The Complication Consult: A Plastic Surgery Perspective on Etiquette, Ownership, and Collegiality After Surgical Complications.

Plastic surgeons are frequently asked to assist when postoperative complications cross service lines and create wound breakdown, soft-tissue necrosis, exposed hardware, infection, dead space, or reconstructive uncertainty. These consultations are often necessary, but their conduct can either preserve trust and collaboration or create a perceived transfer of blame and ownership. This editorial proposes a five-part etiquette framework for complication consultation: candor in naming the problem; courtesy through early, direct, attending-level communication; continuity through ongoing involvement of the index surgeon; completeness of clinical information and planning; and co-ownership of the patient's care. The framework also emphasizes explicit consult questions, objective documentation, transparent patient communication, preservation of reconstructive options, and clear discharge responsibilities. Although presented from a plastic surgery perspective, these principles apply across surgical specialties. A complication consult should be understood as an escalation of care, not abandonment or transfer of inconvenience.