The impatient patient: This is an extremely common issue that we can usually resolve by reassuring a patient that her healing is still underway and that the final result won't be visible for a while. Still, we've had some patients that have gone online to express their frustration about results that are masked by inflammation.
6. The surgeon makes a mistake: Surgeons are human and can, in fact, occasionally make a mistake. Fortunately, most mistakes can be fixed if the patient agrees to it.
In summary, there are many reasons why a patient might perceive her outcome to be poor. Unhappy patients are by far the most vocal. That being said, there are also some posts where the author is completely unknown to us. In these unidentifiable cases, we are left to wonder if a competitor may be responsible for them - especially in cases where the proposed alternative is always the same.
Regardless, these negative posts represent a very small number compared to our hundreds of satisfied patients. Many of these patients have written testimonials which we have posted online and most of them have provided an e-mail address so that they may be contacted.
